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Prior authorization denial rates, plan by plan

Every plan that published a CY2025 filing. Search for an insurer or a plan by name, narrow by state or market, and the charts and the weighted rate below recompute as you go.

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6 of 536
filings in view
16K
standard requests
6.4%
volume-weighted denial rate
2
with validation findings

The weighted rate is computed over filings in view that published both a request total and a denial count; the request figure beside it counts every filing in view.

Distribution of denial rates
filings per 10-point band
5
1
0–10%
10–20%
20–30%
30–40%
40–50%
50–65%
Denial rate vs. request volume
log volume, 1K → 500K · orange marks carry findings
1K10K100K500K
Request volume by market, current filter
Medicare Advantage 16K 6 filings

Filings

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Denial rate Volume Organization Findings
Organization
Plan
Market
St
Std reqs
Denial rate
Findings
Martin's Point Health Care Generations Advantage LPPO - Medical (non-oncology) Medicare Advantage ME 568 12.0% — Martin's Point Health Care Generations Advantage HMO - Medical (non-oncology) Medicare Advantage ME 8K 7.5% — Martin's Point Health Care Generations Advantage HMO - Optum oncology/radiology Medicare Advantage ME 7K 4.9% — Martin's Point Health Care Generations Advantage LPPO - Optum oncology/radiology Medicare Advantage ME 387 2.8% — Martin's Point Health Care Generations Advantage HMO - Behavioral Health Medicare Advantage ME 131 0.0% 2 Martin's Point Health Care Generations Advantage LPPO - Behavioral Health Medicare Advantage ME 17 0.0% 1