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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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28 of 536
filings in view
236K
standard requests
14.3%
volume-weighted denial rate
4
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
13
14
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
Medicaid Managed Care 208K 19 filings
Medicare-Medicaid Plan 28K 1 filings
CHIP Managed Care 0 6 filings
Marketplace QHP 0 1 filings
Medicare Advantage 0 1 filings

Filings

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Denial rate Volume Organization Findings
Organization
Plan
Market
St
Std reqs
Denial rate
Findings
Molina Healthcare Molina Healthcare of South Carolina Medicaid Medicaid Managed Care SC — 27.0% — Molina Healthcare Molina Healthcare of Texas CHIP Medicaid CHIP Managed Care TX — 17.0% — Molina Healthcare Molina Healthcare of Texas STAR Medicaid Managed Care TX — 17.0% — Molina Healthcare Molina Healthcare of New York Medicaid Medicaid Managed Care NY — 16.0% — Molina Healthcare Molina Healthcare of Washington (Apple Health) Medicaid Managed Care WA 140K 16.0% — Molina Healthcare Molina Healthcare of Florida Medicaid Managed Care FL — 15.0% — Molina Healthcare Molina Healthcare of New Mexico (Turquoise Care) Medicaid Managed Care NM — 15.0% — Molina Healthcare Molina Healthcare of Texas CHIP RSA Medicaid CHIP Managed Care TX — 15.0% — Molina Healthcare Molina Healthcare of Illinois (Medicaid) Medicaid Managed Care IL — 14.0% — Molina Healthcare Molina Healthcare of Nebraska - Medicaid Medicaid Managed Care NE — 13.0% — Molina Healthcare Molina Marketplace South Carolina Marketplace QHP SC — 13.0% — Molina Healthcare Senior Whole Health of New York - MLTSS Medicaid Managed Care NY — 13.0% 1 Molina Healthcare Molina Healthcare of Ohio (Medicaid) Medicaid Managed Care OH 68K 12.8% — Molina Healthcare Molina Clinical Services, LLC (Mississippi) Medicaid Managed Care MS — 11.9% — Molina Healthcare Molina Healthcare of Wisconsin - BadgerCare Plus Medicaid Managed Care WI — 10.0% — Molina Healthcare Molina MyCare Ohio Medicare-Medicaid Plan OH 28K 9.2% — Molina Healthcare Molina Complete Care of Arizona (AHCCCS Medicaid) Medicaid Managed Care AZ — 9.0% — Molina Healthcare Molina Healthcare of Nebraska - CHIP CHIP Managed Care NE — 8.0% — Molina Healthcare Senior Whole Health of New York - Medicare Medicare Advantage NY — 8.0% — Molina Healthcare Molina Healthcare of Wisconsin - Medicaid SSI Medicaid Managed Care WI — 7.0% — Molina Healthcare Molina Healthcare of Mississippi, Inc. Medicaid Managed Care MS — 6.7% — Molina Healthcare Molina Healthcare of Texas STAR+PLUS Medicaid Managed Care TX — 6.0% — Molina Healthcare Molina Healthcare of New York Child Health Plus CHIP Managed Care NY — 5.0% — Molina Healthcare Molina Healthcare of Texas CHIP Perinate RSA (at or below 185% FPL) CHIP Managed Care TX — 5.0% 1 Molina Healthcare Molina Healthcare of Idaho (Medicaid Plus) Medicaid Managed Care ID — 4.0% — Molina Healthcare Molina Healthcare of Texas CHIP Perinate MHT (at or below 185% FPL) CHIP Managed Care TX — 4.0% 1 Molina Healthcare Molina Healthcare of California (Medi-Cal) Medicaid Managed Care CA — 2.0% — Molina Healthcare Senior Whole Health of New York - FIDE Medicaid Managed Care NY — 0.0% 1