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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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12 of 536
filings in view
0
standard requests
0.0%
volume-weighted denial rate
0
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
10
2
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
Marketplace QHP 0 12 filings

Filings

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Denial rate Volume Organization Findings
Organization
Plan
Market
St
Std reqs
Denial rate
Findings
Oscar Health Oscar Health - Texas Marketplace QHP TX — 22.7% — Oscar Health Oscar Health - Michigan Marketplace QHP MI — 20.5% — Oscar Health Oscar Health - Arizona Marketplace QHP AZ — 18.9% — Oscar Health Oscar Health - Oklahoma Marketplace QHP OK — 18.5% — Oscar Health Oscar Health - Ohio (issuer 45845) Marketplace QHP OH — 18.4% — Oscar Health Oscar Health - Iowa Marketplace QHP IA — 17.6% — Oscar Health Oscar Health - North Carolina Marketplace QHP NC — 17.1% — Oscar Health Oscar Health - Nebraska Marketplace QHP NE — 16.8% — Oscar Health Oscar Health - Ohio (issuer 29341) Marketplace QHP OH — 16.6% — Oscar Health Oscar Health - Missouri Marketplace QHP MO — 16.1% — Oscar Health Oscar Health - Kansas Marketplace QHP KS — 14.0% — Oscar Health Oscar Health - Tennessee Marketplace QHP TN — 11.9% —