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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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5 of 536
filings in view
368K
standard requests
12.4%
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
3
1
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 253K 3 filings
Medicaid Managed Care 79K 1 filings
Marketplace QHP 37K 1 filings

Filings

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Denial rate Volume Organization Findings
Organization
Plan
Market
St
Std reqs
Denial rate
Findings
Priority Health Priority Health Choice (Medicaid) Medicaid Managed Care MI 79K 25.2% — Priority Health Priority Health Qualified Health Plan Marketplace QHP MI 37K 17.6% — Priority Health Priority Health Medicare Advantage MI 13K 9.6% — Priority Health Priority Health Medicare PPO Medicare Advantage MI 96K 8.2% — Priority Health Priority Health Medicare HMO/HMO-POS Medicare Advantage MI 144K 7.0% —