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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.

Search Market State Min volume · no minimum Reset

110 of 536

filings in view

10.4M

standard requests

12.8%

volume-weighted denial rate

7

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

48

40

20

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 8.0M 64 filings

Medicaid Managed Care 2.4M 36 filings

Medicare-Medicaid Plan 51K 6 filings

CHIP Managed Care 4K 4 filings

Filings

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Denial rate Volume Organization Findings

Organization

Plan

Market

St

Std reqs

Denial rate

Findings

UnitedHealth Group Texas MMP Medicare-Medicaid Plan TX 240 40.4% 1 UnitedHealth Group Massachusetts Senior Care Options Medicare-Medicaid Plan MA 84 33.3% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract R7444 Medicare Advantage — 18 27.8% — UnitedHealth Group New York Child Health Plus CHIP Managed Care NY 2K 26.5% 1 UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H1537 Medicare Advantage — 18K 25.2% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H2001 Medicare Advantage — 1.9M 23.5% — UnitedHealth Group Massachusetts One Care Medicare-Medicaid Plan MA 20K 22.4% — UnitedHealth Group New York Medicaid Advantage Medicaid Managed Care NY 76K 22.4% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H0710 Medicare Advantage — 3K 22.3% — UnitedHealth Group Arizona AHCCCS Complete Care Medicaid Managed Care AZ 95K 22.2% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract R5342 Medicare Advantage — 8K 22.1% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H5435 Medicare Advantage — 82 22.0% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H3307 Medicare Advantage — 647 21.6% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H3379 Medicare Advantage — 67K 21.4% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract R0759 Medicare Advantage — 14K 21.2% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H3418 Medicare Advantage — 35K 21.1% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H0755 Medicare Advantage — 38K 20.9% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H8211 Medicare Advantage — 13K 20.9% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H1659 Medicare Advantage — 810 20.7% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract R2604 Medicare Advantage — 11K 20.6% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H2802 Medicare Advantage — 204K 20.6% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H8768 Medicare Advantage — 311K 20.6% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H0294 Medicare Advantage — 91K 19.8% — UnitedHealth Group Pennsylvania Medicaid Medicaid Managed Care PA 28K 19.8% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H5253 Medicare Advantage — 643K 18.9% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract R3444 Medicare Advantage — 3K 18.6% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H1045 Medicare Advantage — 182K 17.9% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H2406 Medicare Advantage — 416K 17.3% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H1889 Medicare Advantage — 178K 17.1% — UnitedHealth Group New York Essential Plan Program Medicaid Managed Care NY 19K 16.7% — UnitedHealth Group Texas STAR Medicaid Managed Care TX 139K 16.0% — UnitedHealth Group Maryland HealthChoice Medicaid Managed Care MD 44K 16.0% 1 UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H6595 Medicare Advantage — 11K 16.0% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H0432 Medicare Advantage — 40K 15.7% — UnitedHealth Group UnitedHealthcare Community Plan - New Jersey FamilyCare Medicaid Managed Care NJ 279K 15.5% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H0251 Medicare Advantage — 32K 15.4% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H5008 Medicare Advantage — 28K 15.2% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H4604 Medicare Advantage — 88K 14.6% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H3805 Medicare Advantage — 107K 14.5% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H0421 Medicare Advantage — 4K 14.4% — UnitedHealth Group Missouri HealthNet Medicaid Managed Care MO 69K 14.2% — UnitedHealth Group Florida Managed Medical Assistance Medicaid Managed Care FL 71K 13.9% — UnitedHealth Group Healthy Louisiana Medicaid Managed Care LA 136K 13.7% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H0169 Medicare Advantage — 40K 13.5% — UnitedHealth Group UnitedHealthcare Medicare Advantage H0169 Medicare Advantage — 40K 13.5% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H1285 Medicare Advantage — 21K 13.4% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H2445 Medicare Advantage — 19K 13.2% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H2509 Medicare Advantage — 19K 12.9% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H3256 Medicare Advantage — 18K 12.6% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H3794 Medicare Advantage — 15K 11.9% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H7464 Medicare Advantage — 12K 11.9% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H0764 Medicare Advantage — 499 11.6% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H3387 Medicare Advantage — 41K 11.5% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H2292 Medicare Advantage — 280 11.4% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H2247 Medicare Advantage — 19K 11.3% — UnitedHealth Group Virginia Cardinal Care LTSS Medicaid Managed Care VA 49K 11.1% — UnitedHealth Group Virginia Cardinal Care Medicaid Medicaid Managed Care VA 57K 10.9% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H5420 Medicare Advantage — 13K 10.8% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H0624 Medicare Advantage — 10K 10.7% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H6706 Medicare Advantage — 133 10.5% — UnitedHealth Group Washington Apple Health Medicaid Managed Care WA 37K 10.4% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H0321 Medicare Advantage — 39K 10.2% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H3113 Medicare Advantage — 36K 9.9% — UnitedHealth Group Arizona Developmental Disabilities Program Medicaid Managed Care AZ 10K 9.7% — UnitedHealth Group Florida Long Term Care Medicaid Managed Care FL 43K 9.5% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H2385 Medicare Advantage — 601 9.2% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H5322 Medicare Advantage — 136K 9.0% — UnitedHealth Group Michigan Comprehensive Health Care Program Medicaid Managed Care MI 73K 9.0% — UnitedHealth Group Texas CHIP CHIP Managed Care TX 577 9.0% — UnitedHealth Group New York Wellness 4Me (HARP) Medicaid Managed Care NY 4K 9.0% 1 UnitedHealth Group District of Columbia Dual Choice Program Medicare-Medicaid Plan DC 23 8.7% — UnitedHealth Group Washington Apple Health Expansion Medicaid Managed Care WA 21K 8.6% — UnitedHealth Group Nebraska Heritage Health Medicaid Managed Care NE 42K 8.3% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H2582 Medicare Advantage — 86 8.1% — UnitedHealth Group New Mexico Turquoise Care Medicaid Managed Care NM 6K 8.1% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H2272 Medicare Advantage — 3K 8.1% — UnitedHealth Group Kentucky Medicaid Medicaid Managed Care KY 90K 8.0% — UnitedHealth Group Wisconsin Medicaid Medicaid Managed Care WI 81K 7.8% — UnitedHealth Group Rhode Island Medicaid Medicaid Managed Care RI 30K 7.6% — UnitedHealth Group Indiana Hoosier Care Connect Medicaid Managed Care IN 6K 7.4% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H0609 Medicare Advantage — 705K 7.3% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H1360 Medicare Advantage — 2K 7.3% — UnitedHealth Group District of Columbia Dual Choice - Medicaid LTSS Medicare-Medicaid Plan DC 12K 6.6% — UnitedHealth Group Tennessee TennCare Medicaid Managed Care TN 104K 6.5% — UnitedHealth Group Hawaii Quest Integration Medicaid Managed Care HI 20K 6.4% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H2531 Medicare Advantage — 7K 6.2% — UnitedHealth Group MississippiCAN Medicaid Managed Care MS 7K 5.7% — UnitedHealth Group Ohio Public Health Care Program Medicaid Managed Care OH 113K 5.7% — UnitedHealth Group UnitedHealthcare Community Plan of Ohio Medicaid Managed Care OH 113K 5.7% — UnitedHealth Group North Carolina Medicaid Managed Care Medicaid Managed Care NC 153K 5.7% — UnitedHealth Group Texas STAR Kids Medicaid Managed Care TX 18K 5.4% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H4514 Medicare Advantage — 227K 4.8% — UnitedHealth Group Kansas KanCare Medicaid Managed Care KS 94K 4.7% — UnitedHealth Group Arizona Long Term Care Medicaid Managed Care AZ 46K 4.6% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H1278 Medicare Advantage — 213K 4.5% — UnitedHealth Group UnitedHealthcare MyCare Ohio Medicare-Medicaid Plan OH 18K 4.4% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H2226 Medicare Advantage — 13K 4.3% — UnitedHealth Group Pennsylvania CHIP CHIP Managed Care PA 900 4.1% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract R6801 Medicare Advantage — 89K 4.0% — UnitedHealth Group Indiana PathWays for Aging Medicaid Managed Care IN 55K 4.0% — UnitedHealth Group MississippiCAN CHIP CHIP Managed Care MS 616 3.7% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H4527 Medicare Advantage — 258K 3.4% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H9239 Medicare Advantage — 6K 2.5% — UnitedHealth Group UnitedHealthcare Community Plan - Texas STAR+PLUS Medicaid Managed Care TX 130K 2.3% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H0543 Medicare Advantage — 1.6M 1.8% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H6824 Medicare Advantage — 153 1.3% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H5652 Medicare Advantage — 3K 1.2% 1 UnitedHealth Group Idaho Medicaid Plus Medicaid Managed Care ID 2K 0.7% — UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H7833 Medicare Advantage — 2K 0.7% 1 UnitedHealth Group UnitedHealthcare Medicare Advantage - Contract H4032 Medicare Advantage — 8 0.0% 1