Filing · f0107
Aetna MyCare Ohio
CVS Health / Aetna · Medicare-Medicaid Plan · OH · CY2025
In 2025 this plan received 60,748 standard prior authorization requests and denied 3.6% of them. The median for Medicare-Medicaid Plan plans of comparable size is 7.0%.
Standard denial rate
3.6%
60,748 standard requests, 2,171 denied.
28.9% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 60,748 | 58,577 | 2,171 | 3.6% |
| Expedited | 1,085 | 1,018 | 67 | 6.2% |
| Extended review, approved | 0 | |||
Appeals of standard denials
| Appeals filed | 353 |
| Denials overturned | 102 |
| Overturn rate | 28.9% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.0 d | 3.0 d |
| Expedited | 24.0 h | 24.0 h |