Health insurer denial rates, ranked
For the first time, federal rules force insurers to publish how often they deny prior authorization requests. Here’s what their own CY2025 disclosures show, side by side. Every number links to the insurer’s published source.
SOURCE: EACH INSURER’S PUBLIC CMS-0057-F DISCLOSURE · METHODOLOGY · SCOPE VARIES BY INSURER — READ THE NOTES
CY2025 prior authorization denial rates
| # | Insurer | Denial rate | Appeals overturned | Source |
|---|---|---|---|---|
| 1 | Cigna Healthcare Marketplace (Individual & Family) plans only — Cigna divested its Medicare Advantage business to HCSC in early 2025. … | 27% | 16% | VIEW ↗ |
| 2 | UnitedHealthcare Rollup computed from UnitedHealthcare's posted per-contract CMS-0057-F disclosures: 63 Medicare Advantage contracts (… | 12.4% | n/r | VIEW ↗ |
| 3 | Health Care Service Corporation HCSC's posted Medicare Advantage rollup across its Blue plans in IL, MT, NM, OK, and TX (11 contracts) — standard req… | 12% | 80% | VIEW ↗ |
| 4 | Kaiser Permanente Rollup computed from Kaiser Permanente's posted regional CMS-0057-F reports (10 Medicare Advantage contracts across 8… | 9.1% | 44.3% | VIEW ↗ |
| 5 | Devoted Health Computed from Devoted's posted per-contract tables (33 Medicare Advantage contracts), including supplemental dental d… | 8.3% | n/r | VIEW ↗ |
| 6 | Humana Rollup computed from Humana's 41 posted per-contract CMS-0057-F reports (32 Medicare Advantage contracts + 9 state Me… | 6.8% | 53.2% | VIEW ↗ |
| 7 | Blue Cross Blue Shield of Michigan Medicare Advantage rollup computed from BCBSM's posted counts for Medicare Plus Blue PPO and BCN Advantage (standard … | 4.3% | 88.9% | VIEW ↗ |
| 8 | Alignment Health Rollup computed from Alignment's posted per-contract tables (7 Medicare Advantage contracts). About 3.8% of denials w… | 2.4% | 58.6% | VIEW ↗ |
| 9 | SCAN Health Plan From SCAN's posted 2025 CMS report (Medicare Advantage rollup). Denial rate computed from SCAN's posted tables (1.85%… | 1.9% | 45% | VIEW ↗ |
Headline numbers on insurer websites can use narrower baselines than their full federal disclosures. UnitedHealthcare’s site says “91.7% approved”; summing every request in its own posted CMS-0057-F files puts approvals at 87.6%. The difference: the headline excludes post-acute-care and delegated-entity requests. Both figures come from UnitedHealthcare’s own publications — we show the comprehensive one.
Not yet ranked: Aetna, Elevance Health, Centene, Highmark, Florida Blue, Molina Healthcare — these insurers publish contract-by-contract percentages without volumes, so no honest company-wide rate exists yet. Their per-plan data is being ingested.