Health insurance companies rejected almost 1 in 5 in-network claims for plans purchased on the federal exchange in 2024, with a denial rate of 19%.
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A new report from the Kaiser Family Foundation analyzed 2024 data and found denial rates have remained relatively steady over time.
Carriers Oscar Health, Molina Healthcare, Florida Blue, Community Health Choice, Cigna and BlueCross BlueShield of Tennessee turned down the most claims.
Denial rates varied between states, with Hawaii having the highest rate at 27% and South Dakota and New Hampshire the lowest at 7%.
The most common reasons for denials were cited as “other,” administrative reasons, excluded services, lack of prior authorization, and medical necessity or benefit limits.
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