Health insurance claim denial rates range from 13% to 35% by insurer
Key takeaways
- Part of Teaching an AI Agent to Make Beautiful Charts
- Health insurers turn down a lot of claims, and they do not all turn them down at the same rate.
- Claim denials are back in the national conversation.
Part of Teaching an AI Agent to Make Beautiful Charts
Health insurers turn down a lot of claims, and they do not all turn them down at the same rate. In 2024, the largest plans sold on the Affordable Care Act marketplace denied anywhere from 13% to 35% of the in-network claims their members filed. Whether your claim got paid depended a lot on whose name was on your card.
Claim denials are back in the national conversation. Luigi Mangione, charged in the December 2024 killing of United Healthcare CEO Brian Thompson, was back in court this week for a pretrial hearing, and legal analysts expect his trials to double as a referendum on a health care system many people find costly and hard to navigate. He has pleaded not guilty. The outrage is easy to find. The data on how insurers actually behave is harder to come by, so here is what the federal numbers show.