Check how often your insurer denies claims
Every marketplace insurer reports its claims, denials and appeal outcomes to CMS. We visualized all of it.
CMS public dataNothing leaves your browserClaims years 2021-2024279 pages, free
18.6%
of in-network claims denied marketplace-wide (2024)
123
insurers with usable data
0.2%
of denied claims are ever appealed
~35%
of appeals succeed
What the data says
- Marketplace insurers denied about 1 in 5 in-network claims in 2024.
- Only ~0.2% of denied claims are appealed, yet roughly a third of appeals win. Just denied? Write your appeal letter.
- Insurers and providers fought 1.6 million surprise-bill arbitration disputes since 2022. Providers win 87%.
- Open enrollment for 2027 coverage starts November 1. Check the deadlines for your state.
- Denial rates range from under 2% to over 40% between insurers.
- Don't see your insurer? CMS's claims file covers HealthCare.gov states only. Every insurer, in every state, reports how much premium it actually spends on care.
Frequently asked
How often do health insurance companies deny claims?
Across HealthCare.gov marketplace plans, insurers deny roughly 1 in 5 in-network claims on average — the exact rate per insurer is on this page, computed from CMS Transparency in Coverage filings, 2021 through 2024.
Which insurer has the lowest claim denial rate?
The homepage table ranks every marketplace insurer by its in-network denial rate with claim volumes included, so you can compare big and small insurers fairly.
Why do claims get denied?
The most common reasons are prior authorization missing, services deemed not medically necessary, out-of-network care, and clerical errors — the Reasons page has the full CMS breakdown.