The table above ranks every HealthCare.gov marketplace insurer by its in-network claim denial rate for claims year 2024, so the highest and lowest are right at the top and bottom of the list.
What is a good claim denial rate?
Lower is better: a low rate means fewer of your claims get rejected. The marketplace-wide average is roughly one in five in-network claims, so compare each insurer against that.
Why do denial rates differ between insurers?
Insurers differ in plan design, prior-authorization strictness, and how they handle billing codes. A high rate does not always mean bad faith, but it does mean more paperwork fights for patients.
Is this data self-reported?
Yes. Insurers file the counts themselves with CMS under the Transparency in Coverage rule; the site computes the rates from their raw reported numbers.