Claim denial rates in TX
Marketplace insurers reporting in TX.
This page compares every marketplace insurer offering plans in TX by how often they deny claims. For you: a low denial rate means fewer fights to get care covered; check the appeal-overturn rate too, since it shows how often denials were wrong.
Frequently asked
What is the average claim denial rate in Texas?
In 2024, marketplace insurers in Texas denied 18.5% of in-network claims on average, computed from CMS Transparency in Coverage filings.
Which insurer denies the most claims in Texas?
The ranked table on this page compares every marketplace insurer reporting in Texas by its in-network denial rate, with claim volumes so you can weigh big insurers against small ones.
Can I appeal a denied claim in Texas?
Yes — every marketplace plan must offer an internal appeal, and you can then request external review by an independent reviewer. The Appeals page explains the process step by step.