Data updated on May 30, 2026 [at 13:36] from:

American man holding a denied medical insurance claim letter with US health insurance denial rate statistics and rising rejection graph — *Latest US health insurance claim denial rate data reveals which insurance companies reject the most medical claims.*

Table Of Contents

Health Insurance Claim Denial Rate Table 2026
Key Findings
Why Insurance Claims Get Denied
Data Source and Methodology
Final Thoughts
FAQs

Millions of Americans rely on health insurance companies to cover medical expenses, but claim approval rates can vary significantly between insurers.

In this report, we analyze the latest publicly available federal healthcare data to compare medical insurance claim denial rates among major U.S. insurance providers, including Kaiser Permanente, Aetna, UnitedHealthcare, Cigna, and Blue Cross Blue Shield plans.

The data presented below is based on publicly available CMS transparency datasets and is updated regularly to reflect the latest available reporting periods to help you make informed decisions.

Health Insurance Claim Denial Rate Table 2026

Press Ctrl or Comd + F to search for a particular Insurer in the Table

Rank	Insurance Company	Total Claims	Denied Claims	Denial Rate	Acceptance Rate
1	Imperial Health Plan of the Southwest, Inc.	528	224	42.42%	57.58%
2	Imperial Insurance Companies, Inc.	4,307	1,706	39.61%	60.39%
3	CareSource North Carolina Co.	207,708	76,854	37.00%	63.00%
4	Select Health of South Carolina	141,484	51,650	36.51%	63.49%
5	Oscar Buckeye State Insurance Corp.	1,910,531	694,493	36.35%	63.65%
6	UnitedHealthcare Community Plan, Inc.	1,110,639	395,425	35.60%	64.40%
7	Oscar Health Plan, Inc.	344,800	119,454	34.64%	65.36%
8	UnitedHealthcare of Oklahoma, Inc.	378,926	127,738	33.71%	66.29%
9	UnitedHealthcare of Ohio, Inc.	1,235,593	409,921	33.18%	66.82%
10	Community First Insurance Plans	119,190	38,695	32.46%	67.54%
11	Oscar Health Plan of North Carolina, Inc	107,392	33,542	31.23%	68.77%
12	AmeriHealth Caritas North Carolina, Inc.	456,084	139,608	30.61%	69.39%
13	AmeriHealth Caritas Florida, Inc.	92,022	28,025	30.45%	69.55%
14	CareSource West Virginia Co.	962,053	292,979	30.45%	69.55%
15	AmeriHealth Caritas VIP Next, Inc.	182,083	53,852	29.58%	70.42%
16	UnitedHealthcare of South Carolina, Inc.	605,443	177,319	29.29%	70.71%
17	Summa Insurance Company, Inc.	215,623	62,439	28.96%	71.04%
18	Harvard Pilgrim Health Care of NE	117,250	33,793	28.82%	71.18%
19	AvMed, Inc.	469,288	134,771	28.72%	71.28%
20	UnitedHealthcare of Arizona, Inc.	3,109,278	883,016	28.40%	71.60%
21	Moda Health Plan, Inc.	150,551	42,672	28.34%	71.66%
22	Premera Blue Cross Blue Shield of Alaska	819,150	231,364	28.24%	71.76%
23	CHRISTUS Health Plan Louisiana	238,872	66,846	27.98%	72.02%
24	UnitedHealthcare of North Carolina, Inc	1,863,541	515,982	27.69%	72.31%
25	Hawaii Medical Service Association	727,519	198,952	27.35%	72.65%
26	UnitedHealthcare of Mississippi, Inc.	365,368	98,116	26.85%	73.15%
27	BlueCross BlueShield of Tennessee	7,365,517	1,976,181	26.83%	73.17%
28	UnitedHealthcare of Wisconsin, Inc.	789,462	208,915	26.46%	73.54%
29	UnitedHealthcare of Florida, Inc.	4,576,465	1,193,794	26.09%	73.91%
30	Molina Healthcare of Florida, Inc	1,609,637	413,919	25.72%	74.28%
31	McLaren Health Plan Community	108,933	27,904	25.62%	74.38%
32	Health First Commercial Plans, Inc.	2,281,549	577,569	25.31%	74.69%
33	Meridian Health Plan of Michigan, Inc.	4,193,640	1,059,423	25.26%	74.74%
34	Community Health Choice, Inc.	7,456,561	1,858,344	24.92%	75.08%
35	Molina Healthcare of Texas, Inc.	1,045,155	259,999	24.88%	75.12%
36	Health Options, Inc.	43,035,924	10,591,169	24.61%	75.39%
37	Cigna HealthCare of Texas, Inc.	4,219,841	1,014,124	24.03%	75.97%
38	UnitedHealthcare of Texas, Inc.	20,047,828	4,802,293	23.95%	76.05%
39	Molina Healthcare of Utah	129,448	30,751	23.76%	76.24%
40	Molina Healthcare of Ohio, Inc.	2,198,393	521,748	23.73%	76.27%
41	Medica Health Plans	74,787	17,561	23.48%	76.52%
42	CareSource Ohio, Inc.	3,085,983	723,093	23.43%	76.57%
43	Medica Insurance Company	1,367,373	319,019	23.33%	76.67%
44	Molina Healthcare of Mississippi, Inc	757,369	174,066	22.98%	77.02%
45	Anthem Ins Companies Inc(Anthem BCBS)	3,553,957	807,186	22.71%	77.29%
46	Medica Central Insurance Company	64,203	14,532	22.63%	77.37%
47	Sendero Health Plans, Inc.	494,650	111,487	22.54%	77.46%
48	MOLINA HEALTHCARE OF SOUTH CAROLINA, INC	1,138,255	256,367	22.52%	77.48%
49	Cigna Health and Life Insurance Company	4,777,130	1,060,938	22.21%	77.79%
50	Blue Cross and Blue Shield of Kansas City	156,249	34,562	22.12%	77.88%
51	Oscar Insurance Corporation of Ohio	639,135	141,223	22.10%	77.90%
52	Cigna HealthCare of Arizona, Inc	149,478	32,008	21.41%	78.59%
53	CareSource Indiana, Inc.	3,746,232	800,053	21.36%	78.64%
54	Ambetter of North Carolina Inc.	5,146,068	1,082,702	21.04%	78.96%
55	Cigna HealthCare of North Carolina, Inc.	1,079,077	226,995	21.04%	78.96%
56	BridgeSpan Health Company	8,456	1,752	20.72%	79.28%
57	Ambetter Health of Louisiana, Inc.	2,111,052	437,252	20.71%	79.29%
58	Blue Care Network of Michigan	3,524,039	727,206	20.64%	79.36%
59	Highmark Blue Cross Blue Shield West Virginia	2,380,084	485,359	20.39%	79.61%
60	Blue Cross and Blue Shield of Alabama	10,908,371	2,220,164	20.35%	79.65%
61	Buckeye Community Health Plan	4,081,129	820,592	20.11%	79.89%
62	Security Health Plan of Wisconsin, Inc.	1,364,313	273,879	20.07%	79.93%
63	PacificSource Health Plans	4,979	996	20.00%	80.00%
64	Wellmark Health Plan of Iowa, Inc.	4,086,062	812,696	19.89%	80.11%
65	SelectHealth, Inc.	8,646,012	1,707,856	19.75%	80.25%
66	University of Utah Health Insurance Plans	652,716	128,598	19.70%	80.30%
67	Sunshine State Health Plan	1,747,455	344,204	19.70%	80.30%
68	Highmark BCBSD Inc.	2,088,505	406,111	19.45%	80.55%
69	Blue Cross Blue Shield of Texas	61,503,844	11,935,065	19.41%	80.59%
70	Health Net of Arizona, Inc.	3,580,808	693,915	19.38%	80.62%
71	Superior Health Plan	8,781,270	1,701,470	19.38%	80.62%
72	Blue Cross and Blue Shield of Arizona, Inc.	1,604,775	310,940	19.38%	80.62%
73	Blue Cross and Blue Shield of Florida	23,252,714	4,500,594	19.36%	80.64%
74	Blue Cross and Blue Shield of NC	16,959,958	3,217,713	18.97%	81.03%
75	Medica Community Health Plan	524,489	97,212	18.53%	81.47%
76	Florida Health Care Plan, Inc.	3,627,195	671,323	18.51%	81.49%
77	Network Health Plan	313,114	57,922	18.50%	81.50%
78	Regence BlueCross BlueShield of Utah	421,327	77,339	18.36%	81.64%
79	Blue Cross and Blue Shield of Nebraska	608,828	110,643	18.17%	81.83%
80	CommunityCare HMO Inc.	458,029	82,860	18.09%	81.91%
81	Blue Cross Blue Shield of Wyoming	1,333,619	240,656	18.05%	81.95%
82	Blue Cross Blue Shield of Oklahoma	9,295,961	1,665,537	17.92%	82.08%
83	Cox Health Systems Insurance Company	102,975	18,221	17.69%	82.31%
84	Absolute Total Care, Inc	9,103,191	1,605,146	17.63%	82.37%
85	Wellmark of South Dakota	446,393	77,973	17.47%	82.53%
86	Medical Health Insuring Corp. of Ohio	1,360,063	236,813	17.41%	82.59%
87	Blue Cross and Blue Shield of South Carolina	12,121,048	2,095,964	17.29%	82.71%
88	CHRISTUS Health Plan	1,459,196	252,195	17.28%	82.72%
89	HMO Partners, Inc.	1,530,994	257,411	16.81%	83.19%
90	HMO Louisiana, Inc.	6,029,822	1,002,520	16.63%	83.37%
91	Ambetter of Magnolia Inc.	12,226,636	2,020,936	16.53%	83.47%
92	USAble HMO, Inc.	774,831	126,463	16.32%	83.68%
93	Compcare Health Serv Ins Co(Anthem BCBS)	2,886,370	456,796	15.83%	84.17%
94	Paramount Insurance Company	115,113	18,128	15.75%	84.25%
95	USAble Mutual Insurance Company	4,314,995	676,808	15.69%	84.31%
96	Blue Cross and Blue Shield of Kansas, Inc.	1,100,878	171,711	15.60%	84.40%
97	Dean Health Plan	1,117,399	171,981	15.39%	84.61%
98	Scott and White Health Plan	9,635,438	1,476,355	15.32%	84.68%
99	QualChoice Life & Health Insurance Company, Inc.	1,804,696	273,192	15.14%	84.86%
100	Blue Cross Blue Shield of North Dakota	724,618	109,326	15.09%	84.91%
101	QCA Health Plan, Inc.	1,715,924	256,793	14.97%	85.03%
102	Louisiana Health Service & Indemnity Company	1,073,268	156,586	14.59%	85.41%
103	Blue Cross Blue Shield of Michigan Mutual Insurance Company	2,242,734	311,159	13.87%	86.13%
104	Regence BlueCross BlueShield of Oregon	1,068,671	141,734	13.26%	86.74%
105	Blue Cross and Blue Shield of Montana	1,224,773	161,567	13.19%	86.81%
106	Community Insurance Company(Anthem BCBS)	3,841,838	489,897	12.75%	87.25%
107	Aspirus Health Plan, Inc.	405,418	50,973	12.57%	87.43%
108	Montana Health Cooperative	928,281	113,748	12.25%	87.75%
109	Common Ground Healthcare Cooperative	1,533,514	170,257	11.10%	88.90%
110	Taro Health Plan of Oklahoma, Inc.	7,770	841	10.82%	89.18%
111	Healthy Alliance Life Co(Anthem BCBS)	4,249,360	427,441	10.06%	89.94%
112	MercyCare HMO, Inc.	213,818	21,079	9.86%	90.14%
113	Group Health Cooperative of South Central Wisconsin	212,263	19,894	9.37%	90.63%
114	Kaiser Foundation Healthplan of the NW	12,307	1,133	9.21%	90.79%
115	Priority Health	4,220,185	368,344	8.73%	91.27%
116	Quartz Health Benefit Plans Corporation	706,744	61,046	8.64%	91.36%
117	Providence Health Plan	443,992	36,828	8.29%	91.71%
118	Matthew Thornton Hlth Plan(Anthem BCBS)	2,247,274	178,992	7.96%	92.04%
119	Kaiser Foundation Health Plan, Inc.	13,139	955	7.27%	92.73%
120	Capital Health Plan	559,771	39,611	7.08%	92.92%
121	HealthPartners Insurance Company	478,102	31,778	6.65%	93.35%
122	Sanford Health Plan	879,472	45,897	5.22%	94.78%
123	Avera Health Plans, Inc.	440,684	15,405	3.50%	96.50%
124	Community Health Choice Texas, Inc.	0	0	nan%	nan%
125	Boston Medical Center Health Plan, Inc.	0	0	nan%	nan%
126	Celtic Insurance Company	0	0	nan%	nan%
127	Community Care Network Inc	0	0	nan%	nan%
128	Oscar Insurance Company	0	0	nan%	nan%
129	Oscar Health Maintenance Organization of Florida	0	0	nan%	nan%
130	Alliant Health Plans, Inc.	0	0	nan%	nan%
131	Antidote Health Plan of Ohio	0	0	nan%	nan%
132	InStil Health Insurance Company	0	0	nan%	nan%
133	Coordinated Care Corporation Indiana	0	0	nan%	nan%
134	Harbor Health Insurance Company	0	0	nan%	nan%
135	AmeriHealth Caritas Louisiana, Inc.	0	0	nan%	nan%
136	HAP CareSource	0	0	nan%	nan%
137	Simply Healthcare Plans Inc dba Wellpoint Florida Inc	0	0	nan%	nan%
138	Wellpoint Insurance Company	0	0	nan%	nan%
139	Iowa Total Care, Inc.	0	0	nan%	nan%
140	Centene Venture Company Florida	0	0	nan%	nan%
141	UnitedHealthcare Insurance Company	0	0	nan%	nan%
142	UnitedHealthcare Plan of the River Valley, Inc.	0	0	nan%	nan%
143	Antidote Health Plan of Arizona, Inc.	0	0	nan%	nan%
144	UnitedHealthcare Benefits of Texas, Inc.	0	0	nan%	nan%
145	Cigna HealthCare of Florida, Inc.	0	0	nan%	nan%

nan% means “Not a Number”. In our table, it usually happens when the formula:

Denial Rate=Denied Claims​/ Total Claims×100

tries to divide by zero.

The above table includes: Rank, Insurance Company, Total Claims, Denied Claims, Denial Rate, Acceptance Rate, Sorted from highest denial rate → lowest denial rate

Color-coded denial rates:

🔴 High (30%+)
🟡 Medium (20–29.99%)
🟢 Low (<20%)

Key Findings

Kaiser Permanente currently shows one of the lower claim denial rates among major insurers.
Imperial, CareSource, Select Health shows one of the highest claim denial rates among major insurers.
Some large insurers continue to report significantly higher denial percentages compared to industry averages.
Claim denial rates can vary depending on state, network type, and reporting period.

Why Insurance Claims Get Denied

Health insurance claims may be denied for several reasons, including:

Missing documentation (one of the largest reasons)
Out-of-network providers (second largest reason)
Prior authorization issues
Coding errors
Coverage exclusions
Filing deadlines

Understanding denial patterns can help consumers make better insurance decisions and prepare stronger appeals when necessary.

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Data Source and Methodology

This analysis uses publicly available healthcare transparency data published by the Centers for Medicare & Medicaid Services (CMS).

Data source:

CMS Transparency in Coverage Public Use Files
Data.Healthcare.gov

Claim denial rate was calculated using the following formula:

Insurance Denial Rate = (Denied Claims ÷ Total Claims) × 100

The data reflects the latest available reporting periods published by federal healthcare authorities and may not represent real-time claim processing activity.

Final Thoughts

Health insurance claim approval rates remain an important factor for consumers evaluating insurance providers in the United States.

By tracking insurer denial trends over time, consumers can gain better transparency into how insurance companies process medical claims and how approval patterns evolve across the healthcare industry.

Before you buy any insurance you can search for a Insurance and check the rate of their denial country wide and take a decision wether or not to go with that particular Insurer. Insurers in the Serial 64 onwards could be better choice for our readers.

This page is updated regularly as new federal healthcare data becomes available.

FAQs

What is a health insurance claim denial?

A health insurance claim denial occurs when an insurance company refuses to pay for a medical service, treatment, prescription, or healthcare procedure submitted by a patient or healthcare provider.

Why do insurance companies deny medical claims?

Insurance claims may be denied for several reasons, including:

Out-of-network providers
Missing documentation
Lack of prior authorization
Billing or coding errors
Coverage exclusions
Administrative mistakes

Which US insurance companies have the highest claim denial rates?

Claim denial rates vary by insurer and reporting period. This report analyzes publicly available CMS transparency data to compare denial percentages across major health insurance companies operating in the United States.

How is the denial rate calculated?

The denial rate is calculated using the following formula:

Denial Rate = (Denied Claims ÷ Total Claims Received) × 100

A higher percentage indicates that a larger portion of submitted claims were rejected by the insurer.

What is an insurance claim acceptance rate?

The acceptance rate represents the percentage of claims approved by an insurer. It is calculated as:

Acceptance Rate = 100 − Denial Rate

Higher acceptance rates generally indicate a greater likelihood of claims being approved.

Is the insurance claims data real-time?

No. The data is based on the latest publicly available federal CMS transparency datasets and may reflect annual or periodic reporting data rather than real-time insurance activity.

Where does the insurance claims data come from?

The data used in this analysis comes from publicly available healthcare transparency datasets published by the Centers for Medicare & Medicaid Services (CMS) through Data.Healthcare.gov.

Can denied health insurance claims be appealed?

Yes. Patients and healthcare providers can often appeal denied insurance claims. Many insurers provide internal appeal processes, and in some cases, external reviews may also be available.

Why should consumers compare insurance claim denial rates?

Comparing denial rates can help consumers better understand how insurance companies process medical claims and may help when evaluating different health insurance providers.

Are low-premium insurance plans more likely to deny claims?

Not always. Claim denial rates depend on multiple factors including insurer policies, network structure, documentation requirements, and plan design. Premium cost alone does not determine approval rates.

How often is this data updated?

This page is updated regularly whenever new CMS healthcare transparency data becomes publicly available.

Does this data include all US insurance claims?

No. The dataset primarily reflects publicly reported marketplace and qualified health plan data and may not include every private, employer-sponsored, Medicare, or Medicaid claim in the United States.

Authoritative Source Links

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ABOUT THE AUTHOR

Sam

𝕏 💼 ✉️

Sam is one of the founder and driving force behind hospscout.com. With over 15 years of experience & a passion for making healthcare information transparent, he created this platform to help patients, families evaluate Hospitals and Insurances. When he isn’t analyzing healthcare data or updating the site, Sam is dedicated to ensuring users find the reliable insights they need to make informed health decisions.