Health insurance · CMS Transparency in Coverage

Health insurers ranked by claim denial rate

Which health insurers deny the most marketplace claims, measured directly from CMS Transparency-in-Coverage filings, not estimates.

134
Insurers ranked
21%
Avg claims denied
64%
Highest denial

According to the U.S. Centers for Medicare & Medicaid Services Transparency in Coverage Public Use File (PY2025, published March 2026), PlainInsurer analyzed more than 10,000 marketplace claims per insurer across the United States to rank health carriers by claim-denial rate. See our methodology for the full computation.

The headline

Across 134 health insurers with reportable volume, AmeriHealth Caritas Florida, Inc. denies the most marketplace claims (63.8%), while Avera Health Plans, Inc. denies the fewest (2.4%) - a gap of 61 points.

64%
highest (AmeriHealth Caritas Florida)
21%
volume-weighted average
2%
lowest (Avera Health Plans)
134
insurers ranked

Denial rate reflects plan design and risk pool, Medicaid managed-care and narrow-network plans route more claims through utilization review, so high denial volume is not by itself proof of unfair practice.

Highest claim-denial rates

Top 12 health insurers by share of marketplace claims denied (≥10,000 claims on file)

% of claims denied

What this shows These carriers deny the largest share of marketplace claims in the CMS data. Many are Medicaid managed-care organizations, whose product design routes more claims through prior authorization.

Source CMS Transparency in Coverage PUF (PY2025) As of 2025

Volume vs. denial rate

Each bubble is an insurer, placed by how many marketplace claims it handles and what share it denies. The largest carriers in the top band deny the most claims at scale.

Marketplace claims handled vs % denied, CMS Transparency in Coverage (PY2025)

Marketplace claims handled vs % denied, CMS Transparency in Coverage (PY2025) 2×2 strategic matrix plotting 30 entities by Claims handled (000s) → (X) and Denial rate → (Y), with a crosshair dividing the plot into four quadrants. Big & strictSmall & strictBig & lenientSmall & lenient 010,00020,00030,00040,00050,000 10%20%30%40%50% Claims handled (000s) → Denial rate →
Marketplace claims handled vs % denied, CMS Transparency in Coverage (PY2025)

134 health insurers ranked by claim-denial rate (showing top 50)

# Insurer Claim denial rate ClaimsStates
1 AmeriHealth Caritas Florida, Inc. F 63.8% 37K1
2 CareSource North Carolina Co. F 45.7% 11K1
3 UnitedHealthcare Community Plan, Inc. F UnitedHealth Group 45.5% 259K1
4 Select Health of South Carolina F 45.5% 76K1
5 UnitedHealthcare of Ohio, Inc. F UnitedHealth Group 43.5% 448K1
6 UnitedHealthcare of Illinois, Inc. F UnitedHealth Group 43.1% 580K1
7 AmeriHealth Caritas North Carolina, Inc. F 43.0% 249K1
8 UnitedHealthcare of Arizona, Inc. F UnitedHealth Group 41.8% 1874K1
9 UnitedHealthcare Insurance Company F UnitedHealth Group 41.4% 3567K5
10 UnitedHealthcare of Oklahoma, Inc. F UnitedHealth Group 40.3% 180K1
11 Blue Cross and Blue Shield of Montana F 38.7% 254K1
12 UnitedHealthcare of Texas, Inc. F UnitedHealth Group 38.3% 5751K1
13 UnitedHealthcare of Florida, Inc. F UnitedHealth Group 38.2% 2781K1
14 UnitedHealthcare of Mississippi, Inc. F UnitedHealth Group 37.1% 169K1
15 Molina Healthcare of Illinois, Inc. F Molina Healthcare 36.0% 102K1
16 Blue Cross and Blue Shield of Alabama F 35.8% 13274K1
17 UnitedHealthcare of North Carolina, Inc F UnitedHealth Group 34.8% 1638K1
18 Molina Healthcare of Florida, Inc F Molina Healthcare 33.7% 828K1
19 AvMed, Inc. F 33.0% 535K1
20 Cigna HealthCare of Illinois, Inc. F Cigna 30.6% 373K1
21 Banner Health and Aetna Health Plan Inc. F CVS Health 30.5% 2375K1
22 CareSource West Virginia Co. F 30.5% 498K1
23 Molina Healthcare of Utah F Molina Healthcare 30.1% 58K1
24 Community First Insurance Plans F 29.4% 102K1
25 CHRISTUS Health Plan Louisiana F 29.3% 122K1
26 Aetna Health Inc. (a TX corp.) F CVS Health 29.3% 9161K1
27 Molina Healthcare of Texas, Inc. D Molina Healthcare 28.1% 1452K1
28 Sendero Health Plans, Inc. D 28.0% 254K1
29 Summa Insurance Company, Inc. D 27.5% 249K1
30 BlueCross BlueShield of Tennessee D 27.0% 5209K1
31 Premera Blue Cross Blue Shield of Alaska D 27.0% 777K1
32 Molina Healthcare of Michigan, Inc. D Molina Healthcare 26.6% 549K1
33 MOLINA HEALTHCARE OF SOUTH CAROLINA, INC D Molina Healthcare 25.9% 931K1
34 Cigna HealthCare of Texas, Inc. D Cigna 25.8% 6668K1
35 Harvard Pilgrim Health Care of NE D 25.6% 111K1
36 Molina Healthcare of Ohio, Inc. D Molina Healthcare 25.5% 1318K1
37 CareSource Ohio, Inc. D 25.2% 2278K1
38 Community Insurance Company(Anthem BCBS) D Elevance Health 25.2% 3558K1
39 Health Options, Inc. D 25.1% 39668K1
40 Molina Healthcare of Mississippi, Inc D Molina Healthcare 25.1% 267K1
41 Molina Healthcare of Wisconsin, Inc. D Molina Healthcare 24.2% 221K1
42 Hawaii Medical Service Association D 24.2% 678K1
43 Blue Cross Blue Shield of Texas D 24.2% 41369K1
44 Blue Cross Blue Shield of Oklahoma D 24.1% 8891K1
45 Oscar Health Plan, Inc. D 24.0% 223K2
46 CareSource Indiana, Inc. D 23.5% 3193K1
47 Cigna Health and Life Insurance Company D Cigna 23.4% 10727K4
48 Oscar Insurance Company D 23.0% 2969K8
49 Aetna Health Inc. (a FL corp.) D CVS Health 23.0% 12418K1
50 Medica Health Plans C Medica 22.8% 56K1

What to do with this

A high denial rate is a reason to check a plan's appeal record before you enrol.

Verify a plan's current standing with your state insurance department and review its Summary of Benefits and Coverage before any decision. Informational only, not insurance advice.

Source: CMS Transparency in Coverage PUF PY2025. Grades are peer-relative composites of complaint index, denial rate, and prior-authorization data, they do not reflect financial strength. Not affiliated with NAIC or CMS.