Which insurance denies the most claims ?

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Health insurance claim denial rates** can vary significantly from one insurer and plan to another. In this video, we break down the latest 2024 data from HealthCare.gov to see which major health insurance companies had the highest in-network claim denial rates—and what those numbers actually mean for consumers.  Oscar Health recorded the highest average denial rate among large insurers participating in the HealthCare.gov marketplace, at **25% in 2024**. Molina Healthcare and GuideWell Mutual Holding followed at **22%**, while Cigna reached **21%** and UnitedHealth Group recorded **19%**.  In this video, you’ll learn:  * Which major insurers had the highest claim denial rates * How Oscar Health, Molina, Cigna, and UnitedHealth compare * The overall 2024 marketplace denial rate of **19%** * Why out-of-network claims had a much higher **37%** denial rate * How denial rates varied from **3% to 36%** between insurers * Why your state and specific health insurance plan matter * What to check before choosing a health insurance policy  These health insurance claim denial statistics apply specifically to HealthCare.gov marketplace plans and should not be interpreted as representing every health plan in the United States.  If you're comparing health insurance companies, watch the full video to understand the numbers and make a more informed decision. **Like, comment, and subscribe** for more insurance and consumer finance explainers.  #HealthInsurance #InsuranceClaims #ClaimDenial #HealthCaregov #InsuranceCompanies #HealthInsuranceTips #USHealthcare #InsuranceFacts

Transcript

00:00OscarHealth had the highest average in-network claim denial rate among large insurers participating

00:05in the U.S. healthcare.gov marketplace at 25% in 2024. However, there is no single insurer

00:13that denies the most claims across every type of insurance, state, or policy.

00:18OscarHealth, 25%, highest among parent insurers receiving more than 5 million healthcare.gov

00:25claims in 2024. Molina Healthcare, 22%, second highest among the same large insurer group.

00:33Guidewell Mutual Holding, 22%, also recorded a 22% average denial rate.

00:39Cigna, 21%, denied about 1 in 5 in-network claims. United Health Group, 19%, its rate was close to

00:48the overall marketplace average. Across healthcare.gov insurers, 19% of in-network claims were

00:54denied in 2024, representing roughly 85 million of 451 million claims. Out-of-network claims had a

01:03substantially higher denial rate of 37%. At the individual insurer level, rates ranged from 3%

01:10to 36%, showing that location and specific insurer matter considerably. These figures concern health

01:17insurance claims, not auto, home, or life insurance, where denial statistics are measured differently.

01:24They also do not cover every U.S. health plan, particularly many employer-sponsored and state-based

01:30marketplace plans. Practically, if you're comparing health insurers, don't judge a company solely by its

01:36national denial rate. Check the specific plan and state, network rules, prior authorization requirements,

01:42and appeal record. A plan with a lower denial rate may be preferable even if its premium is slightly

01:48higher. Finally, remember that everything we discussed today is for educational purposes only

01:54and does not constitute financial advice. Good luck to everyone, and see you in the next video.

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