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HealthCare.gov Insurers Denied Nearly 1 in 5 In-Network Claims in 2023, but Information About Reasons is Limited in Public Data

HealthCare.gov insurers rejected nearly 19% of claims for in-network services and 37% for out-of-network services in 2023, according to a KFF analysis. The study found high denial rates at certain insurers, including Blue Cross Blue Shield of Alabama (35%) and UnitedHealth Group (33%). The most common reasons for denial were general “other” reasons (34%) and administrative issues (18%). Only 1% of denial decisions were appealed by customers in 2023.

Source: www.kff.org –

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