CMS made every Medicare Advantage plan, Medicaid program and marketplace insurer post its 2025 prior authorization numbers by March 31, 2026. We read the reports and line the numbers up.
How much we’ve read
35,969,452 people are in 703 Medicare Advantage plans. Of those members:
- 67.4% are in plans whose report we’ve read
- 6.9% are in plans whose report we have on file and still need to read
- 18.9% are in plans whose parent company posts reports we’re still matching
- 6.8% are in plans still in our queue
Every line above measures our own progress through the reports.
What the typical plan reported
- 7.7% of standard requests denied (median across 185 plans)
- 9.0% of urgent requests denied (median across 175 plans)
- 73.0% of appealed denials overturned (median across 203 plans)
The biggest plans
| Contract | Plan | Members | Denied | Overturned on appeal |
|---|---|---|---|---|
| H5216 | Humana | 2,366,117 | 6.87% | 65.92% |
| H2001 | UnitedHealthcare | 2,248,592 | 23.4% | 56.9% |
| H5522 | Aetna Medicare | 1,450,917 | 6.97% | 90.32% |
| H7617 | Humana | 1,210,490 | 4.32% | 63.64% |
| H5253 | UnitedHealthcare | 1,156,220 | 18.9% | 55.9% |
| H5521 | Aetna Medicare | 1,037,625 | 7.86% | 89.7% |
| H1036 | Humana | 856,349 | 7.02% | 55.73% |
| H0609 | UnitedHealthcare | 752,808 | 7.3% | 81.7% |
| H2406 | UnitedHealthcare | 563,134 | 17.3% | 62.1% |
| H5619 | Humana | 482,045 | 5.09% | 66.04% |
| H2802 | UnitedHealthcare | 409,930 | 20.6% | 55.9% |
| H1045 | UnitedHealthcare | 395,825 | 17.8% | 47.5% |
| H4461 | Humana | 390,238 | 6.17% | 67.02% |
| H4036 | Anthem Blue Cross and Blue Shield | 368,760 | 5.2% | 79.0% |
| H6622 | Humana | 334,337 | 8.14% | 60.04% |
Missing reports
We searched each of these agencies’ websites and came up empty as of 2026-09-18. The survey page shows where we looked. If you know where one of these lives, email [email protected] and we’ll fix it.
- American Samoa Medicaid FFS
- District of Columbia Medicaid FFS
- Delaware Medicaid FFS
- Georgia Medicaid FFS
- Guam Medicaid FFS
- Iowa Medicaid FFS
- Idaho Medicaid FFS
- Louisiana Medicaid FFS
- Maryland Medicaid FFS
- Minnesota Medicaid FFS
- Missouri Medicaid FFS
- Northern Mariana Islands Medicaid FFS
- Montana Medicaid FFS
- North Carolina Medicaid FFS
- Nebraska Medicaid FFS
How we do this
We start at each insurer’s own report page and download everything it links. Then we pull the numbers out of each file. When a report’s approval and denial rates contradict each other, we hold its numbers back. The full dataset lives on the survey page.