ACA Marketplace Insurers Denied 13% to 35% of In-Network Claims in 2024
By
Dr. Randal S. Olson
Summary
Health insurers on the ACA marketplace denied 13% to 35% of in-network claims in 2024, with significant variation across companies. The article highlights that claim denial rates differ substantially by insurer, meaning a patient's coverage outcome depends heavily on which company they're insured by. The topic has regained national attention following the December 2024 killing of UnitedHealthcare CEO Brian Thompson and the ongoing legal proceedings against Luigi Mangione.
Source
Hacker NewsACA Marketplace Insurers Denied 13% to 35% of In-Network Claims in 2024randalolson.comKey quotes
· 4 pulledHealth insurers turn down a lot of claims, and they do not all turn them down at the same rate.
In 2024, the largest plans sold on the Affordable Care Act marketplace denied anywhere from 13% to 35% of the in-network claims their members filed.
Whether your claim got paid depended a lot on whose name was on your card.
Claim denials are back in the national conversation.
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