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KFF analysis: claims denials and appeals in marketplace plans in 2024
KFF's analysis of federal data on claims denied and appealed in HealthCare.gov plans in 2024. It reports that 19% of in-network claims were denied. It is a source of statistics, not a how-to guide.
Know before you go
The brief analyzes federal data for individual plans sold on HealthCare.gov in 2024; it does not cover employer plans, Medicare or Medicaid. It reports 19% of in-network claims and 37% of out-of-network claims denied, and says denial rates varied widely by insurer. It gives no steps, deadlines or help line, so use it to understand the numbers and then follow a guide for your own appeal. It is written for policy readers and is long.
- Cost
- Free to read.
- Where
- Nationwide
- How to start
- Read the Key Takeaways at the top. Use it when you need a sourced statistic and cite the plan year and the plans it covers.
- Have ready
- The name of your insurer, if you want to compare it with others in the data
Where this comes from
- Provider
- KFF
- Source we read
- https://www.kff.org/patient-consumer-protections/claims-denials-and-appeals-in-aca-marketplace-plans-in-2024/
- Date we read it
- . This is not a fresh check.
- Date the provider printed
- 2026-03-24
- What we checked
- We read the provider's public page. We have not verified availability, eligibility or outcomes for any individual.
Other starting points
- Program or service
AppealArmor
A free web tool that reads a photo or text of your denial letter, shows you what it read, and emails an appeal letter and a Next Steps sheet with where to send it and your deadline. It also has a deadline calculator.
From AppealArmor
- Program or service
California Independent Medical Review decision search
A searchable database of every California Independent Medical Review decision since 1 January 2001. Search by drug, treatment, therapy or condition to read how reviewers decided cases like yours.
From California Department of Managed Health Care
- Program or service
Crohn's & Colitis Foundation appeal letter library
Customizable appeal letters for Crohn's disease and ulcerative colitis treatments, tests and dose changes, including a request to use a biologic without first failing other drugs. Written for the doctor's office to edit.
From Crohn's & Colitis Foundation