Utah Insurance Denial Report

The worst health insurers in Utah
by claim denial rate

Utah averages a 18.1% denial rate — 1.0 points below the national average. About 130,000 claims are denied annually.

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18.1%
Utah avg denial rate
19.1%
National average
130,000
Annual denials in state
>80%
Appeals overturned when filed

Health insurance denials in Utah

In Utah, the average health insurance claim denial rate stands at 18.1%, which is slightly below the national average of 19.1%. This means that out of approximately 130,000 annual claims denied, many patients face significant obstacles in accessing the care they need. For individuals navigating the complexities of health insurance, this statistic highlights a common challenge that can lead to stress and uncertainty regarding their medical coverage. Understanding this denial rate is crucial for patients as it empowers them to take action when their claims are rejected, ensuring they are not left without necessary medical services.

Worst insurers in Utah by denial rate

Source: CMS Marketplace Transparency Report 2023. In-network ACA marketplace claims only.

1

Molina Healthcare

22.4% denial rate

Molina denies 22.4% of claims — 3.3 points above the national average. Their appeal overturn rate is 55%.

GLP-1 Medications: 38% deniedSpecialty Medications: 30% deniedMental Health: 25% denied
Full Molina denial report →
2

UnitedHealthcare

32.5% denial rate

UHC denies 32.5% of claims — 13.4 points above the national average. Their appeal overturn rate is 57%.

Specialty Medications: 43% deniedGLP-1 Medications: 41% deniedMRI / CT Scans: 35% denied
Full UHC denial report →

Your rights as a Utah insurance patient

In Utah, patients have specific rights when it comes to health insurance claims. They are entitled to an internal appeal process, allowing them to contest a denial directly with their insurer. If the internal appeal is unsuccessful, patients can request an external Independent Medical Review, providing an unbiased evaluation of their claim. The Utah Insurance Department oversees these processes and offers resources for patients. Filing a complaint with the department is free and can serve as a powerful tool to pressure insurers into reconsidering denied claims, ensuring that patients advocate effectively for the care they deserve.

Utah Insurance Department
https://insurance.utah.gov

Start My Utah Appeal →

How to appeal a denial in Utah

  1. 1
    Request the denial in writing
    Ask your insurer for the specific clinical criteria and coverage policy they used to deny you. They are legally required to provide it within 30 days.
  2. 2
    File your internal appeal
    Send a written appeal to your insurer within 180 days. Cite your doctor's clinical documentation, relevant medical guidelines, and Utah insurance law. A well-written appeal citing specific laws wins over 80% of the time.
  3. 3
    Escalate to the state if denied again
    If your internal appeal is denied, file an Independent Medical Review (IMR) with the Utah Insurance Department. This is free and decided by independent clinicians. Their decision is often binding.
  4. 4
    Use disputes.health to generate your letter
    Our agents generate a clinic-grade appeal letter in under 15 minutes — citing your state's laws, relevant medical guidelines, and your specific situation. We then submit it to your insurer for you.
How to appeal a denial →GLP-1 denial guide →Mental health denial guide →All public resources →

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