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Healthcare coverage from WYPR is made possible by support from GBMC HealthCare.

Two of Maryland’s top health insurers deny claims at high rates

Insurance claim denials. Photo by WYPR.
WYPR
Insurance claim denials from Aetna and CareFirst.

Two of Maryland’s top three health insurers ranked above the industry average in claims denials in 2023.

Both Blue Cross Blue Shield, known as CareFirst in the region, and UnitedHealthcare deny their beneficiaries’ claims for medical procedures and appointments more than other companies in the field.

CareFirst makes up 55% of Maryland’s health insurance market share and denied 17% of claims in 2023, according to ValuePenguin, a consumer research site that specializes in insurance.

The industry average is 16%.

UnitedHealthcare denied 32% of claims in 2023 and makes up 9% of the state’s market share.

Kaiser Permanente is Maryland’s second largest health insurer with 26% of the market, however, it only denied 7% of claims. However, Kaiser uses a different model than other insurance companies, often using in-house physicians for care.

The topic of claims denials has received a lot of attention after the murder of UnitedHealthcare CEO Brian Thompson.

Towson-native Luigi Mangione was arrested in connection with the murder this week. He has become a divisive figure as his arrest and the murder of Thompson have highlighted issues of class struggle and corporate greed.

UnitedHealthCare reported $22 billion in profits in 2023.

Scott is the Health Reporter for WYPR. @smaucionewypr
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