The Medicare Advantage prior-authorization denial rate rose from 5.6% in 2020 to 7.7% in 2024, according to KFF. That is a meaningful increase — roughly a 38% relative rise — but it is not a doubling, despite headlines that suggest otherwise. In 2024, Medicare Advantage insurers made 52.8 million prior-authorization determinations and denied about 4.1 million of them. For a caregiver, the trend matters less than knowing what to do when a parent's request is the one denied.
Appeals
Medicare Advantage Prior Authorization Denials: How the Rate Rose From 5.6% to 7.7% (2026)
By Chuck Brodsky, Co-Founder, MediNav — Updated July 2026 — 7 min read
Quick answer
If it feels like Medicare Advantage plans are denying more prior-authorization requests than they used to, the data backs up the direction — but the size of the change is often overstated. Getting the number right helps you push back on a denial with accurate footing rather than outrage.
What the numbers actually say
The two endpoints come from two different KFF reports, and each should be cited to its own source. The 5.6% figure for 2020 is from KFF's 2022 analysis, which reported the 2019 through 2021 series. The 7.7% figure for 2024 is from KFF's January 2026 analysis. Read together, they show the share of prior-authorization requests denied rose about two percentage points over four years — a real increase, not a spike.
Why "denials doubled" is wrong
A move from 5.6% to 7.7% is roughly a 38% relative increase, not a doubling. A doubling would put the rate far higher than 7.7%, which the data does not show. The distinction is not pedantic: when you appeal a parent's denial or raise a concern, an accurate figure is harder to dismiss than an exaggerated one. The denial rate did not double; it rose by about a third in relative terms.
The volume behind the percentages
Percentages can obscure scale. In 2024, Medicare Advantage insurers made 52.8 million prior-authorization determinations, and about 4.1 million were denied, per KFF. Even a small percentage of a very large number is a lot of denied care. The volume also reflects rising use of prior authorization overall — requests per enrollee increased over the same period, so more of a parent's care runs through the process than it once did.
What rising denials mean for a caregiver
More prior-authorization steps mean more points where a parent's care can be paused or refused, which makes two habits valuable: expect prior authorization on higher-cost services and start it early, and treat a denial as appealable rather than final. Denials are overturned on appeal far more often than families assume, so a rising denial rate is a reason to appeal more readily, not to give up.
What to do when your parent is denied
Get the denial and its stated reason in writing, ask the ordering physician for a letter of medical necessity, and file within the deadline. The appeals hub has the steps. A denial is a common event, not a verdict.
For related reading, see what the 2024 data shows about appeal overturn rates and how long a parent has to appeal a denial.
When to call MediNav
- Free: Ask a specific question — ask what a rising denial rate means for your parent’s prior-authorization request.
- Free: Run the coverage check — in about two minutes, see what a parent is likely eligible for with 2026 figures for your state.
- Paid ($9–$19/mo): MediNav Watch and Watch+ re-check the figures as they change each year and remind you before deadlines, so nothing lapses unnoticed.
Related guides
- What the 2024 Appeal Data Shows — appeals overturn most denials
- How Long to Appeal a Denial — the 65-day filing window
- Appeal a Medicare Denial for a Parent — the step-by-step appeals hub
- Unused Medicare Benefits — benefits a parent already has
Frequently asked questions
What if I read that Medicare Advantage denials have doubled?
That framing is inaccurate. The prior-authorization denial rate rose from 5.6% in 2020 to 7.7% in 2024, per KFF — roughly a 38% relative increase, not a doubling. A doubling would push the rate far above 7.7%. Use the accurate figures when raising a concern or filing an appeal.
How many prior-authorization requests get denied?
In 2024, Medicare Advantage insurers made 52.8 million prior-authorization determinations and denied about 4.1 million, a 7.7% denial rate, according to KFF. Even a single-digit percentage represents a large number of denied services across the program.
Why are the two percentages cited to different reports?
The 5.6% figure for 2020 comes from KFF's 2022 analysis of the 2019 to 2021 series, while the 7.7% figure for 2024 comes from KFF's January 2026 analysis. Citing each endpoint to its own report keeps the comparison accurate and verifiable.
Does a higher denial rate mean my parent's request will be denied?
Not necessarily. Most prior-authorization requests are approved. The rate rose to 7.7% in 2024, meaning the large majority were not denied. If your parent's request is denied, the more useful fact is that appeals succeed often — so file one.
Is prior authorization being used more overall?
Yes. Alongside the higher denial rate, the number of prior-authorization determinations and requests per enrollee has grown, reaching 52.8 million determinations in 2024. More of a parent's care now passes through prior authorization than a few years ago, so starting the process early helps.
What is the single most useful response to a denial?
Appeal it. Denied prior-authorization requests are overturned on appeal far more often than families expect. Get the denial in writing, secure a physician's letter of medical necessity, and file within the deadline using the appeals hub.
Sources: KFF — MA plans denied a larger share of prior authorization requests in 2022 than in prior years, KFF — Medicare Advantage insurers made nearly 53 million prior authorization determinations in 2024. Last verified July 2026.