State Detail
Iowa
2 plans reporting · CY 2025
Across 2 plans reporting in Iowa, standard prior authorization denial rates range from 14.6% to 31.1%, averaging 22.9%. Among plans reporting appeal outcomes, 73.0% of appealed denials are overturned. All data is from mandatory CMS-0057-F disclosures for calendar year 2025.
Plan Comparison
| Standard | Expedited | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Plan | Org | Requests | Approved | Denied | Appr % | Denial % ▼ | Appeals | Overturn % | Denied Appeal % | Appr Ext % | Denied Ext % | Mean Days | Med Days | Requests | Approved | Denied | Appr % | Denial % | Appeals | Overturn % | Denied Appeal % | Appr Ext % | Denied Ext % | Mean Days | Med Days | Source |
| Centene Corporation | ||||||||||||||||||||||||||
| Ambetter Health (Iowa Total Care)Exchange Plans | Centene Corporation | 3,173 | 2,185 | 988 | 68.9% | 31.1% | 97 | 50.5% | 49.5% | 1.4% | 98.6% | 6.0 | 4.0 | 131 | 85 | 46 | 64.9% | 35.1% | 13 | 61.5% | 38.5% | 0.8% | 99.2% | 1.0 | 1.0 | View source ↗ |
| Wellcare Medicare Advantage (IA H1862)Medicare Advantage | Centene Corporation | 7,292 | 6,226 | 1,066 | 85.4% | 14.6% | 87 | 95.4% | 4.6% | 0.0% | 100.0% | 5.0 | 2.0 | 349 | 300 | 49 | 86.0% | 14.0% | 12 | 75.0% | 25.0% | 0.0% | 100.0% | 1.0 | 1.0 | View source ↗ |
Standard Denial Rates by Plan
Appeals Analysis
Plans in the upper-right deny frequently and have high overturn rates — suggesting inappropriate denials.
Similar Denial Rates