A 2025 national survey found ~1 in 5 privately insured working-age adults faced a coverage denial for doctor-recommended care in the US.
Denials involved patients or family members, and could happen before or after care, including medical procedures or prescription drugs recommended by doctors.
The survey focused on privately insured adults ages 19 to 64, including employer coverage and marketplace or individual plans across the US.
A key patient concern was uncertainty over whether insurance would cover procedures or prescriptions doctors considered needed, especially for serious medical conditions.
Researchers also held 8 online focus groups with 45 privately insured adults to better understand experiences after coverage denials across the US.
