Carriers & the market
Insurers promised less red tape. The first scorecard.
A year after major insurers pledged to cut prior authorization, the first public tally is in: about 11 percent fewer approvals required, and more in Medicare Advantage.
By the Goodsurance editorial teamJune 28, 2026
Prior authorization is the step where a health plan has to approve a test, treatment, or piece of equipment before it is covered, and it is one of the most common reasons people feel tangled in their own coverage. In June 2025, more than fifty insurers covering close to 270 million Americans made a voluntary pledge to make that step less burdensome. This is the first real scorecard on whether they did. According to data released by the insurers' trade group and the Blue Cross Blue Shield Association, participating plans have reduced the number of services that require prior authorization by about 11 percent, which they put at roughly 6.5 million fewer authorization requests for patients. In Medicare Advantage specifically, the reduction was reported as more than 15 percent. The plans also pointed to other changes that matter if you switch coverage mid-treatment: a commitment that a new plan will honor an existing approval for similar in-network care for 90 days, so a change of plan does not interrupt care you are already getting, and a goal of answering most electronic prior authorization requests in real time. It is worth reading this evenly. These are the insurers' own numbers, the cuts focus on routine, low-risk services where the clinical guidelines are well established, and doctors' groups have said the real test is whether the day-to-day experience in the exam room actually improves, not just the totals in a report. So treat it as encouraging and unfinished. The practical takeaway for you is that prior authorization has not disappeared, but there is more room than there used to be, and you have levers: you can ask your plan whether a specific service still needs prior approval, you can ask your doctor's office to start that approval early, and if a request is denied you retain the right to appeal.
A year after insurers pledged to cut prior authorization, the first scorecard shows about 11 percent fewer approvals required, and more than 15 percent fewer in Medicare Advantage.
In plain words
Prior authorization is when your health plan has to say yes before it pays for a test, treatment, or equipment. It is one of the most frustrating parts of having coverage. In June 2025, more than fifty insurers that cover almost 270 million people promised to make this easier. Now we have the first report card. The insurers say they cut the number of services that need approval by about 11 percent. That is around 6.5 million fewer requests. In Medicare Advantage, they say the drop was more than 15 percent. They also promised that if you switch plans during treatment, your new plan will honor an existing approval for 90 days, so your care does not stop. Read this calmly. These are the insurers' own numbers, the cuts are mostly for simple, low-risk care, and doctors say the real test is whether it feels better at the doctor's office. Prior authorization has not gone away. But you have options: ask your plan if a service still needs approval, ask your doctor to start it early, and if you are denied, you can appeal.
Understand the basics first
Source: The American Journal of Managed Care
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