In 2026, the top five commercial payers — UnitedHealthcare, Anthem (Eleva), Cigna, Humana, and Aetna — now control over 82 % of all private-pay long-term care days in the United States. That means eight out of ten non-Medicare/Medicaid residents in your SNF, home health agency, or hospice are covered by one of these giants.
Searches for “unitedhealthcare insurance verification,” “anthem insurance verification,” “cigna insurance verification,” “humana insurance verification,” and “aetna insurance verification” have collectively exploded past 40,000 monthly searches — because getting commercial coverage wrong is expensive and increasingly common.
This 2026 guide gives U.S. LTC providers the exact portals, 270/271 tricks, and payer-specific quirks you need to verify every commercial plan in seconds — so you collect every dollar the first time.
Why Commercial Payer Verification Is Different (and Easier) in 2026?
Commercial insurance plans are the easiest and fastest major payers to verify in U.S. long-term care — and they’re getting better every year.
- >95 % support real-time 270/271 transactions — the highest adoption rate of any payer type (CAQH Index 2024–2025)
- Average response time: 3–8 seconds (faster than Traditional Medicare)
- Deepest benefit detail returned — exact coinsurance %, deductible remaining, skilled nursing days covered, prior-auth flags, in-network status
- Most use just three clearinghouse portals (Availity, Change Healthcare/Optum, NaviNet/Payerpath)
The catch? They also have the strictest prior-authorization rules and most frequent network changes — especially for skilled nursing and home health. One missed pre-auth or out-of-network facility still means a full denial.
In 2025, commercial payers are fast… but unforgiving.
The Top 10 Commercial Payers in U.S. Long-Term Care – 2026 Market Share & Verification Details
These ten payers now control >92 % of all private-pay LTC days in the United States (2025 LTC Payer Mix Report).
|
Rank
|
Payer
|
Est. % of Private LTC Days
|
Primary Portal(s) in 2026
|
Real-Time 270/271 Support
|
Direct Link
|
|---|---|---|---|---|---|
|
1
|
UnitedHealthcare (incl. AARP)
|
28 %
|
Availity / Optum Provider Portal
|
Yes (99 %)
|
|
|
2
|
Humana
|
19 %
|
Availity / Humana Provider Portal
|
Yes
|
|
|
3
|
Anthem / Elevance (Blue Cross)
|
16 %
|
Availity
|
Yes
|
|
|
4
|
Aetna (CVS Health)
|
12 %
|
Availity
|
Yes
|
|
|
5
|
Cigna + Evernorth
|
9 %
|
Cigna for Health Care Professionals
|
Yes
|
|
|
6
|
Centene (WellCare, etc.)
|
4 %
|
Own portal + Availity
|
Yes (most plans)
|
|
|
7
|
Molina Healthcare
|
3 %
|
Molina Provider Portal
|
Yes
|
|
|
8
|
Blue Cross Blue Shield (non-Anthem)
|
3 %
|
Local BCBS + Availity
|
Varies
|
Varies by state
|
|
9
|
Health Net / Centene
|
2 %
|
Own portal
|
Partial
|
|
|
10
|
Coventry / Aetna
|
2 %
|
Availity
|
Yes
|
Same as Aetna
|
Key 2025 fact: Over 90 % of these verifications now go through just three portals — Availity, Optum, and Cigna for HCP — making commercial verification faster than ever when you use 270/271.
The Fastest Way to Verify Any Commercial Plan in 2026: Real-Time 270/271
In 2026, real-time 270/271 is the undisputed king for commercial payer verification — faster, deeper, and more reliable than any portal.
|
Step
|
Action
|
Required Fields
|
What the 271 Instantly Returns (LTC-critical)
|
|---|---|---|---|
|
1
|
Open your EHR, billing system, or clearinghouse
|
Patient search → Eligibility
|
-
|
|
2
|
Enter demographics
|
Member ID, Last name + first initial, DOB, Date of service
|
Auto-validates
|
|
3
|
Select payer
|
UnitedHealthcare, Humana, Anthem, Aetna, Cigna, etc. (auto-populated)
|
-
|
|
4
|
Click “Check Eligibility”
|
One click
|
Response in 3–8 seconds
|
|
5
|
Read response
|
Auto-parsed or raw 271
|
• Active/Inactive + effective/term dates • Deductible remaining (individual + family) • Exact coinsurance % for SNF/home health • Out-of-pocket max status • Skilled nursing days authorized • Prior-authorization required (Y/N + phone #) • In-network status for your exact NPI
|
2025 reality: Over 95 % of UnitedHealthcare, Humana, Anthem, Aetna, and Cigna plans return full benefit detail via 270/271 — more than Medicare and far more than Medicaid. When you have automation, you never log into another portal again.
Payer-by-Payer Verification Guide – The Big 5 in 2026
Here are the exact shortcuts and hidden gotchas for the five commercial payers that dominate U.S. long-term care:
|
Payer
|
2025 Market Share (Private LTC)
|
Fastest Verification Method
|
Direct 2025 Portal Link
|
#1 LTC Gotcha in 2025
|
|---|---|---|---|---|
|
UnitedHealthcare (incl. AARP, Optum)
|
28 %
|
Real-time 270/271 via Availity or Optum
|
Requires facility-specific NPI — chain NPI often rejected
|
|
|
Humana
|
19 %
|
Real-time 270/271 via Availity
|
2025 added pre-auth for ALL SNF stays >20 days nationwide
|
|
|
Anthem / Elevance (Blue Cross in 14 states)
|
16 %
|
Real-time 270/271 via Availity
|
||
|
Aetna (CVS Health)
|
12 %
|
Real-time 270/271 via Availity
|
Shows “SNF days authorized” only after pre-auth is approved
|
|
|
Cigna + Evernorth
|
9 %
|
Direct Cigna for HCP portal or 270/271
|
Strictest timely-filing rule: 45 days from date of service (2025)
|
Pro move: Register once on Availity — it instantly connects you to UnitedHealthcare, Humana, Anthem, Aetna, and 200+ others with a single login. Most top-10 % LTC performers never use individual payer portals anymore.
Common Commercial Payer Denials in LTC in 2026 & How to Prevent Them
These five denials now make up >90 % of all commercial payer write-offs in U.S. long-term care:
|
Denial Reason
|
2025 Frequency
|
Average $ Loss per Stay
|
100 % Preventable Fix
|
|---|---|---|---|
|
Prior authorization not obtained
|
34 %
|
Flag every “prior-auth required = Y” in the 271 response
|
|
|
Out-of-network facility / wrong NPI
|
28 %
|
Full stay
|
Verify exact facility NPI (not chain) before every admission
|
|
Coinsurance / deductible misquoted
|
19 %
|
$8,000–$25,000
|
Always use the 271 response — never trust the insurance card
|
|
Retroactive termination
|
11 %
|
Full stay
|
Re-verify 24–48 hours before new billing period
|
|
Timely filing missed (Cigna = 45 days)
|
8 %
|
Full stay
|
Set calendar alerts the moment eligibility is confirmed
|
One accurate 270/271 check + monthly re-verification eliminates all five.
Frequently Asked Questions – Commercial Payer Verification
Use real-time 270/271 via Availity or Optum Provider Portal — returns full SNF coinsurance and prior-auth flags in 3–8 seconds.
Availity (single login covers all 14 Anthem states) + 270/271. Fastest and most complete.
Yes — almost always. The 271 response shows “prior-auth required = Y” and the exact phone number.
Availity 270/271 (preferred) or Humana provider portal. In 2025 Humana now requires pre-auth for any stay >20 days.
Pre-auth has not been requested yet. Submit auth first — days appear after approval.
Never. Only the real-time 271 response is accurate.
Over 95 % of the top 50 do — including every payer in the top 10.
Conclusion
You now have the complete 2025 commercial payer playbook:
- The top 10 payers that control >92 % of private LTC days
- The single fastest method (real-time 270/271) that works for >95 % of them
- Exact portal links, payer-specific gotchas, and the five denials that cost facilities millions every year
Do it manually and you’ll still beat almost everyone.
Do it with one-click automation that hits UnitedHealthcare, Humana, Anthem, Aetna, Cigna, Medicare, Medicaid, and every MCO in under 15 seconds and you’ll collect every dollar you’ve already earned.
Ready to make commercial payer verification disappear as a problem forever?
