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医療保険市場レポート:プロバイダー別、タイプ別、プランタイプ別、デモグラフィック別、プロバイダータイプ別、地域別、2024年~2032年Health Insurance Market Report by Provider, Type, Plan Type Demographics, Provider Type (Preferred Provider Organizations, Point of Service, Health Maintenance Organizations, Exclusive Provider Organizations ), and Region 2024-2032 |
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医療保険市場レポート:プロバイダー別、タイプ別、プランタイプ別、デモグラフィック別、プロバイダータイプ別、地域別、2024年~2032年 |
出版日: 2024年01月30日
発行: IMARC
ページ情報: 英文 141 Pages
納期: 2~3営業日
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世界の医療保険市場規模は2023年に1兆8,359億米ドルに達しました。今後、IMARCグループは、2024年から2032年にかけての成長率(CAGR)は6.2%を示し、2032年には3兆2,084億米ドルに達すると予測しています。慢性疾患やウイルス感染症の蔓延、複雑な病状に陥りやすい高齢者人口の増加、外科手術件数の増加などが、市場を後押しする主な要因となっています。
医療保険は、個人や家族に医療費の補償を提供する金銭的な取り決めです。個人(保険契約者)と保険会社またはヘルスケアプロバイダーとの間の契約です。保険会社は、定期的な保険料の支払いと引き換えに、保険契約者の対象となる医療費の一部または全額をカバーすることに同意します。保険証券には、対象となる医療サービスや医療費が明記されています。これには、医師の診察、入院、処方薬、予防医療、手術などが含まれます。また、保険契約によっては、歯科治療や視力治療、メンタルヘルス・サービス、その他のヘルスケア・ニーズまでカバーされる場合もあります。
高血圧症、ヒト免疫不全ウイルス(HIV)、がん、心臓疾患、嚢胞性線維症、心血管疾患(CVD)、後天性免疫不全症候群(AIDS)などの慢性疾患やウイルス感染の有病率は顕著に増加しています。このような健康課題の増加は、複雑な病状に罹患しやすい高齢者人口の増加と相まって、世界の医療保険需要の大きな原動力となっています。さらに、医療サービスのコスト高騰と外来処置の拡大が、医療保険市場の成長に寄与しています。さらに、多くの国で政府機関が健康保険の重要性に関する啓蒙活動に積極的に取り組んでいます。これは、外科手術の急増につながる深刻な交通事故の発生率の増加と相まって、市場にプラスの影響を与えています。さらに、業界大手各社は幅広い医療保険プランを提供しており、契約者は独自のニーズや嗜好に基づいて最適な保障を選択できるようになっています。さらに、人工知能(AI)、モノのインターネット(IoT)、ビッグデータ分析、保険金請求プロセスや保険契約管理を合理化するための予測分析などの先進技術を組み込んだ医療保険モバイルアプリケーションの出現は、市場に明るい見通しをもたらしています。
慢性疾患とウイルス感染症の増加
現在、慢性疾患やウイルス感染症の増加に伴い、医療保険に加入することの重要性を認識する個人や家族が増加しています。このため、高額な医療費に対する経済的保障を求める人々が増え、医療保険の需要が急増しています。さらに、保険会社は、慢性疾患を持つ人やウイルス感染症にかかるリスクの高い人の特定のニーズに対応する専門的な保険プランを導入しています。こうした保険プランでは、関連治療や医薬品に対する保障が充実しているため、市場を後押ししています。さらに、政府や規制機関は、慢性疾患やウイルス感染が医療保険セクターに与える影響を注意深く監視しています。保険会社が罹患者に十分な保障とサポートを提供できるよう、新たな規制や義務付けが導入されており、これが市場の成長を加速させています。
世界の老人人口の増加
高齢化に伴い、ヘルスケア・サービスや治療がより多く必要となるのが一般的です。このようなヘルスケアサービスに対する需要の高まりが、高齢者の医療保険加入に対する高い需要を後押ししています。加えて、高齢者は加齢に伴う健康状態や、より頻繁な医療介入の必要性から、医療費の増加に直面することが多いです。さらに、高齢者特有の医療ニーズが、高齢者のニーズに合わせた特殊な保険商品を生み出しています。例えば、メディケアは米国の政府プログラムで、65歳以上の高齢者専用の医療保険を提供しています。さらに、保険会社は高齢者向けに革新的な保険商品やサービスを開発しています。これには、介護施設や在宅介護の費用をカバーする長期介護保険や、慢性疾患や処方薬をカバーする保険などがあります。
外科手術の増加
手術は最も高額な医療行為のひとつであることが多いです。健康保険会社は契約者の保険料を設定する際、こうした費用の上昇を考慮する必要があります。さらに、健康保険に加入すれば、外科手術を行う専門医を含む、より幅広い医療提供者のネットワークを利用することができます。外科手術が必要な場合、このような質の高いヘルスケアへのアクセスは不可欠であり、これが製品の普及率を加速させています。その上、健康保険プランには予防措置や診断検査に対する保険が含まれていることが多いです。これは早期発見・早期介入につながり、将来、より大規模な手術の必要性を減らす可能性があります。さらに、外科手術の多くは、心臓病、糖尿病、肥満などの慢性的な健康状態に関連しています。これらの病態の有病率が増加するにつれて、手術の必要性も増加するため、健康保険はこれらの長期的な健康問題を管理するための重要なリソースとなります。
Figure 81 Mexico: Health Insurance Market: Sales Value (in Million US$), 2018 & 2023
The global health insurance market size reached US$ 1,835.9 Billion in 2023. Looking forward, IMARC Group expects the market to reach US$ 3,208.4 Billion by 2032, exhibiting a growth rate (CAGR) of 6.2% during 2024-2032. The rising prevalence of chronic diseases and viral infections, the growing geriatric population which is more prone to complicated medical conditions, and the growing number of surgical procedures are some of the major factors propelling the market.
Health insurance is a financial arrangement that provides individuals and families with coverage for medical expenses. It is a contract between an individual (the policyholder) and an insurance company or healthcare provider. In exchange for regular premium payments, the insurance company agrees to cover a portion or all of the policyholder's eligible medical costs, depending on the terms and conditions of the policy. The policy specifies what medical services and expenses are covered. This can include doctor's visits, hospitalization, prescription medications, preventive care, surgeries, and more. Coverage may also extend to dental and vision care, mental health services, and other healthcare needs, depending on the policy.
There is a notable increase in the prevalence of chronic diseases and viral infections, including conditions like hypertension, human immunodeficiency virus (HIV), cancer, heart disorders, cystic fibrosis, cardiovascular disease (CVD), and acquired immunodeficiency syndrome (AIDS). This rise in health challenges, combined with a growing elderly population, which is more susceptible to complex medical conditions, represents a major driver for the global demand for health insurance. Additionally, the escalating costs of medical services and the expanding array of outpatient procedures are contributing to the growth of the health insurance market. Furthermore, government agencies in numerous countries are actively engaged in awareness campaigns about the importance of health insurance. This, coupled with the increasing incidence of severe road accidents leading to a surge in surgical procedures, is positively impacting the market. Moreover, prominent industry players are offering a wide range of health insurance plans, empowering policyholders to select the most suitable coverage based on their unique needs and preferences. Additionally, the emergence of health insurance mobile applications incorporating advanced technologies such as artificial intelligence (AI), the internet of things (IoT), big data analytics, and predictive analysis to streamline the claims process and policy management is providing a positive outlook for the market.
Rising prevalence of chronic diseases and viral infections
Presently, with the increase in chronic diseases and viral infections, more individuals and families recognize the importance of having health insurance coverage. This has led to a surge in the demand for health insurance policies as people seek financial protection against high medical expenses. Moreover, insurers are introducing specialized insurance plans that cater to the specific needs of individuals with chronic conditions or those at higher risk of contracting viral infections. These plans offer enhanced coverage for related treatments and medications thus propelling the market. Besides, governments and regulatory bodies are closely monitoring the impact of chronic diseases and viral infections on the health insurance sector. New regulations and mandates are being introduced to ensure that insurers provide adequate coverage and support for affected individuals which is accelerating the market growth.
Growing geriatric population across the globe
As individuals age, they typically require more healthcare services and treatments. This increased demand for healthcare services drives a higher demand for health insurance coverage among the elderly. Besides, older individuals often face higher healthcare costs due to age-related health conditions and the need for more frequent medical interventions. Moreover, the unique healthcare needs of the elderly population have given rise to specialized insurance products tailored to their requirements. Medicare, for instance, is a government program in the United States that provides health coverage specifically for individuals aged 65 and older. Additionally, insurers are developing innovative insurance products and services to cater to the elderly population. These include long-term care insurance, which covers the costs of nursing home care or in-home care, and policies that provide coverage for chronic conditions and prescription medications.
Increasing number of surgical procedures
Surgeries are often among the most expensive medical treatments. Health insurance companies need to account for these rising costs when setting premiums for their policyholders. Moreover, with health insurance, individuals can access a broader network of healthcare providers, including specialists who perform surgical procedures. This access to quality healthcare is essential when surgical interventions are required, which is accelerating the product adoption rate. Besides, health insurance plans often include coverage for preventive measures and diagnostic tests. This can lead to early detection and intervention, potentially reducing the need for more extensive surgeries in the future. Additionally, many surgical procedures are related to chronic health conditions, such as heart disease, diabetes, and obesity. As the prevalence of these conditions increases, so does the need for surgeries, making health insurance a vital resource for managing these long-term health issues.
IMARC Group provides an analysis of the key trends in each segment of the global health insurance market report, along with forecasts at the global, regional, and country levels for 2024-2032. Our report has categorized the market based on provider, type, plan type, demographics, and provider type.
Private Providers
Public Providers
Private providers hold the largest market share
The report has provided a detailed breakup and analysis of the market based on the provider. This includes private providers and public providers. According to the report, private providers represented the largest segment.
Private health insurance providers often offer a wide range of insurance products tailored to different customer needs. These offerings include individual plans, family plans, group plans for employers, and specialized coverage options. This diversity allows them to cater to a broader customer base. Besides, private insurers are known for their ability to innovate and customize insurance plans. They can adapt quickly to changing market demands and introduce new features, such as telemedicine services, wellness programs, and personalized health management tools. Moreover, private insurers often have extensive networks of healthcare providers, including hospitals, clinics, and specialists. These networks provide policyholders with a wide choice of healthcare providers and facilities, enhancing the attractiveness of their insurance plans.
Life-Time Coverage
Term Insurance
Life-time coverage accounts for the majority of market share
A detailed breakup and analysis of the market based on the type has also been provided in the report. This includes life-time coverage and term insurance. According to the report, life-time coverage represented the largest segment.
Lifetime coverage provides policyholders with long-term security and peace of mind. It assures them that their health insurance needs will be met throughout their lifetime, regardless of changing health conditions or age-related issues. Besides, in many cases, lifetime coverage comes with stable premium rates due to which policyholders can lock in a relatively consistent premium amount, making it easier to budget for healthcare expenses over the long term. Moreover, lifetime coverage often offers comprehensive benefits, including coverage for major medical expenses, hospitalization, surgeries, and even preventive care. This makes it a comprehensive solution for policyholders' healthcare needs.
Medical Insurance
Critical Illness Insurance
Family Floater Health Insurance
Others
Medical insurance represents the most popular plan type
A detailed breakup and analysis of the market based on the plan type has also been provided in the report. This includes medical insurance, critical illness insurance, family floater health insurance, and others. According to the report, medical insurance represented the largest segment.
Medical insurance provides coverage for a wide range of healthcare services, including doctor visits, hospital stays, surgeries, prescription drugs, and preventive care. This comprehensive coverage addresses the most fundamental healthcare needs of individuals and families. Besides, healthcare costs can be substantial, and unexpected medical expenses can lead to financial hardship. Medical insurance offers a safety net by covering a significant portion of these costs, reducing the financial burden on policyholders. Moreover, medical insurance plans often include coverage for preventive services like vaccinations, screenings, and wellness check-ups. This encourages individuals to prioritize preventive care, which can lead to early detection and treatment of health issues.
Minor
Adults
Senior Citizen
Adults accounts for the majority of market share
A detailed breakup and analysis of the market based on the demographics has also been provided in the report. This includes minor, adults, and senior citizen. According to the report, adults hold the largest market share.
Many adults obtain health insurance through their employers. Since the majority of adults are part of the workforce, they have access to employer-sponsored health insurance plans. This contributes significantly to the market share held by adults. Moreover, adults often secure health insurance policies that cover their entire families, including children and sometimes elderly parents. This means that one adult's health insurance policy can account for coverage for multiple individuals, further increasing their market share. In addition, insurance companies offer a range of health insurance products tailored to adults, such as individual policies, family plans, and plans with specific benefits for adults, like maternity coverage or preventive care.
Preferred Provider Organizations (PPOs)
Point of Service (POS)
Health Maintenance Organizations (HMOs)
Exclusive Provider Organizations (EPOs)
Preferred provider organizations (PPOs) represent the most popular provider type
A detailed breakup and analysis of the market based on the provider type has also been provided in the report. This includes preferred provider organizations (PPOs), point of service (POS), health maintenance organizations (HMOs), and exclusive provider organizations (EPOs). According to the report, preferred provider organizations (PPOs) represented the largest segment.
PPOs offer policyholders a significant degree of flexibility when it comes to choosing healthcare providers. Unlike Health Maintenance Organizations (HMOs), which often require members to select a primary care physician and obtain referrals for specialist care, PPOs allow individuals to see any healthcare provider, specialist, or hospital of their choice. This flexibility is highly valued by consumers who want control over their healthcare decisions. Besides, PPOs typically provide coverage for both in-network and out-of-network healthcare services. While staying in-network usually results in lower out-of-pocket costs, the option to seek care outside the network is important for individuals who may need specialized or out-of-area services. This flexibility can be especially beneficial in emergencies or when seeking care from specific specialists.
North America
United States
Canada
Asia-Pacific
China
Japan
India
South Korea
Australia
Indonesia
Others
Europe
Germany
France
United Kingdom
Italy
Spain
Russia
Others
Latin America
Brazil
Mexico
Others
Middle East and Africa
North America exhibits a clear dominance in the market
The market research report has also provided a comprehensive analysis of all the major regional markets, which include North America (the United States and Canada); Asia Pacific (China, Japan, India, South Korea, Australia, Indonesia, and others); Europe (Germany, France, the United Kingdom, Italy, Spain, Russia, and others); Latin America (Brazil, Mexico, and others); and the Middle East and Africa. According to the report, North America accounted for the largest market share.
North America, particularly the United States and Canada, has a large and affluent population. This creates a substantial customer base for health insurance providers. The ability to serve millions of customers across diverse demographic groups contributes to the market's size and influence. Besides, the healthcare systems in the United States and Canada are relatively complex, with a mix of public and private providers. This complexity has led to a robust health insurance market where individuals and employers often purchase private health insurance to supplement government-sponsored healthcare programs like Medicare and Medicaid in the U.S. Additionally, healthcare costs in North America are among the highest in the world. This includes expenses related to medical treatments, prescription drugs, hospital stays, and specialized care. Due to these high costs, individuals and businesses seek health insurance coverage to mitigate the financial burden of healthcare expenses.
The competitive landscape of the market is characterized by the presence of multiple players that include established brands, emerging startups, and specialty manufacturers. Presently, leading companies are investing heavily in digital technologies to enhance customer experiences. This includes user-friendly mobile apps and online portals for claims processing, policy management, and customer support. They are also leveraging data analytics and artificial intelligence (AI) to better understand customer needs, identify fraud, and improve underwriting processes. Predictive analytics help insurers in risk assessment and pricing, leading to more accurate premiums. Moreover, many health insurers are offering wellness programs and incentives to encourage policyholders to adopt healthier lifestyles. These programs may include discounts for gym memberships, rewards for meeting health goals, or access to wellness apps and coaching.
Aetna Inc. (CVS Health Corporation)
AIA Group Limited
Allianz SE
Aviva Plc
Berkshire Hathaway Inc.
Cigna Corporation
International Medical Group Inc. (Sirius International Insurance Group Ltd.)
Prudential Plc
United Health Group Inc.
Zurich Insurance Group AG
In November 2022, Berkshire Hathaway announced its partnership with Canada-based SoNomad to offer travel medical insurance. The soNomad Travel Medical Insurance policies are underwritten by the National Liability and Fire Insurance Company in Canada.
In April 2021, Molina Healthcare Inc. and Cigna Corporation signed a merger agreement where the former took ownership of Cigna's Texas Medicaid and Medicare-Medicaid Plan (MMP) as part of this agreement. This merger strengthens Molina Healthcare's position in the market and broadens its healthcare offerings to cater to a broader population.
UnitedHealthcare launched "MyScriptRewards" to provide financial incentives to members who choose lower-cost prescription medications. They also expanded their virtual care offerings to include behavioral health services, making mental health support more accessible.