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、人口統計別、プロバイダータイプ別、地域別、2025年～2033年

医療保険市場の世界市場規模は2024年に1兆9,498億米ドルに達しました。今後、IMARC Groupは、2033年には3兆4,580億米ドルに達し、2025～2033年の成長率（CAGR）は5.9%になると予測しています。慢性疾患やウイルス感染症の流行、複雑な病状にな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。現在、北米が最大の市場シェアを占めているのは、政府が後援するヘルスケア・プログラムの増加によるものです。

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上昇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医療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、市場に明るい展望をもたらしています。

医療保険市場傾向/促進要因：

慢性疾患とウイルス感染の増加

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。

世界の老年人口の増加

高齢になるにつれ、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需要を高めています。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、しばしば高い医療費に直面します。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

手術は最も高額な治療であることが多いです。医療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、医療保険に加入すれば、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、医療保険プランには、予防措置や診断検査の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、医療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。

目次

第1章 序文

第2章 調査範囲と調査手法

• 調査の目的
• ステークホルダー
• データソース
  • 一次情報
  • 二次情報
• 市場推定
  • ボトムアップアプローチ
  • トップダウンアプローチ
• 調査手法

第3章 エグゼクティブサマリー

第4章 イントロダクション

• 概要
• 主要業界動向

第5章 世界の医療保険市場

• 市場概要
• 市場実績
• COVID-19の影響
• 市場予測

第6章 市場内訳：プロバイダー別

• 民間プロバイダー
  • 市場動向
  • 市場予測
• 公共プロバイダー
  • 市場動向
  • 市場予測

第7章 市場内訳：タイプ別

• 生涯補償
  • 市場動向
  • 市場予測
• 定期保険
  • 市場動向
  • 市場予測

第8章 市場内訳：プランタイプ別

• 医療保険
  • 市場動向
  • 市場予測
• 重大疾病保険
  • 市場動向
  • 市場予測
• ファミリーフローター医療保険
  • 市場動向
  • 市場予測
• その他
  • 市場動向
  • 市場予測

第9章 市場内訳：人口統計別

• 未成年
  • 市場動向
  • 市場予測
• 成人
  • 市場動向
  • 市場予測
• 高齢者
  • 市場動向
  • 市場予測

第10章 市場内訳：プロバイダータイプ別

• 優先プロバイダー組織（PPO）
  • 市場動向
  • 市場予測
• ポイントオブサービス（POS）
  • 市場動向
  • 市場予測
• 健康維持機構（HMO）
  • 市場動向
  • 市場予測
• 独占的プロバイダー組織（EPO）
  • 市場動向
  • 市場予測

第11章 市場内訳：地域別

• 北米
  • 米国
  • カナダ
• アジア太平洋地域
  • 中国
  • 日本
  • インド
  • 韓国
  • オーストラリア
  • インドネシア
  • その他
• 欧州
  • ドイツ
  • フランス
  • 英国
  • イタリア
  • スペイン
  • ロシア
  • その他
• ラテンアメリカ
  • ブラジル
  • メキシコ
  • その他
• 中東・アフリカ
  • 市場動向
  • 市場内訳：国別
  • 市場予測

第12章 SWOT分析

• 概要
• 強み
• 弱み
• 機会
• 脅威

第13章 バリューチェーン分析

第14章 ポーターのファイブフォース分析

• 概要
• 買い手の交渉力
• 供給企業の交渉力
• 競合の程度
• 新規参入業者の脅威
• 代替品の脅威

第15章 価格分析

第16章 競合情勢

• 市場構造
• 主要企業
• 主要企業のプロファイル
  • 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

List of Figures

• Figure 1: Global: Health Insurance Market: Major Drivers and Challenges
• Figure 2: Global: Health Insurance Market: Sales Value (in Billion USD), 2019-2024
• Figure 3: Global: Health Insurance Market Forecast: Sales Value (in Billion USD), 2025-2033
• Figure 4: Global: Health Insurance Market: Breakup by Provider (in %), 2024
• Figure 5: Global: Health Insurance Market: Breakup by Type (in %), 2024
• Figure 6: Global: Health Insurance Market: Breakup by Plan Type (in %), 2024
• Figure 7: Global: Health Insurance Market: Breakup by Demographics (in %), 2024
• Figure 8: Global: Health Insurance Market: Breakup by Provider Type (in %), 2024
• Figure 9: Global: Health Insurance Market: Breakup by Region (in %), 2024
• Figure 10: Global: Health Insurance (Private Providers) Market: Sales Value (in Million USD), 2019 & 2024
• Figure 11: Global: Health Insurance (Private Providers) Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 12: Global: Health Insurance (Public Providers) Market: Sales Value (in Million USD), 2019 & 2024
• Figure 13: Global: Health Insurance (Public Providers) Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 14: Global: Health Insurance (Life-Time Coverage) Market: Sales Value (in Million USD), 2019 & 2024
• Figure 15: Global: Health Insurance (Life-Time Coverage) Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 16: Global: Health Insurance (Term Insurance) Market: Sales Value (in Million USD), 2019 & 2024
• Figure 17: Global: Health Insurance (Term Insurance) Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 18: Global: Health Insurance (Medical Insurance) Market: Sales Value (in Million USD), 2019 & 2024
• Figure 19: Global: Health Insurance (Medical Insurance) Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 20: Global: Health Insurance (Critical Illness Insurance) Market: Sales Value (in Million USD), 2019 & 2024
• Figure 21: Global: Health Insurance (Critical Illness Insurance) Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 22: Global: Health Insurance (Family Floater Health Insurance) Market: Sales Value (in Million USD), 2019 & 2024
• Figure 23: Global: Health Insurance (Family Floater Health Insurance) Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 24: Global: Health Insurance (Others) Market: Sales Value (in Million USD), 2019 & 2024
• Figure 25: Global: Health Insurance (Others) Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 26: Global: Health Insurance (Minor) Market: Sales Value (in Million USD), 2019 & 2024
• Figure 27: Global: Health Insurance (Minor) Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 28: Global: Health Insurance (Adults) Market: Sales Value (in Million USD), 2019 & 2024
• Figure 29: Global: Health Insurance (Adults) Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 30: Global: Health Insurance (Senior Citizen) Market: Sales Value (in Million USD), 2019 & 2024
• Figure 31: Global: Health Insurance (Senior Citizen) Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 32: Global: Health Insurance (Preferred Provider Organizations- PPOs) Market: Sales Value (in Million USD), 2019 & 2024
• Figure 33: Global: Health Insurance (Preferred Provider Organizations- PPOs) Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 34: Global: Health Insurance (Point of Service- POS) Market: Sales Value (in Million USD), 2019 & 2024
• Figure 35: Global: Health Insurance (Point of Service- POS) Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 36: Global: Health Insurance (Health Maintenance Organizations- HMOs) Market: Sales Value (in Million USD), 2019 & 2024
• Figure 37: Global: Health Insurance (Health Maintenance Organizations- HMOs) Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 38: Global: Health Insurance (Exclusive Provider Organizations- EPOs) Market: Sales Value (in Million USD), 2019 & 2024
• Figure 39: Global: Health Insurance (Exclusive Provider Organizations- EPOs) Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 40: North America: Health Insurance Market: Sales Value (in Million USD), 2019 & 2024
• Figure 41: United States: Health Insurance Market: Sales Value (in Million USD), 2019 & 2024
• Figure 42: United States: Health Insurance Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 43: Canada: Health Insurance Market: Sales Value (in Million USD), 2019 & 2024
• Figure 44: Canada: Health Insurance Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 45: North America: Health Insurance Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 46: Asia-Pacific: Health Insurance Market: Sales Value (in Million USD), 2019 & 2024
• Figure 47: China: Health Insurance Market: Sales Value (in Million USD), 2019 & 2024
• Figure 48: China: Health Insurance Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 49: Japan: Health Insurance Market: Sales Value (in Million USD), 2019 & 2024
• Figure 50: Japan: Health Insurance Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 51: India: Health Insurance Market: Sales Value (in Million USD), 2019 & 2024
• Figure 52: India: Health Insurance Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 53: South Korea: Health Insurance Market: Sales Value (in Million USD), 2019 & 2024
• Figure 54: South Korea: Health Insurance Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 55: Australia: Health Insurance Market: Sales Value (in Million USD), 2019 & 2024
• Figure 56: Australia: Health Insurance Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 57: Indonesia: Health Insurance Market: Sales Value (in Million USD), 2019 & 2024
• Figure 58: Indonesia: Health Insurance Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 59: Others: Health Insurance Market: Sales Value (in Million USD), 2019 & 2024
• Figure 60: Others: Health Insurance Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 61: Asia-Pacific: Health Insurance Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 62: Europe: Health Insurance Market: Sales Value (in Million USD), 2019 & 2024
• Figure 63: Germany: Health Insurance Market: Sales Value (in Million USD), 2019 & 2024
• Figure 64: Germany: Health Insurance Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 65: France: Health Insurance Market: Sales Value (in Million USD), 2019 & 2024
• Figure 66: France: Health Insurance Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 67: United Kingdom: Health Insurance Market: Sales Value (in Million USD), 2019 & 2024
• Figure 68: United Kingdom: Health Insurance Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 69: Italy: Health Insurance Market: Sales Value (in Million USD), 2019 & 2024
• Figure 70: Italy: Health Insurance Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 71: Spain: Health Insurance Market: Sales Value (in Million USD), 2019 & 2024
• Figure 72: Spain: Health Insurance Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 73: Russia: Health Insurance Market: Sales Value (in Million USD), 2019 & 2024
• Figure 74: Russia: Health Insurance Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 75: Others: Health Insurance Market: Sales Value (in Million USD), 2019 & 2024
• Figure 76: Others: Health Insurance Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 77: Europe: Health Insurance Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 78: Latin America: Health Insurance Market: Sales Value (in Million USD), 2019 & 2024
• Figure 79: Brazil: Health Insurance Market: Sales Value (in Million USD), 2019 & 2024
• Figure 80: Brazil: Health Insurance Market Forecast: Sales Value (in Million USD), 2025-2033

Figure 81 Mexico: Health Insurance Market: Sales Value (in Million USD), 2019 & 2024

• Figure 82: Mexico: Health Insurance Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 83: Others: Health Insurance Market: Sales Value (in Million USD), 2019 & 2024
• Figure 84: Others: Health Insurance Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 85: Latin America: Health Insurance Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 86: Middle East and Africa: Health Insurance Market: Sales Value (in Million USD), 2019 & 2024
• Figure 87: Middle East and Africa: Health Insurance Market: Breakup by Country (in %), 2024
• Figure 88: Middle East and Africa: Health Insurance Market Forecast: Sales Value (in Million USD), 2025-2033
• Figure 89: Global: Health Insurance Industry: SWOT Analysis
• Figure 90: Global: Health Insurance Industry: Value Chain Analysis
• Figure 91: Global: Health Insurance Industry: Porter's Five Forces Analysis

List of Tables

• Table 1: Global: Health Insurance Market: Key Industry Highlights, 2024 and 2033
• Table 2: Global: Health Insurance Market Forecast: Breakup by Provider (in Million USD), 2025-2033
• Table 3: Global: Health Insurance Market Forecast: Breakup by Type (in Million USD), 2025-2033
• Table 4: Global: Health Insurance Market Forecast: Breakup by Plan Type (in Million USD), 2025-2033
• Table 5: Global: Health Insurance Market Forecast: Breakup by Demographics (in Million USD), 2025-2033
• Table 6: Global: Health Insurance Market Forecast: Breakup by Provider Type (in Million USD), 2025-2033
• Table 7: Global: Health Insurance Market Forecast: Breakup by Region (in Million USD), 2025-2033
• Table 8: Global: Health Insurance Market: Competitive Structure
• Table 9: Global: Health Insurance Market: Key Players

The global health insurance market size reached USD 1,949.8 Billion in 2024. Looking forward, IMARC Group expects the market to reach USD 3,458.0 Billion by 2033, exhibiting a growth rate (CAGR) of 5.9% during 2025-2033. 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. At present, North America holds the largest market share owing to increasing government-sponsored healthcare programs.

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.

Health Insurance Market Trends/Drivers:

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.

Health Insurance Industry Segmentation:

Breakup by Provider:

Private Providers

Public Providers

Private providers hold the largest market share

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.

Breakup by Type:

Life-Time Coverage

Term Insurance

Life-time coverage accounts for the majority of market share

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.

Breakup by Plan Type:

Medical Insurance

Critical Illness Insurance

Family Floater Health Insurance

Others

Medical insurance represents the most popular plan type

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.

Breakup by Demographics:

Minor

Adults

Senior Citizen

Adults accounts for the majority of 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.

Breakup by Provider Type:

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

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.

Breakup by Region:

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.

Competitive Landscape:

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.

The market research report has provided a comprehensive analysis of the competitive landscape in the market. Detailed profiles of all major companies have also been provided. Some of the key players in the market include:

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

Key Questions Answered in This Report

• 1. What is the size of the global health insurance market?
• 2. What is the expected growth rate of the global health insurance market?
• 3. What are the key factors driving the global health insurance market?
• 4. What has been the impact of COVID-19 on the global health insurance market?
• 5. What is the breakup of the global health insurance market based on the provider?
• 6. What is the breakup of the global health insurance market based on the type?
• 7. What is the breakup of the global health insurance market based on the plan type?
• 8. What is the breakup of the global health insurance market based on the demographics?
• 9. What is the breakup of the global health insurance market based on the provider type?
• 10. What are the key regions in the global health insurance market?
• 11. Who are the key players/companies in the global health insurance market?

Table of Contents

1 Preface

2 Scope and Methodology

• 2.1 Objectives of the Study
• 2.2 Stakeholders
• 2.3 Data Sources
  • 2.3.1 Primary Sources
  • 2.3.2 Secondary Sources
• 2.4 Market Estimation
  • 2.4.1 Bottom-Up Approach
  • 2.4.2 Top-Down Approach
• 2.5 Forecasting Methodology

3 Executive Summary

4 Introduction

• 4.1 Overview
• 4.2 Key Industry Trends

5 Global Health Insurance Market

• 5.1 Market Overview
• 5.2 Market Performance
• 5.3 Impact of COVID-19
• 5.4 Market Forecast

6 Market Breakup by Provider

• 6.1 Private Providers
  • 6.1.1 Market Trends
  • 6.1.2 Market Forecast
• 6.2 Public Providers
  • 6.2.1 Market Trends
  • 6.2.2 Market Forecast

7 Market Breakup by Type

• 7.1 Life-Time Coverage
  • 7.1.1 Market Trends
  • 7.1.2 Market Forecast
• 7.2 Term Insurance
  • 7.2.1 Market Trends
  • 7.2.2 Market Forecast

8 Market Breakup by Plan Type

• 8.1 Medical Insurance
  • 8.1.1 Market Trends
  • 8.1.2 Market Forecast
• 8.2 Critical Illness Insurance
  • 8.2.1 Market Trends
  • 8.2.2 Market Forecast
• 8.3 Family Floater Health Insurance
  • 8.3.1 Market Trends
  • 8.3.2 Market Forecast
• 8.4 Others
  • 8.4.1 Market Trends
  • 8.4.2 Market Forecast

9 Market Breakup by Demographics

• 9.1 Minor
  • 9.1.1 Market Trends
  • 9.1.2 Market Forecast
• 9.2 Adults
  • 9.2.1 Market Trends
  • 9.2.2 Market Forecast
• 9.3 Senior Citizen
  • 9.3.1 Market Trends
  • 9.3.2 Market Forecast

10 Market Breakup by Provider Type

• 10.1 Preferred Provider Organizations (PPOs)
  • 10.1.1 Market Trends
  • 10.1.2 Market Forecast
• 10.2 Point of Service (POS)
  • 10.2.1 Market Trends
  • 10.2.2 Market Forecast
• 10.3 Health Maintenance Organizations (HMOs)
  • 10.3.1 Market Trends
  • 10.3.2 Market Forecast
• 10.4 Exclusive Provider Organizations (EPOs)
  • 10.4.1 Market Trends
  • 10.4.2 Market Forecast

11 Market Breakup by Region

• 11.1 North America
  • 11.1.1 United States
    • 11.1.1.1 Market Trends
    • 11.1.1.2 Market Forecast
  • 11.1.2 Canada
    • 11.1.2.1 Market Trends
    • 11.1.2.2 Market Forecast
• 11.2 Asia-Pacific
  • 11.2.1 China
    • 11.2.1.1 Market Trends
    • 11.2.1.2 Market Forecast
  • 11.2.2 Japan
    • 11.2.2.1 Market Trends
    • 11.2.2.2 Market Forecast
  • 11.2.3 India
    • 11.2.3.1 Market Trends
    • 11.2.3.2 Market Forecast
  • 11.2.4 South Korea
    • 11.2.4.1 Market Trends
    • 11.2.4.2 Market Forecast
  • 11.2.5 Australia
    • 11.2.5.1 Market Trends
    • 11.2.5.2 Market Forecast
  • 11.2.6 Indonesia
    • 11.2.6.1 Market Trends
    • 11.2.6.2 Market Forecast
  • 11.2.7 Others
    • 11.2.7.1 Market Trends
    • 11.2.7.2 Market Forecast
• 11.3 Europe
  • 11.3.1 Germany
    • 11.3.1.1 Market Trends
    • 11.3.1.2 Market Forecast
  • 11.3.2 France
    • 11.3.2.1 Market Trends
    • 11.3.2.2 Market Forecast
  • 11.3.3 United Kingdom
    • 11.3.3.1 Market Trends
    • 11.3.3.2 Market Forecast
  • 11.3.4 Italy
    • 11.3.4.1 Market Trends
    • 11.3.4.2 Market Forecast
  • 11.3.5 Spain
    • 11.3.5.1 Market Trends
    • 11.3.5.2 Market Forecast
  • 11.3.6 Russia
    • 11.3.6.1 Market Trends
    • 11.3.6.2 Market Forecast
  • 11.3.7 Others
    • 11.3.7.1 Market Trends
    • 11.3.7.2 Market Forecast
• 11.4 Latin America
  • 11.4.1 Brazil
    • 11.4.1.1 Market Trends
    • 11.4.1.2 Market Forecast
  • 11.4.2 Mexico
    • 11.4.2.1 Market Trends
    • 11.4.2.2 Market Forecast
  • 11.4.3 Others
    • 11.4.3.1 Market Trends
    • 11.4.3.2 Market Forecast
• 11.5 Middle East and Africa
  • 11.5.1 Market Trends
  • 11.5.2 Market Breakup by Country
  • 11.5.3 Market Forecast

12 SWOT Analysis

• 12.1 Overview
• 12.2 Strengths
• 12.3 Weaknesses
• 12.4 Opportunities
• 12.5 Threats

13 Value Chain Analysis

14 Porters Five Forces Analysis

• 14.1 Overview
• 14.2 Bargaining Power of Buyers
• 14.3 Bargaining Power of Suppliers
• 14.4 Degree of Competition
• 14.5 Threat of New Entrants
• 14.6 Threat of Substitutes

15 Price Analysis

16 Competitive Landscape

• 16.1 Market Structure
• 16.2 Key Players
• 16.3 Profiles of Key Players
  • 16.3.1 Aetna Inc. (CVS Health Corporation)
    • 16.3.1.1 Company Overview
    • 16.3.1.2 Product Portfolio
    • 16.3.1.3 SWOT Analysis
  • 16.3.2 AIA Group Limited
    • 16.3.2.1 Company Overview
    • 16.3.2.2 Product Portfolio
    • 16.3.2.3 Financials
    • 16.3.2.4 SWOT Analysis
  • 16.3.3 Allianz SE
    • 16.3.3.1 Company Overview
    • 16.3.3.2 Product Portfolio
    • 16.3.3.3 Financials
    • 16.3.3.4 SWOT Analysis
  • 16.3.4 Aviva Plc
    • 16.3.4.1 Company Overview
    • 16.3.4.2 Product Portfolio
    • 16.3.4.3 Financials
    • 16.3.4.4 SWOT Analysis
  • 16.3.5 Berkshire Hathaway Inc.
    • 16.3.5.1 Company Overview
    • 16.3.5.2 Product Portfolio
    • 16.3.5.3 Financials
    • 16.3.5.4 SWOT Analysis
  • 16.3.6 Cigna Corporation
    • 16.3.6.1 Company Overview
    • 16.3.6.2 Product Portfolio
    • 16.3.6.3 Financials
    • 16.3.6.4 SWOT Analysis
  • 16.3.7 International Medical Group Inc. (Sirius International Insurance Group Ltd.)
    • 16.3.7.1 Company Overview
    • 16.3.7.2 Product Portfolio
  • 16.3.8 Prudential Plc
    • 16.3.8.1 Company Overview
    • 16.3.8.2 Product Portfolio
    • 16.3.8.3 Financials
    • 16.3.8.4 SWOT Analysis
  • 16.3.9 United Health Group Inc.
    • 16.3.9.1 Company Overview
    • 16.3.9.2 Product Portfolio
    • 16.3.9.3 Financials
    • 16.3.9.4 SWOT Analysis
  • 16.3.10 Zurich Insurance Group AG
    • 16.3.10.1 Company Overview
    • 16.3.10.2 Product Portfolio
    • 16.3.10.3 Financials
    • 16.3.10.4 SWOT Analysis