United States Health Insurance Market, By Type of Insurance Provider (Public, Private), By Type of Coverage (Individual, Family), By Mode of Purchase (Insurance Companies, Insurance Agents/Brokers, Others (Insurtech Companies, Third Party, etc.)), By End User (Minors, Adults, Senior Citizens), By Region, By Competition, Forecast & Opportunities, 2028

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Summary

Report Description

Forecast Period

2024-2028

Market Size (2022)

USD1150.23 Billion

CAGR (2023-2028)

6.30%

Fastest Growing Segment

Private

Largest Market

South Region


United States health insurance market is expected to be driven by the increasing private health insurance provider and rising medical expenditures during the forecast period.

United States Health Insurance Market Scope

Health insurance coverage includes a variety of features and benefits. It protects policyholders financially against certain treatments. Health insurance policies provide benefits, such as cashless hospitalization, pre- and post-hospitalization coverage, reimbursement, and different add-ons.

The health insurance market is served by different types of insurance providers, including private and public. The public health insurance plans include Medicare, Medicaid, and children’s health insurance programs, and the private health insurance plans include preferred provider organizations (PPO), health maintenance organizations (HMO), and others. The health insurance market in the United States is highly competitive, with multiple market players offering a diverse variety of health insurance products and services.

United States Health Insurance Market Overview

The United States health insurance market has experienced significant growth over the past decade, driven by several factors, such as rising healthcare costs, increasing awareness of health insurance, and a surging population.

The rising prevalence of chronic diseases, such as diabetes, cancer, cardiovascular disease, and neurological diseases, is predicted to increase the need for health insurance in the country. According to the International Diabetes Federation, the United States was expected to have 32.2 million diabetes cases in 2021. By 2030, the number of cases is expected to reach 34.7 million. The expense of treating chronic diseases, such as cancer and heart disease, is extremely high in the country. As a result, many people seek health insurance to avoid the unexpected burden of having to pay large sums of money for hospitals and other medical expenditures.

The health insurance market is a changing regulatory landscape. The Affordable Care Act (ACA) has introduced several reforms to the market, such as enforcing insurers to cover pre-existing conditions and provide minimum essential benefits. The Trump administration repealed the individual mandate penalty, which resulted in fewer people signing up for insurance coverage. However, the Biden administration has reinstated the mandate and proposed further changes, such as expanding Medicaid and increasing subsidies to make insurance more affordable for lower-income Americans.

United States Health Insurance Market Drivers

The cost of healthcare in the United States is rising, and this has a significant effect on market demand for health insurance. In 2021, the United States spent USD 12,914 on healthcare per person, which was USD 5,000 higher than the average in comparable high-income countries.

As healthcare providers continue to invest in new treatments and technologies, the cost of healthcare is likely to remain rising, thus fueling the need for insurers to manage costs while providing adequate coverage to their customers. For instance, according to the United States Census Bureau, in 2021, 216 million individuals had private health insurance, while 117 million had public health insurance in the country. However, the coverage estimates are not mutually exclusive because people avail more than one type of health insurance during the year, the aggregate of those numbers is greater than the country’s U.S. population.

This factor has been essential in boosting the uptake of health insurance among consumers, who often require health insurance coverage.

Furthermore, the growing number of private insurance programs in the country has added to the market for health insurance. According to the National Association of Insurance Commissioners (NAIC), more than 68% of healthcare coverage was provided by private insurance programs, such as PPOs, HMOs, and POS plans. In 2019, the top 25 insurers in the United States accounted for around USD 130 billion, with more than 60% coming from the top 25 health insurers. As of 2019, approximately 6% of Americans acquire non-group health insurance, 50% have insurance provided by the employer, 35% have Medicaid or Medicare insurance, and around 9% are uninsured.

United States Health Insurance Market Trends

The United States health insurance market is constantly evolving, driven by the shift towards consumer-driven healthcare, where individuals are taking a more active role in managing their own health and healthcare spending. As consumers are paying more out of pocket than they would under traditional health plans, this has led to an increase in high-deductible health plans and other insurance types. This factor is expected to boost the market growth of health insurance during the forecast period,

Additionally, the use of technology in healthcare has been on the rise, with many insurers and providers offering mobile apps and other digital tools to help patients manage their health. The emergence of telemedicine has also boosted the health insurance market in the US. Telemedicine, which allows patients to receive care remotely through video consultations and other digital tools, became increasingly popular during the COVID-19 pandemic, as patients were asked to avoid in-person visits whenever possible. Many insurers have begun offering coverage for telemedicine services, allowing them to connect to a doctor via phone or on a video call. Two of the key insurers that are providing telemedicine coverage are Anthem Inc., offering telehealth Services, and Cigna, offering online doctor visits for some of its members. Going forward, this trend is likely to continue over the next few years.

United States Health Insurance Market Challenges

The United States health insurance market faces several challenges that impact both insurers and consumers. One major challenge is the high cost of healthcare in the United States, which drives up the cost of health insurance premiums and makes it difficult for many people to afford the coverage. The cost of healthcare is fueled by a variety of factors, including the high cost of prescription drugs, expensive medical procedures, and a shortage of primary care providers.

Another challenge in the United States health insurance market is the complexity of the system, which can make it difficult for consumers to understand their coverage and make informed choices about their healthcare. The system is characterized by a wide range of plans with varying levels of coverage, copayments, deductibles, and other features, which can be confusing for many consumers. Additionally, the administrative burden of managing insurance claims and payments can be overwhelming for healthcare providers.

United States Health Insurance Market Recent Development

  • In 2021, the company JP Morgan Chase launched Morgan Health, a new business unit focused on improving healthcare for 285,000 employees and dependents covered by JPMorgan’s health insurance plan, and the millions of people in the U.S. with employer-sponsored insurance.
  • In 2022, the Department of Health and Human Services (HHS) introduced a new policy to allow American consumers to find affordable healthcare coverage easily on HealthCare.gov during the next Open Enrollment Period. The new policy includes new standardized “plan options, such as maximum out-of-pocket limitations, deductibles, and cost-sharing features.

United States Health Insurance Market Opportunities

The United States offers ample opportunities for health insurance companies to expand their offerings beyond traditional health insurance products. For example, health insurance companies engage their clients by offering wellness programmes and other services that encourage healthy lifestyles and avoid chronic diseases. Therefore, various companies, such as “United Healthcare Services Inc.,” are offering ancillary products and services, including dental insurance and vision insurance plans, to differentiate themselves within the market and obtain a significant share. These factors are likely to improve the market's opportunities throughout the forecast periods.

Additionally, with the rising healthcare cost, there is a growing demand for affordable health insurance options. Insurers can tap into this market by offering cost-effective plans that provide essential health benefits.


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Market Segmentation

The United States health insurance market is segmented based on the insurance provider, type of coverage, mode of purchase, end user, region, and competitive landscape. Based on the type of insurance provider, the market is classified into public and private. Based on the type of coverage, the market is divided into individuals and family. Based on the mode of purchase, the market is divided into insurance companies, insurance agents/brokers, and others (insurtech companies, third party, etc.). Based on end user, the market is categorized into minors, adults, and senior citizens. Regionally, the United States health insurance market is segmented into South, Midwest, West, and Northeast.

Company Profiles

Anthem Insurance Companies, Inc., United HealthCare Services, Inc., State Farm Mutual Automobile Insurance Company, Centene Corporation, Cigna Corporation, International Medical Group, Inc., Humana Group, Health Care Service Corporation (HCSC), CVS Health Corporation, and Oscar Health, Inc. are the key players in the platform that lead the United States health insurance market.

Attribute

Details

Base Year

2022

Historical Years

2018 – 2021

Estimated Year

2023

Forecast Period

2024 – 2028

Quantitative Units

Revenue in USD Million, and CAGR for 2018-2023 and 2023-2028

Report Coverage

Revenue forecast, company share, competitive landscape, growth factors, and trends

Segments Covered

Type of Insurance Provider

Type of Coverage

Mode of Purchase

End User

Region

Regional Scope

South, Midwest, West, and Northeast

Key Companies Profiled

Anthem Insurance Companies, Inc., United HealthCare Services, Inc., State Farm Mutual Automobile Insurance Company, Centene Corporation, Cigna Corporation, International Medical Group, Inc., Humana Group, Health Care Service Corporation (HCSC), CVS Health Corporation, Oscar Health, Inc.

Customization Scope

10% free report customization with purchase. Addition or alteration to country, regional & segment scope.

Pricing and Purchase Options

Avail customized purchase options to meet your exact research needs. Explore purchase options

Delivery Format

PDF and Excel through Email (We can also provide the editable version of the report in PPT/pdf format on special request)

 

Report Scope:

In this report, the United States health insurance market has been segmented into the following categories, in addition to the industry trends which have also been detailed below:

  • United States Health Insurance Market, By Type of Insurance Provider:
    • Public
    • Private
  • United States Health Insurance Market, By Type of Coverage:
    • Individual
    • Family
  • United States Health Insurance Market, By Mode of Purchase:
    • Insurance Companies
    • Insurance Agents/Brokers
    • Others
  • United States Health Insurance Market, By End User:
    • Minors
    • Adults
    • Senior Citizens
  • United States Health Insurance Market, By Region:
    • South
    • Midwest
    • West
    • Northeast
  • Competitive Landscape

Company Profiles: Detailed analysis of the major companies present in the United States health insurance market.

Available Customizations:

With the given market data, TechSci Research offers customizations according to a company’s specific needs. The following customization options are available for the report:

Company Information

  • Detailed analysis and profiling of additional market players (up to five).

The United States health insurance market is an upcoming report to be released soon. If you wish an early delivery of this report or want to confirm the date of release, please contact us at [email protected]

Table of content

1.    Introduction

1.1.  Product Overview

1.2.  Key Highlights of the Report

1.3.  Market Coverage

1.4.  Market Segments Covered

1.5.  Research Tenure Considered

2.    Research Methodology

2.1.  Objective of the Study

2.2.  Baseline Methodology

2.3.  Key Industry Partners

2.4.  Major Association and Secondary Sources

2.5.  Forecasting Methodology

2.6.  Data Triangulation & Validation

2.7.  Assumptions and Limitations

3.    Executive Summary      

3.1.  Market Overview

3.2.  Market Forecast

3.3.  Key Regions

3.4.  Key Segments

4.    Voice of Customer Analysis (B2C Model Analysis)

4.1.  Brand Awareness

4.2.  Factors Influencing Purchase Decision

4.3.  Sources of Information

5.    United States Health Insurance Market Outlook

5.1.  Market Size & Forecast

5.1.1.    By Value

5.2.  Market Share & Forecast

5.2.1.    By Type of Insurance Provider Market Share Analysis (Public, Private)

5.2.2.    By Type of Coverage Market Share Analysis (Individual, Family)

5.2.3.    By Mode of Purchase Market Share Analysis (Insurance Companies, Insurance Agents/Brokers, and Others (Insurtech Companies, Third Party, etc.).

5.2.4.    By End User Market Share Analysis (Minors, Adults, Senior Citizens)

5.2.5.    By Regional Market Share Analysis

5.2.5.1.        South Market Share Analysis

5.2.5.2.        Midwest Market Share Analysis

5.2.5.3.        West Market Share Analysis

5.2.5.4.        Northeast Market Share Analysis

5.2.6.    By Top 5 Companies Market Share Analysis, Others (2022)

5.3.  United States Health Insurance Market Mapping & Opportunity Assessment

5.3.1.    By Type of Insurance Provider Market Mapping & Opportunity Assessment

5.3.2.    By Type of Coverage Market Mapping & Opportunity Assessment

5.3.3.    By Mode of Purchase Market Mapping & Opportunity Assessment

5.3.4.    By End User Market Mapping & Opportunity Assessment

5.3.5.    By Region Market Mapping & Opportunity Assessment

6.    United States Public Health Insurance Market Outlook

6.1.  Market Size & Forecast       

6.1.1.    By Value

6.2.  Market Share & Forecast

6.2.1.    By Type of Coverage Market Share Analysis

6.2.2.    By Mode of Purchase Market Share Analysis

6.2.3.    By End User Market Share Analysis

7.    United States Private Health Insurance Outlook

7.1.  Market Size & Forecast       

7.1.1.    By Value

7.2.  Market Share & Forecast

7.2.1.    By Type of Coverage Market Share Analysis

7.2.2.    By Mode of Purchase Market Share Analysis

7.2.3.    By End User Market Share Analysis

8.    Market Dynamics

8.1.  Drivers

8.1.1.    Increase healthcare expenditure.

8.1.2.    Increasing number of chronic illnesses

8.1.3.    New product offering

8.2.  Challenge

8.2.1.    High competition

8.2.2.    Rising insurance rates

9.    Impact of COVID-19 on United States Health Insurance Market

9.1.  Impact Assessment Model  

9.1.1.    Key Segments Impacted

9.1.2.    Key Regions Impacted

10. Market Trends & Developments

10.1.              Advantages of health insurance policies

10.2.              Innovative marketing techniques

10.3.              Growing number of private insurance programs

10.4.              Rising Number of Government Initiatives

11. SWOT Analysis

11.1.              Strengths

11.2.              Weaknesses

11.3.              Opportunities

11.4.              Threats

12. United States Economic Profile

13. Policy & Regulatory Landscape

14. Competitive Landscape

14.1.              Company Profiles

14.1.1. Anthem Insurance Companies, Inc.

14.1.1.1.     Company Details

14.1.1.2.     Product & Services

14.1.1.3.     Financials (As per availability)

14.1.1.4.     Key Market Focus

14.1.1.5.     Recent Developments

14.1.1.6.     Key Management Personnel

14.1.2. United HealthCare Services, Inc.

14.1.2.1.     Company Details

14.1.2.2.     Product & Services

14.1.2.3.     Financials (As per availability)

14.1.2.4.     Key Market Focus

14.1.2.5.     Recent Developments

14.1.2.6.     Key Management Personnel

14.1.3. State Farm Mutual Automobile Insurance Company

14.1.3.1.     Company Details

14.1.3.2.     Product & Services

14.1.3.3.     Financials (As per availability)

14.1.3.4.     Key Market Focus

14.1.3.5.     Recent Developments

14.1.3.6.     Key Management Personnel

14.1.4. Centene Corporation

14.1.4.1.     Company Details

14.1.4.2.     Product & Services

14.1.4.3.     Financials (As per availability)

14.1.4.4.     Key Market Focus

14.1.4.5.     Recent Developments

14.1.4.6.     Key Management Personnel

14.1.5. Cigna Corporation

14.1.5.1.     Company Details

14.1.5.2.     Product & Services

14.1.5.3.     Financials (As per availability)

14.1.5.4.     Key Market Focus

14.1.5.5.     Recent Developments

14.1.5.6.     Key Management Personnel

14.1.6. International Medical Group, Inc.

14.1.6.1.     Company Details

14.1.6.2.     Product & Services

14.1.6.3.     Financials (As per availability)

14.1.6.4.     Key Market Focus

14.1.6.5.     Recent Developments

14.1.6.6.     Key Management Personnel

14.1.7. Humana Group

14.1.7.1.     Company Details

14.1.7.2.     Product & Services

14.1.7.3.     Financials (As per availability)

14.1.7.4.     Key Market Focus

14.1.7.5.     Recent Developments

14.1.7.6.     Key Management Personnel

14.1.8. Health Care Service Corporation (HCSC)

14.1.8.1.     Company Details

14.1.8.2.     Product & Services

14.1.8.3.     Financials (As per availability)

14.1.8.4.     Key Market Focus

14.1.8.5.     Recent Developments

14.1.8.6.     Key Management Personnel

14.1.9. CVS Health Corporation

14.1.9.1.     Company Details

14.1.9.2.     Product & Services

14.1.9.3.     Financials (As per availability)

14.1.9.4.     Key Market Focus

14.1.9.5.     Recent Developments

14.1.9.6.     Key Management Personnel

14.1.10.              Oscar Health, Inc.

14.1.10.1.  Company Details

14.1.10.2.  Product & Services

14.1.10.3.  Financials (As per availability)

14.1.10.4.  Key Market Focus

14.1.10.5.  Recent Developments

14.1.10.6.  Key Management Personnel

15. Strategic Recommendations/Action Plan

15.1.              Key Focus Areas

15.2.              Target Type of Coverage

15.3.              Target End User

16. About Us & Disclaimer

 (Note: The companies list can be customized based on the client requirements.)

Figures and Tables

Frequently asked questions

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The average monthly cost of health insurance is USD 539, with a yearly maximum out-of-pocket (MOOP) limit of USD 6,115. This is for a 40-year-old enrolling in a silver plan. However, these prices may vary due to various factors and do not consider cost-sharing reductions or other subsidies.

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Health insurance helps reduce medical expenses, which lowers the cost of care and increases accessibility. In consideration of the country's rising medical costs, it is important to have health insurance to stay protected against financial expenses.

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The increasing health care expenditure, rising prevalence of chronic diseases, and the surge in awareness about the benefits of health insurance plans are driving the United States health insurance market.

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Anthem Insurance Companies, Inc., United HealthCare Services, Inc., State Farm Mutual Automobile Insurance Company, Centene Corporation, Cigna Corporation, International Medical Group, Inc., Humana Group, Health Care Service Corporation (HCSC), CVS Health Corporation, Oscar Health, Inc. are the top 10 players operating in this market.

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Srishti Verma

Business Consultant
Press Release

United States Health Insurance Market to be Led by Public Insurance Providers Through 2028

Jun, 2023

The United States health insurance market is gaining significantly from the rising incidence of chronic diseases and the growing awareness about the benefits of health insurance plans.

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