United States Health And Medical Insurance Market Size
| Study Period | 2020 - 2029 |
| Base Year For Estimation | 2023 |
| Market Size (2024) | USD 1.5 Trillion |
| Market Size (2029) | USD 2.01 Trillion |
| CAGR (2024 - 2029) | 6.00 % |
| Market Concentration | High |
Major Players
*Disclaimer: Major Players sorted in no particular order |
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United States Health And Medical Insurance Market Analysis
The United States Health And Medical Insurance Market size is estimated at USD 1.5 trillion in 2024, and is expected to reach USD 2.01 trillion by 2029, growing at a CAGR of greater than 6% during the forecast period (2024-2029).
The US healthcare system is characterized by high costs for individuals and the lack of universal coverage. The government takes steps to assist economically disadvantaged groups, such as the elderly, disabled, and underprivileged individuals, with healthcare expenses. Due to the absence of a nationwide health insurance system, most Americans rely on their employers for health insurance coverage, either through the employer's plan or by purchasing individual plans directly from insurers. In the market, private health insurance providers compete with each other to provide individuals and families with a variety of healthcare options.
Health insurance provided by employers is an important role to play in the provision of health care, as there are many employers offering healthcare benefits under their workers' compensation packages. This model allows for the sharing of premium costs between employers and employees, often through negotiated group rates with insurance companies. The individual health insurance market serves those without access to employer-sponsored plans or government programs like Medicare and Medicaid, offering plans through the Health Insurance Marketplace established by the Affordable Care Act, as well as directly from insurance companies.
The United States government participates in the health insurance sector through initiatives like Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). Medicare is mainly for individuals aged 65 years and above, while Medicaid and CHIP cater to low-income individuals and families. The Health Insurance Marketplace, also known as the Exchange, is an online application or platform where people can compare and buy health insurance plans from private insurers. These plans are grouped into metal levels (Bronze, Silver, Gold, and Platinum) based on coverage and cost-sharing. The US health insurance market post-COVID is experiencing a surge in demand and evolving coverage options.
In addition, the rising incidences of chronic diseases like diabetes, cancer, heart diseases, and neurodegenerative conditions are expected to boost the uptake of health insurance. The costs linked to treating chronic illnesses such as cancer and heart disease are notably high in the United States. As a result, many individuals opt for health and medical insurance to avoid the sudden financial strain of hefty hospital bills and other medical expenses.
United States Health And Medical Insurance Market Trends
The Online Channel is Expected to Witness New Growth Avenues in the Coming Future
The US health insurance market is experiencing significant growth in the online channel segment between 2024 and 2029. This can be attributed to the convenience of purchasing insurance policies online and the availability of guidance on discounts, offers, and plans provided by insurance companies. These factors enhance consumer confidence in online insurance purchases. The online segment is expected to witness rapid expansion due to the widespread use of the internet and smartphones, advancements in technology, changes in consumer purchasing behavior driven by digitalization, a wide range of insurance products available, and the abundance of discounts and offers on insurance websites. In order to streamline the insurance process, companies are using technology like artificial intelligence, chatbots, and machine learning. For example, AI enables health insurers to collect, analyze, and utilize large volumes of healthcare data to identify new business opportunities and optimize risk management. Additionally, AI can be integrated into insurance software to enhance medical billing while ensuring compliance with HIPAA regulations.
The Private Health Insurance (PHI) Segment is Expected to Fuel the Market Growth in the United States
Private health insurance plans in the United States generally fall into two categories, which include group health insurance and individual health insurance. Group health insurance is usually offered by employers to their employees and often provides coverage for dependents. Individuals and families can buy individual health insurance directly from insurance companies or through a health insurance marketplace.
Private health insurance plans vary in terms of their coverage and cost-sharing arrangements. They typically involve a combination of premiums, deductibles, co-payments, and co-insurance. The specific details of coverage and cost-sharing depend on the plan and the insurance provider. A variety of benefits and services, such as hospitalization, outpatient care, prescription drugs, preventive care, and mental health care, are offered by private health insurance plans. The extent of coverage varies among plans, and individuals should review their policy documents to understand what is covered. Private health insurance premiums can vary widely depending on factors such as age, location, plan type, and coverage level. The cost of private health insurance has been a concern for many Americans, and affordability remains a significant challenge for those who do not receive employer-sponsored coverage or qualify for government assistance programs. However, the increasing number of chronic diseases in the United States, including diabetes, colorectal cancer, heart disease, and degenerative diseases, is likely to lead to an increase in private health insurance enrollment. The costs associated with treating chronic conditions, such as cancer or heart disease, are extremely high in the United States. As a result, many people choose to purchase health insurance to avoid the sudden burden of large hospitals and other out-of-pocket costs.
United States Health And Medical Insurance Industry Overview
The US health insurance market is moderately consolidated. The increasing number of new players in the market is expected to increase the competition levels for the established market players. The rapid adoption of advanced technology for improved healthcare, as well as the introduction of new policies, are significant factors influencing the competitive nature. Furthermore, to gain market share, players are employing various strategies such as expansion, merger and acquisition, partnership, and collaboration.Some of the key players operating in the market are UnitedHealth Group, Elevance Health, Cigna Group, HCSC Group, and Centene Corporation.
United States Health And Medical Insurance Market Leaders
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UnitedHealth Group
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HCSC Group
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Centene Corporation
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Elevance Health
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Cigna Group
*Disclaimer: Major Players sorted in no particular order
United States Health And Medical Insurance Market News
- January 2024: HCSC entered into a binding contract with The Cigna Group to purchase its Medicare Advantage, Medicare Supplemental Benefits, Medicare Part D, and CareAllies businesses. This acquisition will bring significant advantages to HCSC's existing and prospective members, as it will strengthen the company's capabilities and expand its presence, especially in the expanding Medicare sector.
- January 2024: Elevance Health announced its plans to acquire Paragon Healthcare Inc., a well-known company specializing in delivering vital infusible and injectable therapies that enhance and preserve lives.
United States Health And Medical Insurance Market Report - Table of Contents
1. INTRODUCTION
- 1.1 Study Assumptions and Market Definition
- 1.2 Scope of the Study
2. RESEARCH METHODOLOGY
3. EXECUTIVE SUMMARY
4. MARKET DYNAMICS
- 4.1 Market Overview
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4.2 Market Drivers
- 4.2.1 Government Subsidized Health Insurance Schemes is Boosting the Sales of Health and Medical Insurance Policies
- 4.2.2 Aging Population in United States and increasing Healthcare Costs
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4.3 Market Restraints
- 4.3.1 Rising Costs and Limited Coverage
- 4.3.2 Increasing Regulatory complexity
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4.4 Market Opportunities
- 4.4.1 Innovative Digital Health Solutions
- 4.4.2 Merger and Acquisition with the Companies
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4.5 Porter's Five Forces Analysis
- 4.5.1 Threat of New Entrants
- 4.5.2 Bargaining Power of Buyers/Consumers
- 4.5.3 Bargaining Power of Suppliers
- 4.5.4 Threat of Substitute Products
- 4.5.5 Intensity of Competitive Rivalry
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4.6 Government Regulations and Initiatives
- 4.6.1 Brief on Patient Protection and Affordable Care Act (ACA) and its implications on the Overall Health Insurance Coverage
- 4.6.2 Insights on Latest Healthcare Policy Changes and their Effect on the Health Spending by US Citizens
- 4.7 Brief on Health Insurance Premiums and Study on the Effect of Medical Trend Rate on Health Plans
- 4.8 Insights on the Growing Online Sales of Health Insurance and the Growth Prospects in Health Insurance Sector
- 4.9 Technological Advancement and Innovation in Health Insurance Sector
- 4.10 The Impact of the COVID-19 Pandemic on the US health Insurance market
5. MARKET SEGMENTATION
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5.1 By Procurement Type
- 5.1.1 Directly/individually Purchased
- 5.1.2 Employer-Based
- 5.1.2.1 Small Group Market
- 5.1.2.2 Large Group Market
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5.2 By Products and Services Offered
- 5.2.1 Pharmacy Benefit Management
- 5.2.2 High Deductible Health Plans
- 5.2.3 Free-For-Service Plans
- 5.2.4 Managed Care Plans
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5.3 By Place of Purchase
- 5.3.1 On Exchange
- 5.3.2 Off Exchange
6. COMPETITIVE LANDSCAPE
- 6.1 Market Concentration Overview
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6.2 Company Profiles
- 6.2.1 UnitedHealth Group
- 6.2.2 Elevance Health
- 6.2.3 Cigna Group
- 6.2.4 HealthCare Services Group Inc.
- 6.2.5 Centene Corporation
- 6.2.6 Aetna Inc.
- 6.2.7 Kaiser Foundation Group
- 6.2.8 Independence Health Group
- 6.2.9 Molina Healthcare
- 6.2.10 Guidewell Mutual Holding
- 6.2.11 Humana
- 6.2.12 CVS Health*
- *List Not Exhaustive
7. FUTURE MARKET TRENDS
8. DISCLAIMER AND ABOUT US
United States Health And Medical Insurance Industry Segmentation
Health insurance is a type of insurance that covers medical expenses that arise due to an illness. A complete background analysis of the US Health Insurance industry, including an assessment of the national health accounts, economy, and emerging market trends by segments, significant changes in market dynamics, and market overview, is covered in the report. The market is segmented by procurement type, products and services, and place of purchase. By procurement type, the market is segmented as directly purchased and employer-sponsored. By products and services, the market is segmented into pharmacy benefit management, high-deductible health plans, free-for-service plans, and managed care plans. By place of purchase, the market is segmented as on exchange and off exchange. The report offers market size forecasts for the US health insurance market in terms of revenue (USD) for all the above segments.
| By Procurement Type | Directly/individually Purchased | |
| Employer-Based | Small Group Market | |
| Large Group Market | ||
| By Products and Services Offered | Pharmacy Benefit Management | |
| High Deductible Health Plans | ||
| Free-For-Service Plans | ||
| Managed Care Plans | ||
| By Place of Purchase | On Exchange | |
| Off Exchange |
United States Health And Medical Insurance Market Research Faqs
How big is the United States Health And Medical Insurance Market?
The United States Health And Medical Insurance Market size is expected to reach USD 1.5 trillion in 2024 and grow at a CAGR of greater than 6% to reach USD 2.01 trillion by 2029.
What is the current United States Health And Medical Insurance Market size?
In 2024, the United States Health And Medical Insurance Market size is expected to reach USD 1.5 trillion.
Who are the key players in United States Health And Medical Insurance Market?
UnitedHealth Group, HCSC Group, Centene Corporation, Elevance Health and Cigna Group are the major companies operating in the United States Health And Medical Insurance Market.
What years does this United States Health And Medical Insurance Market cover, and what was the market size in 2023?
In 2023, the United States Health And Medical Insurance Market size was estimated at USD 1.41 trillion. The report covers the United States Health And Medical Insurance Market historical market size for years: 2020, 2021, 2022 and 2023. The report also forecasts the United States Health And Medical Insurance Market size for years: 2024, 2025, 2026, 2027, 2028 and 2029.
What factors are driving the growth of the United States Health Insurance Market?
The factors driving the growth of the United States Health Insurance Market are a) Innovations in healthcare technology b) The implementation of the Affordable Care Act (ACA) and technological advancements
United States Health And Medical Insurance Industry Report
The United States health and medical insurance market is experiencing significant growth, driven by increased healthcare expenditure, rising employment, and heightened awareness about health and safety. The market is segmented by demographics, service providers, procurement types, and products and services offered. Key demographic segments include minors, adults, and senior citizens, while service providers are categorized into public and private entities. Procurement types are divided into individually purchased and employer-based plans. The market also offers a variety of products and services, such as pharmacy benefit management, high-deductible health plans, and fee-for-service plans. Technological advancements, such as telemedicine and digital health platforms, are further propelling market growth. The competitive landscape of the U.S. health insurance industry is characterized by a mix of established players and new entrants, with strategies focusing on expansion, mergers, and technological integration to enhance service offerings and customer engagement. Detailed Statistics for the USA Health Insurance market share, size, revenue growth rate, and US health insurance companies provided by Mordor Intelligence™ Industry Reports, include a market forecast outlook and historical overview. Get a sample of this industry analysis as a free report PDF download.
