Australia Private Health Insurance Market - Industry Trends and Forecast to 2029

Australia Private Health Insurance Market, By Type (Critical Illness Insurance, Individual Health Insurance, Family Health Insurance, Disease-Specific Insurance and Others), Health Plan Category/Metal Levels (Bronze, Silver, Gold Platinum and Others), Provider Type (Health Maintenance Organizations (HMOS), Preferred Provider Organizations (PPOS), Exclusive Provider Organizations (EPOS), Point-Of-Service (POS) Plans, High-Deductible Health Plans (HDHPS) and Others), Age Group (Young Adulthood (19-44 Years), Middle Adulthood (45-64 Years) and Older Adulthood (65 Years And Above)), Distribution Channel (Direct Insurance Companies, Insurance Aggregators and Others) Industry Trends and Forecast to 2029.

Market Analysis and Size

A health insurance policy consists of several types of features and benefits. It provides financial coverage to policyholders against certain treatments, health insurance policy offering advantages including cashless hospitalization, pre and posts hospitalization coverage, reimbursement, and various add-ons.

In the health insurance plan, several types of coverage are available: cashless or reimbursement claim. The cashless benefit is available when the policyholder takes treatment from the network hospitals of the insurance company. If the policyholder takes treatment from the hospitals that are not in the list network, in that case, the policyholder meets all the medical expenses and then claims for reimbursement in the insurance company by submitting all the medical bills.

These private health insurance provides financial support to the policy holder as it covers all the medical expenses when the policyholder is hospitalized for the treatment. Data Bridge Market Research analyses that the private health insurance market is expected to reach the value of USD 30,715.92 million by the year 2029, at a CAGR of 2.5% during the forecast period. " Individual Health Insurance” accounts for the most prominent type segment in the respective market owing to rise in private health insurance. The market report curated by the Data Bridge Market Research team includes in-depth expert analysis, import/export analysis, pricing analysis, production consumption analysis, and climate chain scenario.

Market Definition

Health insurance is a type of insurance that provides coverage for all kinds of surgical expenses and medical treatment incurred from the illness or injury. Health insurance applies to a comprehensive or limited range of medical services that cover the full or partial costs of specific services. Health insurance provides financial support to the policyholder as it covers all the medical expenses when the policyholder is hospitalized for the treatment. Health insurance also covers pre as well as post-hospitalization expenses.

Regulatory Framework

According to Private Health Insurance (Prudential Supervision) Act 2015

A private health insurer must have at least one health benefits fund. There are regimes governing:

How health benefits funds are operated; and

Changing the health benefits fund to which a policy of insurance is referable; and

Terminating health benefits funds; and

External management of health benefits funds.

COVID-19 had a Minimal Impact on Private Health Insurance Market

COVID-19 impacted various manufacturing and service providing industries in the year 2020-2021 as it led to the closure of workplaces, disruption of supply chains, and restrictions on transportation. Though, the imbalance between demand and supply and its impact on pricing is considered short-term and is expected to recover as this pandemic comes to an end. Due to outbreak of covid19 throughout the globe, the demand for private health insurance has increased tremendously. Also, the fear of pandemic and the increased cost for medical services helped the health insurance market grow during pandemic. In addition, health insurance companies introduced packages and solutions for covering the medical costs for treating covid19 infected insurers. Thus, even though the other industries suffered a lot during covid19 outbreak, the private health insurance industry was growing significantly.

The Market Dynamics of the Private Health Insurance Market Include:

Drivers/Opportunities

• Increasing cost of medical services

Health insurance provides financial support in cases of serious sickness or accident. Increasing medical services’ costs for surgeries and hospital stays has created a new financial epidemic worldwide. The cost of medical services is comprised of the cost of surgery, doctor fee, hospital stay cost, cost of the emergency room, and diagnostic testing cost, among others. Therefore, this increase in the cost of medical services propels the market's growth.

• Growing number of daycare procedures

Daycare procedures are those types of medical procedure or surgery that primarily requires less stay time in the hospitals. In the daycare procedure, patients must stay in the hospital for a short period. Most of the health insurance companies are now covering daycare procedures in their insurance plans, and for the claim of such types of surgery, there is no compulsion on spending 24 hours in the hospital, which is the minimum stay in the hospital claim insurance. While most health insurance plans cover hospital stays and major surgeries, the policyholders can also claim daycare procedures under their health insurance policy, which propels the demand of the market.

• Mandatory opting for health insurance in public and private sector

Buying a healthcare insurance policy is a mandatory provision for employees in the public and private sectors. Health insurance offers key medical benefits which the employee can avail of while working in a corporate. In case of any emergency or medical issues, the health insurance cover is highly useful to meet treatment expenses. The employee’s health insurance is an extended benefit the individual employer gives to their employees. The health insurance provided covers with the employee and covers their family members under the same policy plan. Also, in certain cases, the employer may pay a part of a premium or insurance coverage of the health insurance policy.

• Increasing old age population

Old age people are likely to get sicker or have health problems due to ageing and weak immune system such as dental issues, heart issues, cancer issues and terminal illness. A good senior citizen health insurance can help senior citizens to opt for good health insurance services to reduce future financial worries. Thus increasing number of old age population can boost the demand for health insurance market.

• Increasing awareness about the benefits of health insurance

In the face of a medical emergency, health insurance allows the consumers to take their mind off the stress related to healthcare costs and focus on the treatment instead with health insurance. Medical emergencies can happen at any time, regardless of our current good health or disciplined lifestyle. Therefore, it is important to plan for and protect our families and ourselves from any unforeseen medical situations, especially when there are elderly parents at home as they are more susceptible to infections or other illnesses.

Restraints/Challenges faced by the Private Health insurance Market

• High cost of premiums

Health insurance covers all types of medical treatment costs. It provides financial support to the policyholder since it covers all the medical expenses when the policyholder is hospitalized for the treatment. Health insurance also covers pre as well as post-hospitalization expenses. To purchase health insurance, the policyholder has to pay insurance premiums regularly to keep the health insurance policy active. The cost of insurance premium is high in the majority of cases based on the insurance plan, which is hampering the growth of the market.

• Lack of awareness regarding health insurance

In the field of healthcare, a large portion of the world population is still not aware of the benefits of health insurance policies. The expenses of medical care are increasing across the world with advancements made in the field. Through the advancement in technology, the healthcare sector is one of the growing segments, however, the penetration rate of health insurance policies remains low due to a lack of awareness regarding the benefits offered by them

This private health insurance market report provides details of new recent developments, trade regulations, import-export analysis, production analysis, value chain optimization, market share, the impact of domestic and localized market players, analyses opportunities in terms of emerging revenue pockets, changes in market regulations, strategic market growth analysis, market size, category market growths, application niches and dominance, product approvals, product launches, geographic expansions, technological innovations in the market. To gain more info on the private health insurance market contact Data Bridge Market Research for an Analyst Brief. Our team will help you take an informed market decision to achieve market growth.

Recent Developments

• In March 2021, Medibank Private Limited invested $10 million in health tech company Medinet to support the growing role of virtual health in Australia – part of its strategy to drive better health outcomes by supporting more preventative and integrated care. This development will enhance the company’s image and helps to increase its business.
• In September 2021, HCF partnered with health a rail, transport and energy health fund to provide dedicated and personalized support, services and products to health employees. This development helped company to increase its business.

Australia Private Health Insurance Market Scope

The private health insurance market is segmented on the basis of type, health plan category/metal levels, provider type, age group and distribution channel. The growth amongst these segments will help you analyze meagre growth segments in the industries and provide the users with a valuable market overview and market insights to help them make strategic decisions for identifying core market applications.

Type

• Critical Illness Insurance
• Individual Health Insurance
• Family Health Insurance
• Disease-Specific Insurance
• Others

On the basis of type, the market is segmented into critical illness insurance, individual health insurance, family health insurance, disease-specific insurance and others.

Health Plan Category/Metal Levels

• Bronze
• Silver
• Gold
• Platinum
• Others

On the basis of health plan category/metal levels, the market is segmented into bronze, silver, gold platinum and others. 

 Provider Type

• Health maintenance organizations (HMOS)
• Preferred provider organizations (PPOS)
• Exclusive provider organizations (EPOS)
• Point-of-service (POS) plans
• High-deductible health plans (HDHPS)
• Others

On the basis of provider type, the market is segmented into health maintenance organizations (HMOS), preferred provider organizations (PPOS), exclusive provider organizations (EPOS), point-of-service (POS) plans, high-deductible health plans (HDHPS) and others.

Age Group

• Young Adulthood (19-44 Years)
• Middle Adulthood (45-64 Years)
• Older Adulthood (65 Years And Above)

 On the basis of age group, the market is segmented into young adulthood (19-44 years), middle adulthood (45-64 years) and older adulthood (65 years and above).

Distribution Channel

• Direct Insurance Companies
• Insurance Aggregators
• Others

 On the basis of distribution channel, the market is segmented direct insurance companies, insurance aggregators and others.

Competitive Landscape and Private Health Insurance Market Share Analysis

The private health insurance market competitive landscape provides details by competitor. Details included are company overview, company financials, revenue generated, market potential, investment in research and development, new market initiatives, Australia presence, production sites and facilities, production capacities, company strengths and weaknesses, product launch, product width and breadth, application dominance. The above data points provided are only related to the companies' focus related to private health insurance market.

Some of the major players operating in the private health insurance market are AIA Group Limited (Hong Kong), HCF (Australia), Allianz (Germany), Suncorp Group (Australia), Medibank Private Limited (Australia), HSBC Group (Hong Kong), Tokio Marine (Japan), Great Eastern Holdings Limited (Malaysia), The Royal Automobile Club of WA (Inc.). (Australia), AXA (France), Income (Australia), Aetna Inc. (A subsidiary of CVS Health), Cigna among others.