Indonesia Private Health Insurance Market – Industry Trends and Forecast to 2030

Indonesia Private Health Insurance Market Analysis and Size

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, coverage of pre and post-hospitalization, reimbursement, and various add-ons.

Increasing costs for medical services and the growing number of daycare procedures are some of the drivers boosting private health insurance demand in the market. With the increasing demand for health insurance, major companies are expanding their product portfolios in different countries to strengthen their presence for these products and solutions in the market.

The major restraint which is impacting the market growth is the high cost of premiums. Also, the strict documentation process for claim reimbursement is acting as a restraint for market growth.

Data Bridge Market Research analyzes that the Indonesia private health insurance market is expected to reach the value of USD 3,321.75 million by 2030, at a CAGR of 2.1% during the forecast period. The product type segment accounts for the largest segment in the Indonesia private health insurance market.    

Market Definition

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

In the health insurance plan, several types of coverage are available that are cashless or claim reimbursement. A cashless benefit is available when the policyholder takes treatment from the network hospitals of the insurance company. If the policyholder takes treatment from 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.

Indonesia Private Health Insurance Market Dynamics

This section deals with understanding the market drivers, opportunities, restraints, and challenges. All of this is discussed in detail below:

DRIVERS

• Increasing Cost of Medical Services

Health insurance provides financial support in case of serious sickness or accident. Increasing medical services’ cost for surgeries and hospital stays has created a new financial epidemic around the world. The cost of medical services includes the cost of surgery, hospital stay cost, cost of an emergency room, diagnostic testing cost, and others.

Health insurance plans give coverage for many different types of surgeries and ailments along with other aspects of medical treatment. Some of the insurances are specific to dental treatment, cancer insurance, terminal illness insurance, and others. Medical costs are increasing rapidly, in many medical cases, health insurance covers ambulance costs, the cost of medicines, hospitalization costs, tests as well as the expenditure of post-hospitalization, due to this, people secure their life by taking health insurance policies. For this reason, the increasing cost of medical services is acting as a driver for market growth.

• Growing Number of Day Care Procedures

Day-care procedures are those types of medical procedures or surgeries that primarily require less stay time in the hospitals. In the daycare procedure, patients are required to stay in the hospital for a short period of time. Most health insurance companies are now covering the procedures of daycare 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 to 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 is expected to propel the market growth.

Due to the technological advancements in the medicinal industry, the daycare procedures that earlier required prolonged stays in hospitals can now be completed in less than 24 hours. Health insurance policies earlier covered only those types of expenses, which involved expensive treatments for critical illnesses that would require prolonged stays in hospitals.

Moreover, policyholders can receive a claim for daycare procedures in both ways, cashless and claim reimbursement, due to which the growing numbers of daycare procedures are growing in the market and are boosting the market growth.

OPPORTUNITY

• Increasing Awareness about the Benefits of Health Insurance

Health insurance is an arrangement whereby an insurance company undertakes to insure medical expenses in the event of an illness or accident that results in hospitalization of the insured. Generally, insurance companies have relationships with major hospitals to provide cashless treatment to individual policyholders along with their family members. They also provide tax benefits on the premium amount paid where the amount paid as a premium for health insurance coverage can be deducted from the taxable income. In the event that the insurance company has no connection with the hospital, it will reimburse the costs incurred by the insured.

In the face of a medical emergency, health insurance allows consumers to take their minds off the stress related to healthcare costs and focus on treatment instead with health insurance. Medical emergencies can happen at any time. 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.

In conclusion, a health insurance policy equips us to get the best healthcare treatment without worrying about the huge costs payable at the time of discharge. This, in turn, increases the demand for private health insurance in southeast Asian countries, which is expected to act as an opportunity for market growth.

RESTRAINT

• High Cost of Premium

Every insurance company has specific guidelines on which to base their premium decisions. In recent years, due to the high cost of medical examination and treatment, the number of people who have medical examinations and treatment covered by health insurance has increased significantly. People are going beyond individual policies and are buying policies for their families to ensure they have a financial cushion in case of an emergency, which in turn increases the price of the premium for that insurance. Moreover, people above the age of 60 have a different bracket of premiums, which depends on the type of health policies and also on the income of consumers. Thus, it puts pressure on the aged people as they have a low range of income and are more prone to diseases.

In conclusion, in order to make up for the broader coverage that the new guidelines now offer, insurers are innovating their products with revised rates, making plans more comprehensive and more expensive for users. This, in turn, decreases the demand for private health insurance and thus, restricts market growth.

CHALLENGE

•  Lack of Awareness Regarding Health Insurance

In the field of healthcare, a large portion of the world's 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.

Some people have a misconception regarding health insurance such as, there is no need for health insurance if an individual is healthy, only cashless insurance exists, the Maternity program will not be covered, buying insurance saves taxes, and more. Most of the population around the world is not aware of the benefits of health insurance. Health insurance provides financial support to patients at the time of their medical treatment, still, most countries believe that buying health insurance is not a worthy investment. This lack of awareness is one of the major hurdles in the penetration of the health insurance sector around the world. Thus, the lack of awareness regarding the benefits of health insurance is acting as a challenge to market growth.

Recent Developments

• In July 2021, Sun Life Indonesia presented Salam Anugerah Keluarga Insurance, a Comprehensive Solution for One Family in One Policy. It is beneficial for the family to take health insurance, which offers all solutions under one policy.
• In January 2021, Cigna announced an additional USD 450.00 million capital investment in Cigna Ventures to drive continuous healthcare transformation, innovation, and growth. Cigna Ventures will use this new funding to continue to invest in companies that are making groundbreaking progress across three primary pillars: insights and analytics, digital health and experience, and care delivery and enablement. This development will bring goodwill to the company.

Indonesia Private Health Insurance Market Scope   

The Indonesia private health insurance market is categorized into nine notable segments based on product type, business solution, assistance/service type, level of coverage, type of insurance plans, demographics, coverage type, end user, and distribution channel. The growth amongst these segments will help you analyze major 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.   

PRODUCT TYPE

• INTO MEDICLAIM INSURANCE
• HOSPITALIZATION COVERAGE INSURANCE
• CRITICAL ILLNESS INSURANCE
• INDIVIDUAL COVERAGE INSURANCE
• FAMILY FLOATER COVERAGE INSURANCE
• SENIOR CITIZEN COVERAGE INSURANCE
• UNIT LINKED HEALTH PLANS
• PERMANENT PRIVATE HEALTH INSURANCE
• OTHERS

Based on product type, the market is segmented into mediclaim insurance, hospitalization coverage insurance, critical illness insurance, individual coverage insurance, family floater coverage insurance, senior citizen coverage insurance, unit linked health plans, permanent private health insurance, and others. 

BUSINESS SOLUTION

• LEAD GENERATION SOLUTIONS
• REVENUE MANAGEMENT & BILLING SOLUTIONS
• ROBOTIC PROCESS AUTOMATION
• INSURANCE CLOUD SOLUTIONS
• CLAIMS ADMINISTRATION CLOUD SOLUTIONS
• VALUE-BASED PAYMENTS SOLUTIONS
• ARTIFICIAL INTELLIGENCE & BLOCKCHAIN SOLUTIONS
• INTELLIGENT CASE MANAGEMENT SOLUTIONS
• OTHERS

Based on business solution, the market is segmented into lead generation solutions, robotic process automation, artificial intelligence & blockchain solutions, revenue management & billing solutions, claims administration cloud solutions, value-based payments solutions, intelligent case management solutions, insurance cloud solutions, and others.  

ASSISTANCE/SERVICE TYPE

• INPATIENT/DAYCARE
• HOSPITAL ACCOMMODATION
• MEDICAL EVACUATION
• ONCOLOGY
• REHABILITATION TREATMENT
• PALLIATIVE CARE
• ORGAN TRANSPLANT
• PSYCHIATRY AND PSYCHOTHERAPY
• LASER EYE TREATMENT
• ACCIDENTAL DEATH BENEFIT
• MATERNITY
• DENTAL
• OUT-PATIENT
• REPATRIATION PLAN
• OTHERS

Based on assistance/service type, the market is segmented into inpatient/daycare, hospital accommodation, accidental death benefit, palliative care, maternity, medical evacuation, repatriation plan, out-patient, dental, oncology, laser eye treatment, psychiatry and psychotherapy, organ transplant, rehabilitation treatment, and others.

LEVEL OF COVERAGE

• BRONZE
• SILVER
• GOLD
• PLATINUM

Based on level of coverage, the market is segmented into bronze, silver, gold, and platinum.

TYPE OF INSURANCE PLANS

• HEALTH MAINTENANCE ORGANIZATIONS (HMOS)
• PREFERRED PROVIDER ORGANIZATIONS (PPOS)
• EXCLUSIVE PROVIDER ORGANIZATIONS (EPOS)
• POINT-OF-SERVICE (POS) PLANS
• INDEMNITY PRIVATE HEALTH INSURANCE
• HEALTH SAVINGS ACCOUNT (HSA)
• QUALIFIED SMALL EMPLOYER HEALTH REIMBURSEMENT ARRANGEMENTS (QSEHRAS)
• OTHERS

Based on type of insurance, the market is segmented into Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Exclusive Provider Organizations (EPOs), Point-Of-Service (POS) plans, indemnity private health insurance, Health Savings Account (HSA), Qualified Small Employer, Health Reimbursement Arrangements (QSEHRAs), and others.

DEMOGRAPHICS

• ADULTS
• MINORS
• SENIORS

Based on demographics, the market is segmented into adults, seniors, and minors.

COVERAGE TYPE

• LIFETIME COVERAGE
• TERM COVERAGE

Based on coverage type, the market is segmented into lifetime coverage and term coverage.

END USER

• FAMILY
• CORPORATE
• INDIVIDUAL
• COUPLE

Based on end user, the market is segmented into individual, couple, family, and corporate.

DISTRIBUTION CHANNEL

• DIRECT SALES
• HOSPITALS
• CLINICS
• FINANCIAL INSTITUTIONS
• E-COMMERCE
• OTHERS

Based on distribution channel, the market is segmented into direct sales, financial institutions, hospitals, clinics, e-commerce, and others.

Competitive Landscape and Indonesia Private Health Insurance Market Share Analysis

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

Some of the major players operating in the Indonesia private health insurance market are Pacific Cross, Allianz Indonesia, Etiqa, PT FWD Insurance Indonesia., Aetna Inc. (Subsidiary of CVS health), BUPA Global, Manulife, PT BANK MANDIRI (PERSERO) TBK, AXA, AIA Group Limited, PRUDENTIAL INDONESIA, Medibank Private Limited., BNI Life (Subsidiary of Bank Negara Indonesia), Sun Life Financial, PT AVRIST ASSURANCE, Great Eastern Holdings Limited, Now Health International, PT Tokio Marine Life Insurance Indonesia (Subsidiary of Tokoi Marine Holdings), Cigna, and ALLIANZ WORLDWIDE CARE LIMITED among others.

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