The U.S. individual health insurance market size is anticipated to reach USD 2.54 trillion by 2030. The market is anticipated to expand at a CAGR of 6.08% from 2023 to 2030. Major factors contributing to the growth include the increasing prevalence of chronic disorders, increase in insurer participation, and new product offerings. An individual health insurance plan's main advantage is that each individual has their own sum insured, as compared to a family floater where the sum insured is shared by everyone who is covered under the policy.
Furthermore, the rising prevalence of chronic diseases including cancer, diabetes, and cardiovascular disease in the U.S. is contributing to the market growth. For instance, as per the International Institute for Research on Cancer about 2,281,658 new cancer cases were reported in the U.S. in 2020, with about 612,390 fatalities in the same year. Although having access to an employer-sponsored health insurance policy is helpful for employees in an emergency, it does not provide the same level of protection as a separate individual health policy. As a result, the demand for individual health insurance has increased.
The majority of the population in the U.S. relies on government-sponsored healthcare schemes. The Medicare health insurance program covers all individuals 65 years of age and older, while the majority of working adults are covered by employer-sponsored health insurance programs. The rising expense of healthcare and the restricted coverage provided by public and group insurance plans are driving greater demand for the private sector.
The key market players include United Health Group Incorporated, Elevance Health (formerly Anthem, Inc.), Health Care Service Corporation, Cigna; Kaiser Foundation Health Plan, Inc, Independence Holding Company (IHC Group), Providence Health Plan, Point32Health, and Highmark. They are implementing a variety of strategies including merger and acquisition, partnerships, collaboration, and expansion. partnerships, collaboration, merger and acquisition, and expansion. For instance, in January 2021, Tufts Health Plan and Harvard Pilgrim Health Care merged to form Point32Health. This strategy was intended to improve the combined companies' ability to compete with some of their bigger competitors.
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Furthermore, the rising prevalence of chronic diseases including cancer, diabetes, and cardiovascular disease in the U.S. is contributing to the market growth. For instance, as per the International Institute for Research on Cancer about 2,281,658 new cancer cases were reported in the U.S. in 2020, with about 612,390 fatalities in the same year. Although having access to an employer-sponsored health insurance policy is helpful for employees in an emergency, it does not provide the same level of protection as a separate individual health policy. As a result, the demand for individual health insurance has increased.
The majority of the population in the U.S. relies on government-sponsored healthcare schemes. The Medicare health insurance program covers all individuals 65 years of age and older, while the majority of working adults are covered by employer-sponsored health insurance programs. The rising expense of healthcare and the restricted coverage provided by public and group insurance plans are driving greater demand for the private sector.
The key market players include United Health Group Incorporated, Elevance Health (formerly Anthem, Inc.), Health Care Service Corporation, Cigna; Kaiser Foundation Health Plan, Inc, Independence Holding Company (IHC Group), Providence Health Plan, Point32Health, and Highmark. They are implementing a variety of strategies including merger and acquisition, partnerships, collaboration, and expansion. partnerships, collaboration, merger and acquisition, and expansion. For instance, in January 2021, Tufts Health Plan and Harvard Pilgrim Health Care merged to form Point32Health. This strategy was intended to improve the combined companies' ability to compete with some of their bigger competitors.
U.S. Individual Health Insurance Market Report Highlights
- The public type segment dominated the market in 2022, due to the widespread use of government-sponsored health insurance (Medicare) in the country
- Private sector is predicted to undergo maximum growth due to the introduction of new products by the private players in the market
- The seniors demographic segment held the largest market share in 2022, as in the U.S. all citizens 65 years and above are covered under the government-sponsored Medicare health insurance plan
- The South region dominated the market by capturing about 37.5% of the overall share, as a substantial population is covered by individual health insurance in the region
- The West region held the second-largest share of the individual health insurance market and is further expected to experience the fastest growth rate over the forecast period
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Table of Contents
Chapter 1. Methodology and Scope1.1. Market Segmentation & Scope
1.1.1. Type
1.1.2. Demographics
1.1.3. Estimates and forecast timeline
1.2. Research Methodology
1.3. Information Procurement
1.3.1. Purchased database
1.3.2. internal database
1.3.3. Secondary sources
1.3.4. Primary research
1.3.5. Details of primary research
1.4. Information or Data Analysis
1.4.1. Data analysis models
1.5. Market Formulation & Validation
1.6. Model Details
1.6.1. Commodity flow analysis (Model 1)
1.6.1.1. Approach 1: Commodity flow approach
1.6.2. Volume price analysis (Model 2)
1.6.2.1. Approach 2: Volume price analysis
1.7. List of Secondary Sources
1.8. List of Primary Sources
1.9. Objectives
1.9.1. Objective 1
1.9.2. Objective 2
Chapter 2. Executive Summary
2.1. Market Outlook
2.2. Segment Outlook
2.2.1. Type outlook
2.2.2. Demographic outlook
2.3. Competitive Insights
Chapter 3. U.S. Individual Health Insurance Market Variables, Trends & Scope
3.1. Market Lineage Outlook
3.1.1. Parent market outlook
3.1.2. Related/ancillary market outlook
3.2. Penetration & Growth Prospect Mapping
3.3. Industry Value Chain Analysis
3.3.1. Reimbursement framework
3.4. Market Dynamics
3.4.1. Market driver analysis
3.4.1.1. Increasing prevalence of chronic diseases
3.4.1.2. Increase in insurer participation and new product offerings
3.4.2. Market restraint analysis
3.4.2.1. Presence of alternative health insurance plans
3.5. U.S. Individual Health Insurance Market Analysis Tools
3.5.1. Industry Analysis - Porter’s
3.5.1.1. Supplier power
3.5.1.2. Buyer power
3.5.1.3. Substitution threat
3.5.1.4. Threat of new entrant
3.5.1.5. Competitive rivalry
3.5.2. PESTEL Analysis
3.5.2.1. Political landscape
3.5.2.2. Technological landscape
3.5.2.3. Economic landscape
3.5.3. Major Deals & Strategic Alliances Analysis
3.5.4. Market Entry Strategies
Chapter 4. U.S. Individual Health Insurance Market: Type Estimates & Trend Analysis
4.1. Definitions and Scope
4.1.1. Public
4.1.2. Private
4.2. Type Market Share, 2022 & 2030
4.3. Segment Dashboard
4.4. U.S. Individual Health Insurance Market by Type Outlook
4.5. Market Size & Forecasts and Trend Analyses, 2018 to 2030 for the following
4.5.1. Public
4.5.1.1. Public market estimates and forecast 2018 to 2030 (USD Billion)
4.5.2. Private
4.5.2.1. Private market estimates and forecast 2018 to 2030 (USD Billion)
Chapter 5. U.S. Individual Health Insurance Market: Demographics Estimates & Trend Analysis
5.1. Definitions and Scope
5.1.1. Minor
5.1.2. Adult
5.1.3. Senior
5.2. Demographic Market Share, 2022 & 2030
5.3. Segment Dashboard
5.4. U.S. Individual Health Insurance Market by Demographic Outlook
5.5. Market Size & Forecasts and Trend Analyses, 2018 to 2030 for the following
5.5.1. Minor
5.5.1.1. Minor market estimates and forecast 2018 to 2030 (USD Billion)
5.5.2. Adult
5.5.2.1. Adult market estimates and forecast 2018 to 2030 (USD Billion)
5.5.3. Senior
5.5.3.1. Senior market estimates and forecast 2018 to 2030 (USD Billion)
Chapter 6. U.S. Individual Health Insurance Market: Regional Market Analysis, 2018 - 2030 (USD Billion)
6.1. Definitions & Scope
6.2. Regional Market Share Analysis, 2022 & 2030
6.3. Regional Market Dashboard
6.4. Regional Market Snapshot
6.5. Regional Market Share, 2022
6.6. Market Size, & Forecasts, and Trend Analysis, 2018 to 2030:
6.7. Northeast
6.7.1. Northeast Market estimates and forecast, 2018 - 2030 (USD Billion)
6.7.2. Connecticut
6.7.2.1. Connecticut Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.7.3. Massachusetts
6.7.3.1. Massachusetts Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.7.4. Pennsylvania
6.7.4.1. Pennsylvania Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.7.5. New Jersey
6.7.5.1. New Jersey Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.7.6. New York
6.7.6.1. New York Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.7.7. Others (Maine, New Hampshire, Rhode Island, Vermont)
6.7.7.1. Others Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.8. Midwest
6.8.1. Midwest Market estimates and forecast, 2018 - 2030 (USD Billion)
6.8.2. Illinois
6.8.2.1. Illinois Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.8.3. Indiana
6.8.3.1. Indiana Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.8.4. Michigan
6.8.4.1. Michigan Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.8.5. Ohio
6.8.5.1. Ohio Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.8.6. Wisconsin
6.8.6.1. Wisconsin Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.8.7. Iowa
6.8.7.1. lowa Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.8.8. Minnesota
6.8.8.1. Minnesota Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.8.9. Missouri
6.8.9.1. Missouri Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.8.10. Others (Kansas, Nebraska, North Dakota, South Dakota)
6.8.10.1. Others Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.9. South
6.9.1. South Market estimates and forecast, 2018 - 2030 (USD Billion)
6.9.2. Florida
6.9.2.1. Florida Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.9.3. Georgia
6.9.3.1. Georgia Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.9.4. Maryland
6.9.4.1. Maryland Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.9.5. North Carolina
6.9.5.1. North Carolina Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.9.6. South Carolina
6.9.6.1. South Carolina Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.9.7. Virginia
6.9.7.1. Virginia Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.9.8. Alabama
6.9.8.1. Alabama Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.9.9. Kentucky
6.9.9.1. Kentucky Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.9.10. Tennessee
6.9.10.1. Tennessee Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.9.11. Louisiana
6.9.11.1. Louisiana Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.9.12. Texas
6.9.12.1. Texas Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.9.13. Others (Delaware, West Virginia, Mississippi, Arkansas, Oklahoma)
6.9.13.1. Others Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.10. West
6.10.1. West Market estimates and forecast, 2018 - 2030 (USD Billion)
6.10.2. Arizona
6.10.2.1. Arizona Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.10.3. Colorado
6.10.3.1. Colorado Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.10.4. Nevada
6.10.4.1. Nevada Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.10.5. California
6.10.5.1. California Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.10.6. Oregon
6.10.6.1. Oregon Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.10.7. Washington
6.10.7.1. Washington Market estimates and forecast, by product, 2018 - 2030 (Billion)
6.10.8. Others (Idaho, Montana, New Mexico, Utah, Wyoming, Alaska, Hawaii)
6.10.8.1. Others Market estimates and forecast, by product, 2018 - 2030 (Billion)
Chapter 7. Competitive Landscape
7.1. Recent Developments & Impact Analysis, By Key Market Participants
7.2. Company/Competition Categorization
7.2.1. Innovators
7.3. Vendor Landscape
7.3.1. List of key distributors and channel partners
7.3.2. Key customers
7.3.3. Key company market share analysis, 2022
7.3.4. United Health Group Incorporated
7.3.4.1. Company overview
7.3.4.2. Financial performance
7.3.4.3. Product benchmarking
7.3.4.4. Strategic initiatives
7.3.5. Elevance Health (formerly Anthem, Inc.)
7.3.5.1. Company overview
7.3.5.2. Financial performance
7.3.5.3. Product benchmarking
7.3.5.4. Strategic initiatives
7.3.6. Health Care Service Corporation
7.3.6.1. Company overview
7.3.6.2. Financial performance
7.3.6.3. Product benchmarking
7.3.6.4. Strategic initiatives
7.3.7. Cigna
7.3.7.1. Company overview
7.3.7.2. Financial performance
7.3.7.3. Product benchmarking
7.3.7.4. Strategic initiatives
7.3.8. Kaiser Foundation Health Plan, Inc
7.3.8.1. Company overview
7.3.8.2. Financial performance
7.3.8.3. Product benchmarking
7.3.8.4. Strategic initiatives
7.3.9. Independence Holding Company (IHC Group)
7.3.9.1. Company overview
7.3.9.2. Financial performance
7.3.9.3. Product benchmarking
7.3.9.4. Strategic initiatives
7.3.10. Providence Health Plan
7.3.10.1. Company overview
7.3.10.2. Financial performance
7.3.10.3. Product benchmarking
7.3.10.4. Strategic initiatives
7.3.11. Point32Health
7.3.11.1. Company overview
7.3.11.2. Financial performance
7.3.11.3. Product benchmarking
7.3.11.4. Strategic initiatives
7.3.12. Highmark
7.3.12.1. Company overview
7.3.12.2. Financial performance
7.3.12.3. Product benchmarking
7.3.12.4. Strategic initiatives
List of Tables
Table 1 List of Abbreviations
Table 2 U.S. individual health insurance market, by type 2018 - 2030 (USD Billion)
Table 3 U.S. individual health insurance market, by demographics, 2018 - 2030 (USD Billion)
Table 4 Northeast individual health insurance market, by type 2018 - 2030 (USD Billion)
Table 5 Northeast individual health insurance market, by demographics, 2018 - 2030 (USD Billion)
Table 6 Midwest individual health insurance market, by type 2018 - 2030 (USD Billion)
Table 7 Midwest individual health insurance market, by demographics, 2018 - 2030 (USD Billion)
Table 8 South individual health insurance market, by type 2018 - 2030 (USD Billion)
Table 9 South individual health insurance market, by demographics, 2018 - 2030 (USD Billion)
Table 10 West individual health insurance market, by type 2018 - 2030 (USD Billion)
Table 11 West individual health insurance market, by demographics, 2018 - 2030 (USD Billion)
List of Figures
Fig. 1 Market research process
Fig. 2 Data triangulation techniques
Fig. 3 Primary research pattern
Fig. 4 Market research approaches
Fig. 5 Value-chain-based sizing & forecasting
Fig. 6 QFD modeling for market share assessment
Fig. 7 Market formulation & validation
Fig. 8 U.S. individual health insurance market: market outlook
Fig. 9 U.S. individual health insurance market competitive insights
Fig. 10 Parent market outlook
Fig. 11 Related/ancillary market outlook
Fig. 12 Penetration and growth prospect mapping
Fig. 13 Industry value chain analysis
Fig. 14 U.S. individual health insurance market Driver Impact
Fig. 15 U.S. individual health insurance market Restraint Impact
Fig. 16 U.S. individual health insurance market Strategic Initiatives Analysis
Fig. 17 U.S. individual health insurance market: Type Movement Analysis
Fig. 18 U.S. individual health insurance market: Type outlook and key takeaways
Fig. 19 Public market estimates and forecast, 2018 - 2030
Fig. 20 Private market estimates and forecast, 2018 - 2030
Fig. 21 U.S. individual health insurance market: Demographics Movement Analysis
Fig. 22 U.S. individual health insurance market: Demographics outlook and key takeaways
Fig. 23 Minors Market Estimates and Forecast, 2018 - 2030
Fig. 24 Adults Estimate and Forecast, 2018 - 2030
Fig. 25 Seniors Estimate and Forecast, 2018 - 2030
Fig. 26 Participant Categorization- U.S. individual health insurance market
Fig. 27 Market share of key market players U.S. individual health insurance market
Companies Mentioned
- United Health Group Incorporated
- Elevance Health (formerly Anthem, Inc.)
- Health Care Service Corporation
- Cigna
- Kaiser Foundation Health Plan, Inc
- Independence Holding Company (IHC Group)
- Providence Health Plan
- Point32Health
- Highmark
Methodology
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Table Information
| Report Attribute | Details |
|---|---|
| No. of Pages | 110 |
| Published | March 2023 |
| Forecast Period | 2022 - 2030 |
| Estimated Market Value ( USD | $ 1.6 trillion |
| Forecasted Market Value ( USD | $ 2.54 trillion |
| Compound Annual Growth Rate | 6.0% |
| Regions Covered | United States |
| No. of Companies Mentioned | 9 |
