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Insurance in the Individual- Medical Market

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Statistics show that for the past five years, there was a decline in the number of individual health insurance providers. However, there are new players now emerging in the medical market.



Due to budget constraints, more and more business employers are tightening their belts. And so the individual will resort to purchasing an individual health insurance, the marketplace for individual insurance therefore is expecting long-term unprecedented growth.



The primary purchasers or buyers of an individual health insurance are the employed who includes the self employed, individuals who are not eligible for employer sponsored coverage, and those purchasing insurance policies for family members. Other groups like the unemployed which include retirees, graduates, and temporary-laid off individuals are also driven to the individual insurance marketplace.



The uninsured population is made up of these unemployed and employed segments. Individual health insurance providers must therefore prioritize these uninsured individuals, and set up strategies to be able to accommodate this growing influx of people.



There are certain market scenarios which could even add up to the increasing demand for individual health insurance. Here are several factors that contribute to the growth in the individual medical market:



- the ‘play-or-pay’ system, which requires employers to offer or give health insurance


- the increase of employment among different firms which offers health benefits


- product and/or distribution gaps
- legislation-adoption which authorizes association health plans


- tax incentives implemented by the government for individual health insurance


- successful promotion of HSAs


- growth in the consumer-driven healthcare


- employer sponsorship is declining continuously


- marketing and products that now reach the uninsured


- slow job-growth




Before, the individual health insurance market was controlled by only a handful of health insurance companies. Now, more health insurance companies are attracted to the individual medical market because of the continuing growth of uninsured individuals looking for health insurance.



The individual medical market is more attractive today since there are now more health insurance providers, not to mention the enhanced technology, expanded marketing-channels, and improved underwriting.



The rise in consumer directed healthcare and consumer accountability would let the individual medical come as a natural extension. HSAs are added financial incentives and are applicable to certain employer funded plans.



The individual medical market offers a lot of opportunity for new health insurance providers, but they should overcome possible pitfalls.



Proper timing is important and very critical. Just jumping into the market a little too early with a poorly-designed pricing and plan will be remembered by the distribution channel ‘forever’ and you may not gain a positive look from possible clients.



If you enter too late, you might loose the opportunity of capturing the profitable segments.



Health insurance plans that are new in the individual medical market should adapt to the sophisticated marketing tactics and strategies that are required to be able to reach most of the individual consumers.



Health insurance providers must provide for a wide range of plan designs and plan price points, so they can address diversity successfully.



The health plans should embrace individual medical services and products which require pricing arrangements and innovative funding, together with organizational flexibility and speed.



The challenge for individual health insurance providers therefore lies in integrating and selecting partners that is in line with their very own business-models despite the HAS evolving requirements.



The opportunities and challenges that the individual medical market presents should be taken into consideration by health insurance providers to ensure their success.








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