Philippines Healthcare Insurance Market Analysis

Philippines Healthcare Insurance Market Analysis

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The Philippines healthcare insurance market is projected to grow from $4.46 Bn in 2022 to $8.31 Bn by 2030, registering a CAGR of 8.1% during the forecast period of 2022-2030. The main factors driving the growth would be mandatory opting for health insurance, the growing number of daycare procedures, increasing healthcare costs and increasing awareness. The market is segmented by the component, provider, coverage, health insurance plans and end-user. Some of the major players include Philippine Health Insurance Corporation, MediCard, Kaiser International, Maxicare, Caritas Health Shield, KanMend, Singlife, Sun Life and PRU Life.

ID: IN10PHHS008 CATEGORY: Healthcare Services GEOGRAPHY: Phillipines AUTHOR: Neha Davda

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Philippines Healthcare Insurance Market Executive Summary

The Philippines healthcare insurance market is projected to grow from $4.46 Bn in 2022 to $8.31 Bn by 2030, registering a CAGR of 8.1% during the forecast period of 2022-30. Health spending in the Philippines increased by 18.5% from $16.8 Bn in 2020 to $20 Bn in 2021. Its expansion grew faster than the 12.8% rise from the prior year.

The Philippines' expanding healthcare insurance market strives to give Filipinos access to healthcare services and financial security. The government provides the majority of the funding for the nation's healthcare system, although private health insurance companies also contribute significantly to increasing access to healthcare services.

In the Philippines, there are primarily two types of healthcare insurance providers: government-sponsored and private. The bulk of the populace, even those working in the unofficial sector, is covered by the Philippine Health Insurance Corporation (PhilHealth), a government-sponsored health insurance program. Nonetheless, some Filipinos might find that its coverage is insufficient, which has contributed to the growth of private health insurance companies. A greater range of advantages are available from private health insurance companies, including coverage for specialised medical procedures, operations, and hospital stays in exclusive facilities. Maxicare, Medicard, and Intellicare are a few of the top private health insurance providers in the Philippines. These businesses provide a selection of healthcare plans that are specifically designed to satisfy the requirements of various people, families, and business clients.

Philippines Healthcare Insurance Market

Market Dynamics

Market Growth Drivers

The Philippines' healthcare Insurance market is expected to be driven by factors such as:

  1. Mandatory opting for health insurance- Employees in both the public and private sectors in the Philippines are required to purchase health insurance, which is anticipated to spur market expansion
  2. The growing number of daycare procedures- The majority of health insurance providers now include daycare treatments in their insurance plans, so there is no longer a requirement that patients stay in the hospital for the required minimum of 24 hours in order to file an insurance claim for these sorts of surgeries. The fact that policyholders can also claim childcare procedures under their health insurance policy while the majority of health insurance plans only cover hospital stays and major surgery is what drives the market's demand
  3. Increasing Healthcare costs- For the past few years, the Philippines' healthcare costs have been continuously rising as a result of an ageing population, growing demand for healthcare services, and rising costs for medical equipment and drugs. As a result, more Filipinos are realising the value of having health insurance to assist in defraying these expenses
  4. Increasing awareness- Filipinos are starting to focus on their health and wellness as they become more health-conscious. Due to the rising expenses of preventative treatment and health maintenance, there is a greater need for healthcare services, including healthcare insurance

Market Restraints

The following factors are expected to limit the growth of the healthcare insurance market in the Philippines:

  1. High cost of insurance- Although the demand for healthcare insurance is increasing as a result of rising healthcare expenditures, many Filipinos continue to face major entry barriers due to the high cost of insurance premiums. There are few affordable insurance options, and many people and families cannot afford the higher premiums for more comprehensive plans
  2. Limited provider network- Limited provider networks are a common feature of the Philippines' healthcare insurance plans, which can make it challenging for insured people to locate physicians and hospitals that take their insurance. Moreover, it may lessen supplier competition, raising prices for customers
  3. Inadequate infrastructure- The Philippines continues to have issues with its healthcare system, particularly in rural regions. It may be challenging for insured people to get the care they require due to limited access to healthcare facilities and medical personnel. This may also reduce the attraction of healthcare insurance as a means of obtaining healthcare services

Competitive Landscape

Key Players

  • Philippine Health Insurance Corporation- PhilHealth is the country's government-run national health insurance program. It offers health insurance to all Filipinos, whether they are employed, independent contractors, or poor
  • MediCard (AIA Philippines)- One of the greatest health maintenance organisations (HMOs) in the Philippines, Medicard has a wide network of licenced healthcare providers all across the nation
  • Kaiser International (PHL)- Kaiser International offers groups, individuals, corporations and families, numerous short-term and long-term packages that satisfy diverse healthcare requirements. People can create a secure future by having a strategy to deal with unavoidable medical costs in this way
  • Maxicare (PHL)- One of the biggest healthcare insurance companies in the Philippines, Maxicare provides a variety of services and health insurance plans. It features a network of over 56,000 doctors and specialists, over 1,000 hospitals, and clinics
  • Caritas Health Shield (PHL)- The multi-year plans that Caritas Health Shield offers its clients are its most well-known feature. The MAX Health Care Program, Improved Core 6 & 10 Health Care Program, Supreme Health Care Program, KIDDIE Health Care Program, and Ultra Health Care Program are some of their offerings
  • Other major players (PHL)- KanMend, Singlife, Sun Life and PRU Life

Notable Deals

March 2023- MediCard has been fully acquired by AIA Philippines. Together, AIA Philippines and MediCard are in a better position to seize opportunities and maintain their position as the nation's top provider of protection, long-term savings, and healthcare services. Future MediCard health coverage and care services for Filipinos can be anticipated to be more comprehensive, effective, and efficient.

1. Executive Summary
1.1 Service Overview
1.2 Global Scenario
1.3 Country Overview
1.4 Healthcare Scenario in Country
1.5 Healthcare Services Market in Country
1.6 Recent Developments in the Country

2. Market Size and Forecasting
2.1 Market Size (With Excel and Methodology)
2.2 Market Segmentation (Check all Segments in Segmentation Section)

3. Market Dynamics
3.1 Market Drivers
3.2 Market Restraints

4. Competitive Landscape
4.1 Major Market Share

4.2 Key Company Profile (Check all Companies in the Summary Section)

4.2.1 Company Overview Product Applications and Services Recent Developments Partnerships Ecosystem Financials (Based on Availability)

5. Reimbursement Scenario
5.1 Reimbursement Regulation
5.2 Reimbursement Process for Services
5.3 Reimbursement Process for Treatment

6. Methodology and Scope

Healthcare Insurance Market Segmentation

By Provider (Revenue, USD Billion):

It mainly includes healthcare insurance that provides safety against the increasing cost of medical treatments and in case of health emergencies such as critical illnesses. Hence, it is the best way to safeguard medical expenses.

  • Public
  • Private

By Coverage Type (Revenue, USD Billion):

In terms of sales and market share, it is anticipated to rule the market over the projection period. This is explained by a number of benefits provided by life insurance, including guaranteed death payout and permanent coverage. Additionally, investing in these kinds of plans enables working professionals to save taxes

  • Life Insurance
  • Term Insurance

By Health Insurance Plans (Revenue, USD Billion):

  • Health Maintenance Organization (HMO)
  • Preferred Provider Organization (PPO)
  • Exclusive Provider Organization (EPO)
  • Point of Service (POS)
  • High Deductible Health Plan (HDHP)

By Demographics (Revenue, USD Billion):

  • Minors
  • Adults
  • Seniors

There is a high prevalence of lifestyle disease in the adult population that can increase health risks in the future. The population is more prone to cardiac and other diseases that require hospitalization. Healthcare insurance plans for seniors are more of a necessity, especially in the case of retirement. Also, it carries various advantages such as no medical screening before buying plans, includes coverage of the outpatient department, and provides the benefit of fee annual checkups along with lifetime renewability.

By End-user (Revenue, USD Billion):

  • Individuals
  • ?Corporates

A large number of people buy individual health plans as they are also customizable. Also, it gives more control over deductibles, co-pays, and benefits limits and is not dependent on employment status.

Insights10 will provide you with the reports within 10 key parameters which are:

  1. Market Overview
  2. Market Growth Drivers & Restraints
  3. Epidemiology of Disease Type
  4. Market Segmentation
  5. Market Share
  6. Competitive Landscape
  7. Key Company Profiles
  8. Healthcare Policies & Regulatory Framework
  9. Reimbursement Scenario
  10. Factors Driving Future Growth

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Last updated on: 06 June 2023

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