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About the report

After collating pricing data from 100 countries, the Cost of Health Insurance Report 2020-2021 ranks countries based on their average IPMI premiums, for both individual and family plans. It also reveals the key drivers shaping health insurance costs, before exploring some noteworthy trends from around the globe.
We have witnessed change at a rate never experienced before as COVID-19 deeply impacts Singapore’s healthcare sector and the insurance industry. To adjust in a short amount of time, further integration of digital technology has become essential in the way new insurance products are designed and delivered to consumers. More so, technology can help to contain costs but also keep premiums in check."
Olivier Zeller,
Chief Executive Officer at Pacific Prime Singapore

What is the cost of international
health insurance globally?

Once again, the US tops the chart in 2020 as the most expensive location for individual and family health insurance. Yet, a number of countries around the globe saw their average individual premiums decrease, as opposed to 2019.
In addition to this, Hong Kong and Singapore take the second and third spots as the most expensive countries for individual and family health insurance this year, pushing Canada down the list from second in 2019.
Top 5 most expensive countries for individual
and family health insurance in the world
Average individual premium in 2020 (USD)
1. The United States - $7,703
2. Hong Kong - $6,146
3. Singapore - $5,677
4. Canada - $5,230
5. Dubai - $5,207
Average family premium in 2020 (USD)
1. The United States - $21,817
2. Hong Kong - $17,425
3. Singapore - $15,964
4. Dubai - $15,377
5. Israel - $13,614

What are the key drivers shaping
health insurance in Singapore?

Inflated medical charges
Inflated medical charges
Singapore continues to face overcharging, overservicing, and inappropriate medical interventions, which contributes to higher IPMI premiums. To tackle these issues, special guidelines for surgical procedures are available from the Ministry of Health that aim to promote price transparency, and act as a reference point for insurers when reviewing claims.
Lifestyle factors
Lifestyle factors
The rate of chronic diseases like diabetes and circulatory diseases are on the rise. These diseases are largely associated with poor lifestyle choices and continue to drive the top claims resulting in the overuse of medical care. To ensure IPMI premiums are kept in check, the Health Promotion Board (HPB) hopes to address unfavorable lifestyle factors by educating the population in Singapore on the importance of healthy living.
Aging population
Aging population
Singapore is facing an aging population, which places a heavy burden on the healthcare system and increases healthcare costs. In turn, IPMI premiums increase to accommodate the cost of treating senior members of the population as they develop health conditions. Community support can reduce the frequency of visits to hospital and medical facilities, and also keep costs down in the long run.
Increased use of digital technology
Increased use of digital technology
Telemedicine or virtual health consultations during the COVID-19 pandemic has increased tremendously and can help contain medical costs, as policyholders don’t need to visit a general practitioner in person. Moving forward, many insurers will be embracing digital health solutions to increase efficiency and cost containment. That being said, investments in telemedicine systems and networks can increase the costs in the short run.
Overuse of insurance
Overuse of insurance
Policyholders in Singapore look for the latest and most expensive treatment, or even opt for procedures that are not needed. Overuse of insurance will likely result in higher premiums further down the line. To tackle this trend, measures are in place such as co-pays that have been reintroduced on the local integrated Medishield plans.

What are the key drivers shaping
health insurance premiums globally?

Changing demand for care
Changing demand for care
The COVID-19 pandemic has increased healthcare utilization and expenditure, particularly when it comes to telemedicine and virtual healthcare solutions, as indicated in many countries like Singapore.
Cost of care
Cost of care
Healthcare costs have far exceeded general inflation due to rising prescription drug prices, a surge in chronic conditions associated with unhealthy lifestyle factors, an aging population, and more.
Increased regulation
Increased regulation
From tax reporting procedures and anti-money laundering laws to consumer protection and personal data privacy regulations, insurers have to comply with various requirements across multiple jurisdictions, with many of them struggling to deal with the costs of compliance.
Continued challenges related to fraud
Continued challenges related to fraud
Fraudulent claims made by dubious healthcare providers and policyholders remain a massive problem for the health insurance industry, resulting in higher IPMI premiums and upfront expenses for all policyholders, as well as lower benefits or coverage.
The rise of insurtech
The rise of insurtech
The COVID-19 pandemic has pushed a number of insurers to adopt and accelerate their digital measures. Initial investment costs could impact IPMI premiums going into 2021.

An in-depth look at
our key findings

The Americas remains a dominant region in the top 20 most expensive countries
The Americas remains a dominant region in the top 20 most expensive countries
According to our ranking table, a staggering 12 out of 20 countries in the Americas have the most expensive IPMI premiums. Unsurprisingly, the US is at the top again due to its high cost of healthcare, despite a significant decline in prices this year.
 Latin America may experience an increase in premiums in the next 5 years
Latin America may experience an increase in premiums in the next 5 years
Unlike other regions, Latin America is characterized by extensive mental health coverage. As behavioral and mental health conditions are the third most expensive conditions, experts forecast an increase in IPMI premiums within the next 5 years. Nevertheless, each country in the region has its own healthcare trend.
 Hong Kong has reclaimed its place as the second most expensive location in the world for health insurance
Hong Kong has reclaimed its place as the second most expensive location in the world for health insurance
Pointing to a number of factors, such as over-utilization of health insurance, a rapidly aging population, and the devastating COVID-19 pandemic, Hong Kong becomes the second most expensive location in the world in 2020 for both individual and family IPMI plans.
 China's premiums are going through a correction after years of increase
China's premiums are going through a correction after years of increase
China’s IPMI premiums have seen a decline, as demand became sluggish in the world's second-largest economy during the COVID-19 pandemic. On the digitalization front, insurers are adopting technology and innovation, as well as creating new waves of changes in the country’s insurance landscape.
 A number of countries' premiums have decreased in 2020
A number of countries' premiums have decreased in 2020
In total, 36 countries witnessed lower IPMI premiums than last year, and the overall trend this year is a decrease in the cost of health insurance, predominantly due to the unprecedented impact that the COVID-19 pandemic continues to have on healthcare systems the world over.
 Insurers are taking a closer look at their regional pricing strategies
Insurers are taking a closer look at their regional pricing strategies
Insurers are reevaluating their pricing strategies for IPMI premiums for each region in order to strike the right balance between excellent service quality and operational sustainability, as well as prepare for similar crises moving forward.

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