An In-Depth Guide to Health Insurance App Development

Health continues to be a topmost priority, especially in the post-pandemic period. As more and more people are opting for health insurances, development companies are coming up with consumer-centric health and medical apps, to secure their healthcare treatment plans incase of any adversities.

Health insurance application allows patients to reach out to healthcare providers, as per terms and conditions notified in the app. Along with this, medical insurance apps facilitates processes for patients such as premium renewal, eligibility verification, and much more.

These app benefits is increasing the rate of health insurance application installations and development. January 2021 had the highest number of app installations, with 36 percent rise in the number of apps installed than the previous month.

Table of Content:

1. Health insurance industry market

2. Reasons for health insurance app development

3. Types of health insurance app

4. Revenue models for health insurance app development

5. Features of health insurance app

6. Steps to develop health insurance app

7. Cost of mobile health insurance app development

Health Insurance Industry: Market Overview

Aspects such as rise in the geriatric population in the USA and increase in chronic diseases is stimulating the growth of the health insurance industry. According to a report by the United States Census Bureau, for the first time in the US history, the older adults are projected to outnumber kids by 2034.

Older population need long-term care, social services, and 24/7 access to healthcare services, their needs are different as compared to children and youth. Hence, to cover all their care expenses, they can opt for an health insurance plan.

Furthermore, CDC states that six in ten Americans suffer from at least one chronic disease such as cancer, heart illness, or diabetes. These chronic ailments are one of the leading causes of death in the USA, hence health insurance policies help to ensure better care facilities to counter chronic conditions.

According to a report by McKinsey, the health insurance revenues of private companies are expected to double by 2025, as more and more people are choosing to secure their health treatment plans in the post pandemic period. Along with this, government spending in the healthcare industry, puts health insurance companies as intermediaries to handle expenses, resulting in revenue management.

All these factors point out that the health insurance industry is estimated to grow profusely in the upcoming years, which eventually paves way for health insurance app development.

Compelling Reasons for Health Insurance App Development

Benefits For Consumers

1. Fast Access to Insurance Plans and Policies

Picking out a suitable health insurance plan is hard and at times, people may end up picking out a bad insurance plan for themselves. A study by concluded that deciding insurance plans (in this case dominated plans) wasn’t driven by the complexity and size of the insurance plan or the deductibles, but by lack of knowledge of health insurance policies.

Mobile health insurance apps play a significant role in overcoming this challenge. Consumers can easily search for required criteria and select appropriate plan. The aim of building a medical insurance app is to engage users and create more loyal consumers.

A consumer-centric app approach helps to avoid situations where patient isn’t aware whether insurance covers a prescribed drug or a surgery. Easy access to health plan data and medical history makes it simple for healthcare professionals to treat patients accordingly.

2. Search for a Suitable Healthcare Provider

To find the best healthcare provider, patients analyze doctors’ proximity, acceptance of insurance plans, reviews, etc., which takes ample of time. In-app search engines, makes it easier to filter doctors based on their specialty, experience, location, and more.

Further, health plans can have special discounted rates with certain hospitals and clinics in the area, allowing patients to pay less, and are called as in-network.

Additionally, medical insurance apps help to narrow down searches to general practice, family practice, and internal medicine to suit user needs. Face-to-face meetups with providers can be a deal breaker for patients/consumers after shortlisting them via an app.

3. Cost Reduction

Suitable policy selection through medical insurance apps, opens up potential for substantial cost savings on premiums. Applications are designed to offer unbiased recommendations and compare various policies for consumers. Apps provide policy suggestions based on patients’ medical history, income, medication prices, and health.

Further, insurance apps are an excellent way to get discounts, coupons, and vouchers on premium purchases. Instant access to appropriate plan selection helps to save money on healthcare services as well. People can avoid spending on drugs, surgeries, long-term care, and chronic diseases with a suitable insurance plan.

4. Optimized Claim Processing

Claim processing is challenging for both health providers and patients/policy holders. Providers rely on claims management process to keep their operations running smoothly.

For policy holders, claim rejection serves as the biggest barrier in paying for healthcare services. Reasons such as incorrect data, invalid diagnosis code, subscriber not found, etc. can lead to denial of claims.

Health insurance application is one of the ways to ensure proper processing of health claims, and avoid denials. Insurance apps contain all the essential medical data, which eliminates chances of filing incorrect or invalid information.

5. Healthcare Transparency

The new healthcare price transparency policy enforced by the CMS (Centers for Medicare and Medicaid Services) requires group health plans and issuers or individual health insurance to disclose pricing data. They are liable to share pricing information pertaining to:

a. Machine readable files encompassing costs for services and items

b. An internet based price comparison tool that allows an individual to receive a prediction of their cost-sharing responsibility for a service or an item, taken from provider, for 500 services or items.

c. An internet based price comparison tool that allows an individual to get an estimate of their cost-sharing responsibility for all items and services taken from providers.

Benefits For Insurance Companies

1. Enhanced Productivity due to Automation

According to the Oxford University report, 47 percent of the US workers have a higher probability of seeing their jobs automated in the next 20 years. Integration of technologies such as AI (Artificial Intelligence) and machine learning in health insurance applications can help to automate documentation, data management, payments, and more.

Additionally, automation replaces humans and carries out work for them. This reduces chances of human errors, thus guaranteeing an increase in productivity and efficiency of insurance companies.

Moving on, automation of mundane work helps staff to focus on other aspects of business such as quality assurance, customer retention strategies, new health insurance policies, and more.

2. Increase in Revenue

Consumer experience plays a vital role in increasing revenues of health insurance companies. User-friendly insurance application with all the essential features attracts consumers, which eventually leads to increase in sales and revenue.

Furthermore, using smart app promotion tactics, diversity in portfolios, and knowing the needs of target audience helps to generate insurance sales, thereby boosting revenue.

3. More Consumer Base

Insurers can increase consumer base by offering excellent customer support and services. By keeping in mind that the 100th customer is as important as the first one assures effective customer services. This eventually increases their satisfaction rate and experience, resulting in the formation of a strong consumer base for health insurance companies.

Apps can be designed to provide 24/7 customer services, with an in-build tutorial videos and FAQs to solve common queries. Additionally, companies can go a step further and start their newsletter. This showcases that companies are willing to provide policy information for free from the start.

4. On-Demand Support and Communication

Through medical insurance applications, insurers can keep a constant communication with policy holders, and respond to their inquiries.

Chatbots can be of help to maintain interaction and on-demand support when an insurance agent isn’t available to take a call. Chatbots powered with voice recognition technology and artificial intelligence provides quality experience to policy holders.

Major Types of Health Insurance Application

1. For Patients

Health insurance application for patients provides services and features such as authorized login to maintain safety standards. It also has a built-in biometric feature for additional safety and to safeguard vital patient data such as payment history, card information, medical history, etc.

Furthermore, application for patients eliminates the need for excessive paperwork, and buying insurance plans from one or more insurers becomes easy. Through medical insurance app designed for patients, communication with care specialists and seeking diagnosis becomes easy. They can also search for doctors and clinics as per their health requirements and services, through geolocation feature.

Apart from this, one of the major benefits offered by apps designed for patients is smooth claim management and recurring payments, along with offering assistance to the elderly. This type of app can be integrated within other medical systems too, such as EHR, patient portals, medical billing software, etc.

2. For Healthcare Providers

Healthcare providers work with multiple patients, which indirectly pushes them to operate with several insurance companies. It’s impossible to use separate apps for managing all insurance companies, hence one app can be build which is the sole access point for numerous insurance databases.

This type of medical insurance application helps healthcare professionals to keep a track of specific insurers and patients. It also verifies eligibility, patient documentation and insurance IDs.

Providers can manage insurance claims without connecting with insurance companies directly. Additionally, electronic integrations generates less paperwork, thereby reducing cumbersome administrative tasks.

3. For Insurance Companies

Automated or electronic insurance process via applications replaces paperwork with online forms and files, which are easy to search for when in need. Apps for insurance companies are designed to generate reports and analytics on their business performance.

Further, through these apps, companies can get instant updates on every patients’ case, eligibility status, current status, premium dues, and renewals. Applications are integrated with company databases for better data management, and its access is restricted to certain individuals.

Revenue Models for Health Insurance App Development

1. Health Insurance Reimbursement

Healthcare reimbursement models are basically billing systems through which healthcare facilities get paid for the services they offer to patients, via insurance companies or patients themselves.

There are multiple healthcare reimbursement models adopted by hospitals and clinics, according to their functions and goals. Value-based care and fee-for-service are two popular models used in healthcare facilities.

a. Value-Based Model: Payment in value-based care model is based on quality over quantity, and providers work towards bringing positive medical outcomes. This type of reimbursement model is preferred by Medicaid and Medicare.

b. Fee-for-Service: Here, billing is based on cost of services, and healthcare professionals are paid as per services. Cost is based on preset prices, and can lead to price inflation and redundancy in care.

2. Freemium Model

Freemium model works best for mobile app users. This model offers limited or basic features to users for free, and then charges a premium for more advanced features. Freemium models are popular amongst internet-based business and software applications.

It also has the ability to attract large initial users, as there’s no money associated to try out a service or application. Free insurance plan or medical tests can be offered to grow consumer acquisition. This helps to increase consumer base, and later on application can be upgraded as per user needs.

3. Licensure Model

Medical insurance apps are monetizing through licensing agreements. Software development companies transfer their rights to an app for certain duration in exchange for a fee.

Source of income includes licensing service, dashboard, or device to consumers, selling medications through app, and collecting development fees.

4. In-App Advertising

Profits can be made by providing ad space to advertisers, for example upcoming healthcare services, hospital projects, new insurance plan launches, etc. Advertisements can cause disturbances to users, while operating insurance applications, hence assure to not overdo it.

Consider using pop-ups or push notifications every once in a while. However, placing the right ad at the right place encourages user engagement, retention, and eventually revenue. This type of approach is popular amongst gaming apps, and are highly effective as they are user initiated.

5. In-App Purchase

In-app purchase model allows developers to launch their app for free, and pushes users to buy features, items, and services as per needs. For instance, insurance companies can sell multiple insurance plans and policies from the application itself, to make purchases easier for consumers.

It’s recommended to have safety protocols in place to assure secured payment gateways for in-app purchases. Additionally, stores such as iTunes and Google Pay allow users to install apps with an in-app purchase option, letting the user know that the downloaded app has this feature.

Potential Features of Health Insurance App

1. Health Insurance Plans

This feature allows users to choose a suitable healthcare insurance plan from a myriad of options. App developers can consider incorporating questionnaire to help users narrow down their plan selection process.

A plan comparison chart or table also aids users to quickly scan through features, characteristics, and prices, in order to decide which one is the best for them. Furthermore, health insurance plan feature allows users to select plan as per their monthly or annual income, family, type of disease suffering from, and age category.

2. Buying and Renewal of Insurance Policies

Under this feature, the process of buying and renewal of insurance policies are automated, so that no user experiences delays in payments. This works as a subscription type service tied up to credit card.

This feature allows users to execute transactions pertaining to medical policies online without having to visit an insurance company office or contacting agents, unless queries arise. These options can be designed in a custom insurance application development for mobiles.

This requires an in-app integration with bank-IDs, payment gateways, and card information. Highest security standards and firewalls are key aspects needed to build such an application.

3. Claims Submission and Management

Claims is a crucial part of insurance business, and an efficient claims management process in insurance application makes it easier for users to submit their claims. This feature can include a short and simple form which is easy to fill and submit via mobile or tablet.

Further, it’s simple to track claims progress with this feature, and all documents related to claims are within user’s reach. This feature allows users to save time by opting for online transaction of claims, thus adding transparency to process, as both consumer and consultant has access to the final claim.

4. Access to Health Information

This feature allows users to check their lab results, medications, and health records in one place. If health insurance app is enabled with a doctor-patient communication feature, then users can share their data with physicians. This feature helps to submit and obtain electronic prescription to insurers for compensation.

5. Locating Healthcare Provider

Insurance companies have long-term partnerships with medical professionals, hospitals, and clinics, along with pharmacists and drug stores. This helps to form a network in areas and showcase the same on a health insurance application.

With a locating feature, users can get access to geolocation of nearby medical services which are affiliated with insurance providers. It also gives real-time directions to users, and a search button to look for drugstores in the vicinity. With a price comparison chart for medication, users can better analyze their compensations via insurers.

6. Payments

Private health insurance companies prefer monthly premium payments, and offer varied payment methods to users, so they can pick whichever is suitable for them. Some of the payment options feasible for app are debit/credit cards, app payment such as PayPal, or online banking.

7. Reminders/Alerts

This feature updates both insurers and policy holders about upcoming dues, insurance expiry dates, monthly premiums, renewals, upcoming appointments, and new policies.

At times, in busy schedule, it’s hard to keep a track of dues, bills, and health appointments. Hence, reminders are a plausible solution to ensure that users don’t miss out on premiums and stay up-to-date on their policies updates and expirations.

4 Steps to Develop Health Insurance App

1. Research and Planning

This stage consists of information gathering, listing out requirements, and researching on the overall project workflow. This stage involves finalizing the goal and answering why you’re building the app?

Prioritizing goals brings clarity for team members, and helps them to build app accordingly. Planning includes finalizing a platform for application launch, and two of the known platforms are iOS and Android.

Moving on, estimating overall expenditure, including hidden costs falls under this stage. Preparing a budget for app development assures that all the right resources are in place. Finally, market research and competitor analysis helps to understand market size, risks, and acceptability of an app by users.

2. Design Phase

Requirements listed out in the first stage helps to map out UX/UI design for insurance application. This section talks on the role of UX/UI played in the development process, instead of discussing in detail about healthcare UX/UI design process.

App designs helps to communicate better and deliver values of product to users in an ideal way. A prototype design is an excellent guide to improve user experience, find out gaps in the app development, and fix them before launch. At the end of the design phase, it’s expected to have a user experience wireframe for various screen resolutions and an interactive prototype.

3. App Development

App development process is all about turning design into a live application through coding. This process is mainly divided into mobile, backend, and frontend development.

Mobile development includes client-side interface, app’s creation, and incorporation of endpoints from backend. Consider using Flutter or React Native for cross-platform applications, and for native ones Kotlin or Swift are best options.

Backend development creates behind-the-scenes functions which are necessary for working of an app. Consider using backend languages such as PHP, Node.js, and Java.

Frontend development involves building an interface and is used to develop web-based admin panels for smartphone products. Consider using Angular, React.js, and Vue.js for frontend development.

Additionally, to enrich app capabilities and to speed up project development process, consider adding tools such as digital signing, geolocation, and API integrations. Incorporating EHR/EMR software, CRM systems, and other clinical solutions in medical insurance app facilitates smooth data exchange between patients and insurers.

4. Testing, Launch, and Maintenance

At this phase, QA testers conduct multiple manual and automated tests to assure that health insurance app fulfills all quality standards such as compliance and security, and meets project requirements. Once app is tested for bugs and is fixed, it’s ready to be launched in the market, and move to app stores.

Post release maintenance is vital to keep an application going and beat competition. Regular app updates and feature additions help to keep an insurance app in good shape, and brings in clients.

Cost of Mobile Health Insurance App Development

On an average, cost of health insurance app development ranges from $70,000 to $85,000. This cost primarily depends on the development team, their location, and the type of medical insurance app developed.

a. Development Team Types: This include freelancers, in-house, outsourced, and local agency. Prices of app development varies as per their types. An estimate of their average costs for app development are: freelancers $45,000, in-house $180,000, outsource $80,000, and local agency $200,000.

b. Location of Development Team: In the USA, UK, Western Europe, and Australia, the cost of developing an app is expensive due to labor costs. Contrary, South Asia region has the lowest development price.

For more information on health insurance app development and if you’re looking to develop a healthcare application for your organization, then connect with Arkenea, an top-rated healthcare software development company. With our expert development team and 10+ years of experience in the healthcare development industry, we will provide you with the best in class healthcare app that suits industry standards.