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Announcing the release of Cost of International Health Insurance Report – 2018

Pacific Prime is proud to present our latest report – the Cost of International Health Insurance Report for Individuals and Families 2018; a welcome addition to our collection of professional industry reports.

Now in its fourth iteration, this free report, as with previous versions, addresses the average cost of International Private Medical Insurance (IPMI) in 100 countries. This year, in addition to the figures and charts, we have also streamlined our reporting to reflect industry and regional changes we have noticed influencing premiums globally.

For a newly updated look at our rankings and Analysis sections (primary global drivers behind the cost of IPMI), you may read our online version here.

If you want to uncover all of our in-depth and comprehensive information, you can download a copy of our full written report in PDF format. This version encompasses a complete ranking of the average cost of medical insurance in 100 countries for different demographics, as well as our full length analysis (four key drivers behind the five key findings).

In this feature, we are going to showcase the highly-coveted contents in our report, such as some of our rankings, key findings, and analysis.

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Ranking the top 20 and bottom 5 most expensive countries

In this section, we dissect the cost of international health insurance in 100 countries, and rank the 20 most expensive locations, along with the five least expensive locations.

To generate the rankings, we have collected data from seven major international health insurers in all covered countries, which offer three levels of plan – namely inpatient; inpatient + outpatient; and inpatient + outpatient + maternity plans.

Furthermore, for each plan we have also chosen to display premiums for individuals and families respectively; so that alongside an overall ranking, we also include ranking tables for individual and family plans to deliver a more accurate picture of the costs by demographics.

By taking the premiums for each of the demographics above, along with the three levels of plan, and averaging them together for each country, we have come up with our rankings for 2018.

Ranking based on the average price of plans (overall)

Rank Country Average Cost – USD % of
1 US $23,120 100%
2 Hong Kong $12,927 55.9%
3 Canada $10,361 44.8%


Unsurprisingly, after considering the overall premiums for both individuals and families, the country with the highest average cost of international health insurance in 2018 is the United States (USD 23,120), while the country with the lowest is Angola (USD 6,021), which constitutes a price difference of 73.2%.

There are a number of notable changes when we compare the figures with those of last year. The most prominent shift is found in Dubai. Thanks to premium increases and the introduction of a 5% VAT tax, the Emirate has increased its ranking from 9th in 2017 to 4th in 2018.

Ranking based on the average price of plans (for individuals/families)

For ranking based on the average price of plans for individuals or families, please download the FULL version of our Cost of International Health Insurance Report – 2018.

Compound Annual Growth Rate (CAGR) of the average price of plans from 2015 – 2018

In this newly added section, we calculate the Compound Annual Growth Rate (CAGR) of average premiums from 2015 to 2018 in the top 20 most expensive and 5 least expensive
locations for IPMI plans in 2018.

While some countries have moved upwards in the rankings, others have seen decreases in overall premiums. Among the 25 countries, Canada and Indonesia have seen the overall largest CAGRs at 6.95% and 6.7% respectively, while Croatia and the Dominican Republic have the largest negative CAGRs at -1.49% and -1.25% respectively.

However, please note that such decreases do not indicate that all premiums of health insurance plans have dropped in countries with negative rates. This is because the CAGR is an average number, and there might, in fact, be a large amount of variation among different insurance plans.

Pacific Prime’s Analysis

Divided into two parts, this section illustrates the four key drivers behind IPMI premiums, and analyzes the five key findings we have found in the report.

Key drivers behind IPMI premiums

There are four key drivers behind IPMI premiums that are applicable globally:

Increased demand for international quality private care

As mentioned in the 2017 version of this report, we see that IPMI is becoming more common among the growing middle-to-upper class in many developing countries, such as Indonesia. As well, there are more demands for medical treatment, modern medical equipment, and supplies. Together with the increasing prevalence of medical tourism, these trends drive up the cost of healthcare and, subsequently, IPMI premiums.

Increased cost of healthcare

Healthcare costs have been rising globally and consistently for years (8.7% this year on average, according to Aon’s 2018 Global Medical Trend Rates report), and we do not see any sign that this trend will abate in near future. With the increased cost of healthcare, the premiums of IPMI naturally increase too.

Increased regulation

We notice that many countries have strict regulations when it comes to both healthcare and health insurance, especially those where IPMI is popular, be it due to insurance licensing for insurers or mandatory cover for residents.

Insurance licensing regulations mandate that insurers need to possess immense capital, and have led to increased compliance requirements, as well as the need for extensive practice of due diligence. This, in turn, raises the operating costs of insurers, and thus health insurance premiums.

Mandatory insurance coverage requires all residents to have compliant health insurance plans, in which most costly types of care have to be covered. This then puts pressure on insurers, and inevitably pushes up insurance premiums.

Continued challenges with fraud regulation

Health insurance fraud has been plaguing the industry and influencing premiums ever since we started publishing the Cost of Health Insurance report. If you look at the problem on a global scale, it is estimated that health care fraud causes financial losses of up to tens of billions each year in the US alone. Therefore, insurers have been making more effort in detecting and investigating fraud to provide fairer premiums for all policyholders.

Analysis of key findings

Drawing on our professional knowledge and extensive experience in analyzing figures within the insurance industry, our team of experts have provided a detailed overview of the following five key findings, and cited different factors or events that may have contributed to them. We believe this part will be of most interest and importance to our readers.

  1. Three of the top 20 most expensive countries have seen increased rankings
  2. The gap between premiums in the US and everywhere else has increased
  3. The Americas has emerged as a dominant region in the top 20 most expensive locations
  4. Onshore premiums are not drastically different from their global counterparts
  5. Some countries have seen premiums decrease

Again, for the full version of our analysis, you can download the PDF version of our Cost of International Health Insurance Report – 2018.

Seek Professional Advice from Pacific Prime

Under the banner of simplifying insurance, Pacific Prime is an independent, established insurance broker with almost two decades of experience and nine offices around the world. Other than our weekly blogs featuring the latest insurance trends and news. We also boast a wide selection of guides and reports for in-depth and insightful analyses.

Our team of specialists know the ins and outs of different employee benefit solutions and private insurance products, and are always on hand to impartially match the best plan with your needs. Feel free to contact us to get answers to any questions pertaining to insurance, a free quote, or a plan comparison!

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