U.S. Healthcare Discount Plan Market Size, Share & Trends Analysis Report By Service (Dental Care, Health Advocate, Virtual Visits, Alternative Medicines, Prescription Drugs, Vision Care, Hearing Aids), And Segment Forecasts, 2023 - 2030

Report Overview

The U.S. healthcare discount plan market size was estimated at USD 1.72 billion in 2022 and is anticipated to grow at a compound annual growth rate (CAGR) of 10.4% from 2023 to 2030. The strong presence of Discount Medical Plan Organizations (DMPOs) offering affordable discount plans for distinct services, such as health advocacy, vision care, virtual visits, chiropractic care, dental care, alternative medicines, and prescription drugs, in the U.S. is a key factor expected to boost the DMPOs familiarity among the U.S. patient population. The U.S. market has a wide array of highly discounted health programs packaged with multiple benefits, such as individual coverage & family coverage.

These programs offer higher discounts than traditional high monthly premium insurance plans. The above-mentioned factors accelerate the adoption of healthcare discount plans. Key market players are focusing on devising strategies to increase public-private partnerships, collaborations, & investments and expand business coverage to minimize medication costs and offer users affordable & accessible healthcare solutions. Furthermore, increasing collaborative efforts among care providers and healthcare payers & insurance providers to reduce costs & expenses and enhance patient experience & quality of care is significantly improving clinical outcomes and boosting the market growth.

However, the presence of affordable health insurance companies in the country offering multiple health service plans is hindering market growth. Some players, such as United Healthcare, Cigna, BlueCross, Kaiser Permanente, and BlueShield, offer affordable and better insurance than medical discount plans. Thus, the high adoption of cheap insurance coverage plans over conventional discount plans is expected to limit market growth. Despite a significant number of players, there is a greater need to reinstate a well-structured insurance market capable of providing healthcare coverage at reasonable prices to most individuals not covered by employer-sponsored insurance policies or not considered under public entitlement programs.

The growing healthcare costs are driving consumers to adopt health discount plans rapidly. Although healthcare bundled payments offer value for providers, payers, and patients, consumers are not capable of exploiting their full potential. However, a wide range of healthcare discount solutions are being actively developed in the private health sector to encourage demand for forward-looking health plans. Key market participants are focusing on devising innovative product & service offerings to expand their portfolio and serve the growing demand. These key players promote affordable medical treatment plans through their service portfolio. For instance, the Health Care Transformation Task Force-an association of key health payers and health providers including Anthem, Aetna, and state-level Blue Cross Blue Shield plans, Sentara Healthcare, and Geisinger - had around 50.0% of its payer and provider members’ payment arrangements done via APMs in 2017, which increased to nearly 75.0% by 2020. Similarly, United Healthcare in March 2019, through its California Health Care Investment Program, invested USD 19 million to develop multiple health centers in California, improve patient care experience, enhance clinical outcomes across California, and deliver care to underserved communities of Santa Clara, Solano, and Santa Barbara.

The growing demand for health/medical discount plans to curb rising costs is anticipated to propel market growth. According to Centers for Medicare & Medicaid Services (CMS) and National Health Expenditure Accounts (NHEA) estimates, the healthcare spending in the U.S. in 2020 is USD 4.1 trillion or USD 12,530 per individual, accounting for 19.7% of the country’s overall GDP, thus, making the U.S. healthcare industry one of the largest industries. A growing number of mergers & acquisitions, collaborations, partnerships, and joint ventures among industry players enhance the quality of care, offer affordable treatment options, and deliver patient satisfaction. For instance, in April 2020, Cigna & Express Scripts partnered with Buoy Health to provide screening tools for COVID-19 and help customers & members understand their risks regarding the pandemic. In December 2019, Humana acquired Enclara, and this acquisition helped Humana advance in its clinical management expertise by expanding and leveraging Enclara’s capabilities.

The COVID-19 pandemic had a significant impact on the U.S. healthcare discount plan industry. The COVID-19 pandemic caused disruptions across the healthcare industry and forced governments to impose lockdowns and travel restrictions to minimize the transmission of infection. Care facilities and institutes underwent major structural transformations, and medical procedures were prioritized. The pandemic has exposed a flaw in the current benefit plans. They do not provide affordable coverage for critical services, such as telehealth, prescription drugs, diagnostics, and medical care, associated with pandemic–related illnesses.

Some government and private healthcare providers are offering additional support & protective equipment to caregivers, expanding telehealth access, and increasing flexibility in Medicaid benefits, to address COVID-19 public health emergency. The immediate implementation of reforms in the Value-based Insurance Design (V-BID) model by the Centers for Medicare & Medicaid Services (CMS) ensures affordable and easy access to critical clinical services.

Service Insights

In terms of service, the others service segment dominated the market in 2022 with the largest revenue share of 19.6%. The others segment includes medical supplies, lab services, LASIK & ultrasound, diabetic supplies, laboratory tests, X-rays, MRI, CT scans, diagnostics, surgeries, urgent care, endoscopies, and mammography. Market players are devising discount plans coupled with additional benefits on these services, and the growing awareness about the same among consumers is driving the growth of the segment. For instance, New Benefits, Ltd. offers 10 to 80% off on various laboratory testing services and 40 to 50% off on LASIK surgery costs. On the other hand, the virtual visits segment is anticipated to register the fastest growth rate over the forecast years.

This is owing to the rising burden of chronic diseases, increasing healthcare costs & the growing need to reduce out-of-pocket expenses. The launch of new discount plans, increasing startup funding, and growing penetration of health insurance companies to market the discount plans offered by DMPOs, especially in the U.S., are among the factors estimated to boost market growth in the coming years.

The virtual visits segment is estimated to register the fastest-growing CAGR of 13.1% over the forecast period. Owing to the convenience that it provides, it is gaining more popularity in the U.S. healthcare discount plan industry. For instance, AmeriPlan offers a monthly package of USD 19.95 for telemedicine services, which include online consultation, recommendation, & prescription medication with 24/7 access to doctors on the phone or over video calls. Such services also help members save out-of-pocket expenditures and avoid long clinic or hospital waiting times. Market participants are partnering and collaborating to launch discount plans promoting quality treatment & care at low costs.

Key Companies & Market Share Insights

Key players are focusing on devising innovative product development strategies through mergers & acquisitions, and collaborations to expand portfolios and strengthen the business position. For instance, in October 2022, UnitedHealthcare announced the expansion of its individual and family plans, providing more affordable benefits to customers in the U.S. The benefits may include USD 0 unlimited primary care, USD 0 unlimited virtual urgent care, a chance to win a USD 100 gift card, dental and vision coverage, prescriptions as little as USD 3 to USD 0 deductibles, and free digital fitness classes. Some plans also offer 24/7 virtual visits for urgent, primary, and specialty care at no additional costs.

In January 2020, Cigna and Oscar entered a strategic partnership to deliver commercial health solutions to small businesses, enabling them to expand their network & product choice while remaining cost-effective. In June 2019, Optum acquired DaVita Medical Group serving more than 80 health plans to lower healthcare costs (primary, specialty, urgent, and surgical care) and improve patient experience & health. Some prominent players in the U.S. healthcare discount plan market include:

Discount Medical Plan Organizations (DMPOs)

• Coverdell

• Access One Consumer Health, Inc.

• New Benefits, Ltd.

• Alliance Healthcare of Florida, Inc.

• Ameriplan

• CARRINGTON International Corp.

Marketer

• Cigna

• Sam’s West, Inc.

• United Health Group

• DentalPlans.com, Inc.

• American Dental Care Partners, Inc.

• Humana, Inc.

• Blue Cross and BlueShield Association

• Xpress Healthcare

• Discounts by Design

• Freshbenies

U.S. Healthcare Discount Plan MarketReport Scope

U.S. Healthcare Discount Plan Market Report Segmentation

This report forecasts revenue growth at a country level and provides an analysis of the latest industry trends in each of the sub-segments from 2018 to 2030. For this study, Grand View Research has segmented the U.S. Healthcare Discount Plan Marketreport based on service:

• Service Outlook (Revenue, USD Million, 2018 - 2030)

  • Health Advocate

  • Virtual Visits

  • Alternative Medicines

  • Prescription Drugs

  • Dental Care

  • Vision Care

  • Hearing Aids

  • Chiropractic Care

  • Nurse Services

  • Vitamins & Supplements

  • Wellness Plans

  • Podiatry Plans

  • Others