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Private Medical Insurance - Ireland - July 2015

Although the recession certainly had a negative impact on private medical insurance ownership levels among RoI consumers, the effect was not nearly as profound as might have been expected given the severity of the downturn. This illustrates the strong attachment that RoI consumers have for private cover. It can therefore be expected that economic growth will bring about a corresponding increase in ownership among RoI consumers. The situation, however, is very different in NI; NI consumers do not have anything like the same level or strength of attachment to private medical insurance and, because affordability is not the main obstacle for consumers in the region, economic growth will not inevitably lead to increased ownership of private medical insurance among NI consumers. Rather, among NI consumers, there is an array of psychological obstacles, which are arguably far more difficult to overcome than economic or financial ones.

This report examines the broader trends affecting the private medical insurance market in NI and RoI, and, specifically, how these trends are likely to impact upon the value and volume of policy sales. It also draws extensively on in-depth independently commissioned consumer research (Toluna, May 2015) to analyse ownership (and non-ownership) of private medical insurance, and where consumers obtain their information from when purchasing medical insurance.

This report answers the following questions:

  • What health-related activities do Irish consumers participate in?
  • How many consumers have private medical insurance?
  • Where do consumers source information on private health cover?
  • What are consumers' general attitudes towards private health cover?
  • Why do some consumers not have private medical insurance?
  • How healthy are Irish consumers?

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Table of contents

  1. Introduction

      • Key themes in the report
        • Definitions
          • Consumer research
            • Market size rationale
              • Data sources
                • Abbreviations
                • Executive Summary

                    • The market
                      • Total annual premiums to top €2.6 billion (£2.2 billion) in 2015
                        • Figure 1: Estimated value of private medical insurance annual premiums, NI and RoI, 2010-15
                      • Forecast
                        • Figure 2: Indexed value of private medical insurance annual premiums, NI and RoI, 2010-20
                      • Market factors
                        • Economic recovery and jobs growth underway in NI and RoI
                          • Consumer confidence steadily improving in NI and RoI
                            • But household incomes still lagging overall economic improvements
                              • Irish population getting older - with important consequences for health insurance
                                • Public system funding shortfalls could cause consumer dissatisfaction
                                  • Cost of private health cover continuing to increase
                                    • The consumer
                                      • Four-in-10 Irish consumers rate their own health as 'average'
                                        • Figure 3: How consumers rate their current level of health, NI and RoI, May 2015
                                      • High level of interaction with healthcare services and providers
                                        • Figure 4: Health-related activities that consumers themselves have undertaken in the last two years, NI and RoI, May 2015
                                      • Private cover popular in RoI, but not so much in NI
                                        • Figure 5: Types of health/medical plans or policies that consumers currently have, NI and RoI, May 2015
                                      • Main obstacle to ownership - affordability in RoI, relevance in NI
                                        • Figure 6: Reasons why consumers do not have health/medical plans or insurance plans, NI and RoI, May 2015
                                      • Employers the main source of info in NI, but multiple sources in RoI
                                        • Figure 7: Sources of information used before taking out private medical insurance, NI and RoI, May 2015
                                      • Consumers are confused, sceptical and dubious when it comes to private cover
                                        • Figure 8: Agreement with statements relating to medical/health insurance, NI and RoI, May 2015
                                      • What we think
                                      • Issues and Insights

                                        • What health-related activities do Irish consumers participate in?
                                          • The facts
                                            • The implications
                                              • How many consumers have private medical insurance?
                                                • The facts
                                                  • The implications
                                                    • Where do consumers source information on private health cover?
                                                      • The facts
                                                        • The implications
                                                          • What are consumers' general attitudes towards private health cover?
                                                            • The facts
                                                              • The implications
                                                                • Why do some consumers not have private medical insurance?
                                                                  • The facts
                                                                    • The implications
                                                                      • How healthy are Irish consumers?
                                                                        • The facts
                                                                          • The implications
                                                                          • Market Overview

                                                                            • Key points
                                                                              • Both Irish economies back to growth, with RoI performing strongest
                                                                                • Figure 9: GDP growth projections, NI, UK and RoI, 2013-16
                                                                              • Job creation up, unemployment down in NI and RoI
                                                                                • Figure 10: Average annual employment, % change, actual, forecast and projected, NI and RoI, 2014-16
                                                                                • Figure 11: Unemployment rate, as % of labour force, RoI, 2012-16
                                                                              • Consumer confidence continuing on upward trend
                                                                                • Figure 12: Consumer sentiment, RoI, December 2011-June 2015
                                                                                • Figure 13: Consumer confidence, NI, December 2011-March 2015
                                                                              • Household incomes lagging the overall recovery, however
                                                                                • Ageing of Irish population will impact on demand and cost
                                                                                  • Figure 14: Population, by age group, NI, 2011 and 2026
                                                                                  • Figure 15: Population, by age group, RoI, 2011 and 2026
                                                                                • Financial pressures affecting public health system standards
                                                                                  • Figure 16: NHS total managed expenditure, £bn, 2010/11-2015/16
                                                                                  • Figure 17: HSE annual budget (€bn), RoI, 2011-14
                                                                                • Cost of corporate PMI to increase significantly in UK (including NI)
                                                                                  • Introduction of Lifetime Community Rating releases pent-up demand…
                                                                                    • ...but premium increases weren't far behind
                                                                                    • Market Size and Forecast

                                                                                      • Key points
                                                                                        • Total PMI annual premiums to exceed €2.6 billion (£2.2 billion) in 2015
                                                                                          • Figure 18: Value of private medical insurance annual premiums, IoI, NI and RoI, 2010-20
                                                                                        • Premium price increases account for growth since recession
                                                                                          • Figure 19: Number of consumers with private medical insurance (inpatient cover), Millions, RoI, 2001-14
                                                                                        • PMI total market value to reach almost €3.2 billion by 2020
                                                                                          • Figure 20: Indexed value of private medical insurance annual premiums, IoI, NI and RoI, 2010-20
                                                                                      • Strengths and Weaknesses

                                                                                        • Strengths
                                                                                          • Weaknesses
                                                                                          • Companies and Innovations

                                                                                            • Key points
                                                                                              • Innovations
                                                                                                • Get Checked!
                                                                                                  • Appy to help
                                                                                                    • Company profiles
                                                                                                      • RoI
                                                                                                        • Voluntary Health Insurance (VHI)
                                                                                                          • Laya Healthcare
                                                                                                            • Aviva
                                                                                                              • GloHealth
                                                                                                                • HSF Health Plan
                                                                                                                  • NI
                                                                                                                    • Bupa
                                                                                                                      • H3 Health insurance
                                                                                                                        • AXA PPP Healthcare
                                                                                                                        • The Consumer – Current Level of Health

                                                                                                                          • Key points
                                                                                                                            • Consumers generally positive about own level of health
                                                                                                                              • Figure 21: How consumers rate their current level of health, NI and RoI, May 2015
                                                                                                                            • 'Average' assessment of heath consistent across demographics
                                                                                                                              • Figure 22: Consumers who rate their current level of health as average, by gender, age and social class, NI and RoI, May 2015
                                                                                                                            • ABC1s and 35-44s most likely to say their health is 'above average'
                                                                                                                              • Figure 23: Consumers who rate their current level of health as above average, by gender, age and social class, NI and RoI, May 2015
                                                                                                                            • C2DEFs and older consumers (especially in NI) most likely to self-rate as 'below average'
                                                                                                                              • Figure 24: Consumers who rate their current level of health as below average, by gender, age and social class, RoI and NI, May 2015
                                                                                                                          • The Consumer – Health-Related Activities Undertaken

                                                                                                                            • Key points
                                                                                                                              • Strong demand for healthcare services among NI and RoI consumers
                                                                                                                                • Figure 25: Health-related activities that consumers themselves have undertaken in the last two years, NI and RoI, May 2015
                                                                                                                              • GP visits top the list of healthcare activities among Irish consumers
                                                                                                                                  • Figure 26: Consumers who have had an appointment with a GP in the last two years, by gender, age and social class, NI and RoI, May 2015
                                                                                                                                • Self-employed in RoI more likely than employees to have visited a GP
                                                                                                                                  • Figure 27: Consumers who have had an appointment with a GP in the last two years, by work status, NI and RoI, May 2015
                                                                                                                                • Less focus among consumers on preventing illness
                                                                                                                                    • Figure 28: Consumers who have sought advice on maintaining/improving health in the last two years, by gender, age and social class, NI and RoI, May 2015
                                                                                                                                  • Parents of young children particularly likely to have used healthcare
                                                                                                                                    • Figure 29: Health-related activities that consumers' family members have undertaken in the last two years, NI and RoI, May 2015
                                                                                                                                • The Consumer – Penetration of Private Medical Insurance

                                                                                                                                  • Key points
                                                                                                                                    • Ownership of health-related insurance far higher among RoI consumers
                                                                                                                                        • Figure 30: Types of health/medical plans or policies that consumers currently have, NI and RoI, May 2015
                                                                                                                                      • C2DEFs most likely to have no health or medical plan in place
                                                                                                                                          • Figure 31: Consumers who have no health or medical plans, by age, gender and social class, NI and RoI, May 2015
                                                                                                                                        • ABC1s, 35-44s most likely to have cover through work
                                                                                                                                          • Figure 32: Consumers who have private medical insurance arranged 'through my/my partner's work', by gender, age and social class, RoI, May 2015
                                                                                                                                        • Consumers aged 55+ most likely to arrange cover independently
                                                                                                                                          • Figure 33: Consumers who have private medical insurance 'that I/my partner arranged independently', by gender, age and social class, RoI, May 2015
                                                                                                                                        • Younger consumers more inclined to put aside cash to cover costs
                                                                                                                                          • Figure 34: Consumers who have money set aside 'in case I ever need to pay for medical treatment', by gender, age and social class, RoI, May 2015
                                                                                                                                      • The Consumer – Reasons for not having Private Medical Insurance

                                                                                                                                        • Key points
                                                                                                                                          • Affordability the obstacle in RoI, but unnecessary in NI eyes
                                                                                                                                            • Figure 35: Reasons why consumers do not have health/medical plans or insurance plans, NI and RoI, May 2015
                                                                                                                                          • C2DEFs and 35-44s most likely to cite affordability
                                                                                                                                            • Figure 36: Consumers who do not have health/medical plans or insurance plans because 'I cannot afford to spend money on health cover', by gender, age and social class, NI and RoI, May 2015
                                                                                                                                          • Satisfaction with NHS broadly consistent across all demographics in NI
                                                                                                                                              • Figure 37: Consumers who do not have health/medical plans or insurance plans because 'I am happy to use the NHS/HSE for any of my medical needs', by gender, age and social class, NI and RoI, May 2015
                                                                                                                                            • Men, C2DEFs and 55+ most likely to say 'not interested' in private cover…
                                                                                                                                              • Figure 38: Consumers who do not have health/medical plans or insurance plans because 'I am not interested in health cover', by age, gender and social class, NI, May 2015
                                                                                                                                            • ...while men and 55+s also most inclined to lack trust in providers
                                                                                                                                              • Figure 39: Consumers who do not have health/medical plans or insurance plans because 'I do not trust insurance companies to pay out in the event of a claim', by age, gender and social class, NI, May 2015
                                                                                                                                          • The Consumer – Sources of Information

                                                                                                                                            • Key points
                                                                                                                                              • RoI consumers getting information from multiple sources
                                                                                                                                                • Figure 40: Sources of information used before taking out private medical insurance, NI and RoI, May 2015
                                                                                                                                              • ABC1s and 25-44s most inclined to get information via an employer
                                                                                                                                                • Figure 41: Consumers who obtained information from 'My or my partner's employer' before taking out private medical insurance, RoI, May 2015
                                                                                                                                              • Consumers aged 45-54 accessing information via insurers' websites
                                                                                                                                                • Figure 42: Consumers who obtained information from insurer's website before taking out private medical insurance, RoI, May 2015
                                                                                                                                              • Consumers aged 55+ using price comparison websites
                                                                                                                                                • Figure 43: Consumers who obtained information from price comparison websites before taking out private medical insurance, RoI, May 2015
                                                                                                                                              • C2DEFs and 18-24s turning to family and friends for information
                                                                                                                                                • Figure 44: Consumers who obtained information from family/friends before taking out private medical insurance, RoI, May 2015
                                                                                                                                              • Providers the main source of information on various health plans
                                                                                                                                                  • Figure 45: Sources of information used before taking out a health cash/dental/optical plan, NI and RoI, May 2015
                                                                                                                                              • The Consumer – Attitudes towards Private Medical Insurance

                                                                                                                                                • Key points
                                                                                                                                                  • Majority of consumers are confused about policy options and details
                                                                                                                                                    • Figure 46: Agreement with statements relating to medical/health insurance, NI and RoI, May 2015
                                                                                                                                                  • Confusion around policies peaks among consumers aged 25-34
                                                                                                                                                    • Figure 47: Agreement with statement, 'It is difficult to know which private health insurance policy to buy', by gender and age RoI, May 2015
                                                                                                                                                  • Majority of policyholders willing to make an effort to save money
                                                                                                                                                    • Figure 48: Agreement with statement relating to money-saving behaviour, by gender and age, NI and RoI, May 2015
                                                                                                                                                  • Consumers unconvinced about value of private cover
                                                                                                                                                      • Figure 49: Consumers who disagree with the statement, 'Private health insurance is good value for money', by gender and age, RoI, May 2015
                                                                                                                                                    • Confidence in public health system highest among NI consumers
                                                                                                                                                      • Figure 50: Agreement with statement, 'The NHS/HSE means that private health insurance is just a luxury', by gender and age, NI and RoI, May 2015
                                                                                                                                                      • Figure 51: Agreement with statement, 'I believe private health insurance gives a standard of care that the NHS/HSE can't match', by age and social class, NI and RoI, May 2015
                                                                                                                                                  • Appendix

                                                                                                                                                    • NI Toluna tables
                                                                                                                                                      • Figure 52: How consumers rate their current level of health, by demographics, NI, May 2015
                                                                                                                                                      • Figure 53: Health related activities that consumers themselves have undertaken in the last two years, by demographics, NI, May 2015
                                                                                                                                                      • Figure 54: Health related activities that consumers themselves have undertaken in the last two years, by demographics, NI, May 2015 (continued)
                                                                                                                                                      • Figure 55: Health related activities that consumers themselves have undertaken in the last two years, by demographics, NI, May 2015 (continued)
                                                                                                                                                      • Figure 56: Health related activities that consumers’ family members have undertaken in the last two years, by demographics, NI, May 2015
                                                                                                                                                      • Figure 57: Health related activities that consumers’ family members have undertaken in the last two years, by demographics, NI, May 2015 (continued)
                                                                                                                                                      • Figure 58: Health related activities that consumers’ family members have undertaken in the last two years, by demographics, NI, May 2015 (continued)
                                                                                                                                                      • Figure 59: Types of health/medical plans or policies that consumers currently have, by demographics, NI, May 2015
                                                                                                                                                      • Figure 60: Types of health/medical plans or policies that consumers currently have, by demographics, NI, May 2015 (continued)
                                                                                                                                                      • Figure 61: Sources of information used before taking out a health cash/dental/optical plan, by demographics, NI, May 2015
                                                                                                                                                      • Figure 62: Sources of information used before taking out a health cash/dental/optical plan, by demographics, NI, May 2015 (continued)
                                                                                                                                                      • Figure 63: Sources of information used before taking out private medical insurance, by demographics, NI, May 2015
                                                                                                                                                      • Figure 64: Sources of information used before taking out private medical insurance, by demographics, NI, May 2015 (continued)
                                                                                                                                                      • Figure 65: Sources of information used before taking out other types of health insurance, by demographics, NI, May 2015 (continued)
                                                                                                                                                      • Figure 66: Sources of information used before taking out other types of health insurance, by demographics, NI, May 2015 (continued)
                                                                                                                                                      • Figure 67: Reasons why consumers do not have health/medical plans or insurance plans, by demographics, NI, May 2015
                                                                                                                                                      • Figure 68: Reasons why consumers do not have health/medical plans or insurance plans, by demographics, NI, May 2015 (continued)
                                                                                                                                                      • Figure 69: Agreement with the statement ‘Private health insurance is good value for money’, by demographics, NI, May 2015
                                                                                                                                                      • Figure 70: Agreement with the statement ‘The NHS/ HSE means that private health insurance is just a luxury’, by demographics, NI, May 2015
                                                                                                                                                      • Figure 71: Agreement with the statement ‘I would be willing to use an app/wearable monitor if it meant lower premiums for my private health insurance’, by demographics, NI, May 2015
                                                                                                                                                      • Figure 72: Agreement with the statement ‘It is difficult to know which private health insurance policy to buy’, by demographics, NI, May 2015
                                                                                                                                                      • Figure 73: Agreement with the statement ‘I trust private health insurers to treat me fairly’, by demographics, NI, May 2015
                                                                                                                                                      • Figure 74: Agreement with the statement ‘I believe private health insurance gives a standard of care that the NHS/state can’t match’, by demographics, NI, May 2015
                                                                                                                                                      • Figure 75: Agreement with the statement ‘It is better to buy health coverage earlier in life to avoid higher fees later in life’, by demographics, NI, May 2015
                                                                                                                                                      • Figure 76: Agreement with the statement ‘Health coverage is an important factor for me when searching for a job’, by demographics, NI, May 2015
                                                                                                                                                      • Figure 77: Agreement with the statement ‘I think it is important to spend more on health insurance compared to other types of insurance (eg car insurance, house insurance)’, by demographics, NI, May 2015
                                                                                                                                                      • Figure 78: Agreement with the statement ‘I would prefer to get all my health /life insurance cover from the same provider’, by demographics, NI, May 2015
                                                                                                                                                    • RoI Toluna tables
                                                                                                                                                      • Figure 79: How consumers rate their current level of health, by demographics, RoI, May 2015
                                                                                                                                                      • Figure 80: Health related activities that consumers themselves have undertaken in the last two years, by demographics, RoI, May 2015
                                                                                                                                                      • Figure 81: Health related activities that consumers themselves have undertaken in the last two years, by demographics, RoI, May 2015 (continued)
                                                                                                                                                      • Figure 82: Health related activities that consumers themselves have undertaken in the last two years, by demographics, RoI, May 2015 (continued)
                                                                                                                                                      • Figure 83: Health related activities that consumers’ family members have undertaken in the last two years, by demographics, RoI, May 2015
                                                                                                                                                      • Figure 84: Health related activities that consumers’ family members have undertaken in the last two years, by demographics, RoI, May 2015 (continued)
                                                                                                                                                      • Figure 85: Health related activities that consumers’ family members have undertaken in the last two years, by demographics, RoI, May 2015 (continued)
                                                                                                                                                      • Figure 86: Types of health/medical plans or policies that consumers currently have, by demographics, RoI, May 2015
                                                                                                                                                      • Figure 87: Types of health/medical plans or policies that consumers currently have, by demographics, RoI, May 2015 (continued)
                                                                                                                                                      • Figure 88: Sources of information used before taking out a health cash/dental/optical plan, by demographics, RoI, May 2015
                                                                                                                                                      • Figure 89: Sources of information used before taking out a health cash/dental/optical plan, by demographics, RoI, May 2015 (continued)
                                                                                                                                                      • Figure 90: Sources of information used before taking out private medical insurance, by demographics, RoI, May 2015
                                                                                                                                                      • Figure 91: Sources of information used before taking out private medical insurance, by demographics, RoI, May 2015 (continued)
                                                                                                                                                      • Figure 92: Sources of information used before taking out other types of health insurance, by demographics, RoI, May 2015
                                                                                                                                                      • Figure 93: Sources of information used before taking out other types of health insurance, by demographics, RoI, May 2015 (continued)
                                                                                                                                                      • Figure 94: Reasons why consumers do not have health/medical plans or insurance plans, by demographics, RoI, May 2015
                                                                                                                                                      • Figure 95: Reasons why consumers do not have health/medical plans or insurance plans, by demographics, RoI, May 2015 (continued)
                                                                                                                                                      • Figure 96: Agreement with the statement ‘Private health insurance is good value for money’, by demographics, RoI, May 2015
                                                                                                                                                      • Figure 97: Agreement with the statement ‘The NHS/HSE means that private health insurance is just a luxury’, by demographics, RoI, May 2015
                                                                                                                                                      • Figure 98: Agreement with the statement ‘I would be willing to use an app/wearable monitor if it meant lower premiums for my private health insurance’, by demographics, RoI, May 2015
                                                                                                                                                      • Figure 99: Agreement with the statement ‘It is difficult to know which private health insurance policy to buy’, by demographics, RoI, May 2015
                                                                                                                                                      • Figure 100: Agreement with the statement ‘I trust private health insurers to treat me fairly’, by demographics, RoI, May 2015
                                                                                                                                                      • Figure 101: Agreement with the statement ‘I believe private health insurance gives a standard of care that the NHS/state can’t match’, by demographics, RoI, May 2015
                                                                                                                                                      • Figure 102: Agreement with the statement ‘It is better to buy health coverage earlier in life to avoid higher fees later in life’, by demographics, RoI, May 2015
                                                                                                                                                      • Figure 103: Agreement with the statement ‘I would be willing to travel out of the country for medical treatment if it was cheaper (eg the UK)’, by demographics, RoI, May 2015
                                                                                                                                                      • Figure 104: Agreement with the statement ‘Health coverage is an important factor for me when searching for a job’, by demographics, RoI, May 2015
                                                                                                                                                      • Figure 105: Agreement with the statement ‘I think it is important to spend more on health insurance compared to other types of insurance (eg car insurance, house insurance)’, by demographics, RoI, May 2015
                                                                                                                                                      • Figure 106: Agreement with the statement ‘I would prefer to get all my health/life insurance cover from the same provider’, by demographics, RoI, May 2015

                                                                                                                                                  Companies Covered

                                                                                                                                                  To learn more about the companies covered in this report please contact us.

                                                                                                                                                  Private Medical Insurance - Ireland - July 2015

                                                                                                                                                  £1,095.00 (Excl.Tax)