2021 Guide to Health Insurance App Development + Case Study


Max Litvinov

Sep 14, 2021 | 22 min read


Over the past few years, we have seen massive technological changes in the healthcare industry, particularly in regards to how hospitals and insurers interact with patients and consumers. According to the 2019 Insurance Industry Outlook, there is a significant rise in people’s expectations for personalization, flexible policies, and services that offer more convenience. 

Today, people are looking for the fastest and most innovative digital solutions for all their needs, and their healthcare demands are not left behind. Insurance companies are also constantly looking for ways to make their services more accessible to a broader range of clients. And a mobile app for health insurance is the answer to both parties.

Creating a mobile health insurance app can be an immersive task for software development companies. The ideal healthcare insurance software should contain health insurance plan comparisons, a capable and accessible healthcare providers pool, claim payment management, etc. These features require high precision levels and expertise to build them.

To get it right the first time, it’s best to entrust this job to a team that can build and deploy it correctly. Appvales is one such software development company with an excellent track record building software for startups and enterprise systems, right from the MVP stages to the final product. With our level of competency and experience, you can rest assured our developers will build you an outstanding mobile insurance software.

Insurance Apps Market Overview

Before we get into the intricacies of insurance mobile app development, we must first familiarize ourselves with the mobile apps insurance industry. In addition, information on mobile health and smartphone use is also necessary during the insurance mobile app development process for a complete analysis. 

Analyzing these statistics will give you more insight into why healthcare insurance software is necessary. They will also inform you of the vast market and potential in the sector.

Here is up-to-date data on relevant industries:

  • According to Statista, there was a 65% growth in mobile health apps downloaded worldwide during the COVID-19 pandemic.
  • Two-thirds of the largest US hospitals offer mobile health apps. 
  • Using mHealth tools and mobile app wearables help 8.74% of patients to cope with their health issues.
  • Because of the pandemic, the US health and the medical insurance industry will see a revenue increase of 6.6% in 2021.

From the statistics above, it is clear that both the health insurance industry and the mHealth sector have high growth potential. Therefore, it’s best to leverage it to gain a  competitive advantage.

Top Insurance App Business Models

Like every other application, your insurance business app has to work with an effective business model. Currently, there are 3 top insurance app business models.

  1. The “Freemium” model:

The focus of this model is on the consumer. In this model, users are given free insurance as a value-added service. Apart from the free offer, this model also provides a premium insurance offer. 

The premium insurance offer must have attractive coverage to compel users to opt for it instead of settling with the free offer. This now serves as a source of revenue for your insurance company. There is also the possibility of running in-app ads and generating revenue from there as well. 

Startup insurance companies typically use this model to encourage new users. Families or users that are just using an insurance management app for the first time will also prefer to use this model. 

  1. The Licensure model:

Here, the insurance company pays the software company for rights to the software for a specified period.

During that time, the company will license an aspect of the software to either healthcare providers or customers. Because your insurance company has total control over the software, any use of it and its features will generate revenue. 

This model generates recurring revenue for your insurance company. Here are the ways software licensure can generate income for your company:

  • Licensing/ selling a service or device to clients: For instance, certain health insurance apps come with wearables that will help monitor the vitals of the customer. Clients will have to pay for the wearable to access that specific service.
  • Selling medications on the app. 
  1. Health Insurance Reimbursement:

Here, the focus is on the mobile app, not the patients or healthcare providers.

In this model, a health insurance management system can integrate a feature that carries out therapeutic services. When this feature of the app is FDA-approved, it can replace a traditional diagnostic device.

For instance, AlivCor ECG Mobile Heart Monitor has been approved by the FDA. Now, it is used by health providers instead of the traditional ECG monitor because it is a cheaper alternative. The care providers will have to pay to use the product, of course.

Now, imagine your insurance app has a feature like that. That means the healthcare provider will reimburse your company every time that aspect is used instead of the traditional device covered by the insurance plan.

Although this model is relatively new, it will cause market disruptions. This is because it focuses on innovation and creating intelligent solutions for the healthcare industry.

Core Features of Health Insurance App

Different insurance apps come with varying features. However, certain core features must be included to ensure the success of the healthcare insurance software. They include:

  1. A profile:

A profile consists of the user’s health information as well as their healthcare ID. You must encode adequate security measures to protect client information during the insurance mobile app development.

  1. Health Insurance Plan Search/Comparison:

The majority of the time, patients are unsure of which healthcare insurance plan to opt for. This is because their choice depends on multiple factors like their budget, the health issue they are undergoing, etc. 

On that note, your insurance web application or mobile application should ensure this decision is easier for them to make. For example, your app should have a search function to enable your clients to browse all possible health insurance plans. In addition, your app should display all the necessary information on each insurance policy to ensure transparency.

It would also be good to include a mini-questionnaire to help tailor plans for the users based on their answers. This is what an innovative app, myOscar, does. That way, patients get to choose the right policy for them.

  1. Claims management:

Another essential feature to include in your mobile insurance software is the ability to quickly make claims without the stress of waiting on a call or standing in a queue. Your app should provide the different claim options so the patient can quickly search, view, and select one.

There should be an option for uploading pictures and signing a digital signature to prevent insurance fraud. Lemonade, another fast-growing insurance healthcare app, even allows the use of videos to submit claims.

There should also be a speedy response to claims, else that lag would defeat the purpose of convenient insurance management. 

  1. Knowledge repository:

Fundamentally, your insurance business app should contain a type of knowledge base that will help your customers become more responsible policyholders. Having interactive content like blogs would be more profitable than static PDF documents.

  1. Connection to a network of healthcare providers:

The ability to simply search for and find an accessible healthcare provider is one of the most significant benefits of the personal insurance apps. However, customer satisfaction reduces when an app doesn’t have a unified and extensive list of connected healthcare providers.

Your insurance software should consider healthcare providers based not only on location but also on other categories such as experience, specialty, language, user’s budget, etc. That way, the app can easily link users to a healthcare provider personalized for their immediate needs.

  1. Billing options:

Renewal and purchase of insurance plans should be easy for the users. Your insurance app should offer multiple payment options to enable users to pick whichever option is more convenient.

myOscar handles its billing solutions by providing various channel options for its users. They can pay:

  • With a debit card or a checking account online.
  • By calling a concierge.
  • By mailing a check
  • In the app, through integrated checkout options.
  1. Appointments management:

Linking healthcare providers to their patients is one significant benefit of an insurance or health app. The app should also be able to manage things like appointments and meetings for the user. It is also necessary to invest in telemedical features like video conferencing, calls, and messaging between patients and healthcare providers.

  1. Virtual branch:

The app has to be viewed as a virtual extension of the insurance company itself. Therefore, contacts and email addresses of insurance agents should be easily accessible to the customers. This is in case they need any assistance with their insurance policy.

In the next section, you will find out that mobile insurance apps should have different software for the three various parties involved. The software for the healthcare provider and patient has similar core features. However, some extra features are necessary for the insurer’s app.

They include:

  • Client information: Insurance agencies should add new users via an app, edit their contact information, and view their billing history.
  • Insurance policy management. When there are updates to standard policies, agents should input the information into the app.
  • Data analytics. It is necessary to include the statistics of users in the insurer’s app. This is so they can monitor trends and analyze data to provide better services to clients. This will keep the business successful and keep customers satisfied.

Types of Insurance Apps in Healthcare

A standard health insurance app offers three services within one software. Or it could be one app split into three different models for the three parties involved in the process.

  1. A patient health insurance app:

For patients, the app must be straightforward to use and understand. During insurance mobile app development, it is best to ensure that the app provides more functions for the patient, aside from purchasing insurance plans. Develop an app that can also serve as a repository of drug information, healthcare tips, and insurance information. 

Below are the roles a mobile health insurance app should fill in the lives of users:

  • A source of easily accessible information on different healthcare providers.
  • A guide to the best healthcare provider to head to, taking specialty and budget into consideration.
  • A simple and transparent insurance provider that they can trust.
  • A means of reducing the high cost of medical bills.
  1. An app that aids healthcare providers:

A health insurance app should be aimed at making the daily routine of healthcare providers more straightforward. It should be a source of necessary patient information so that healthcare providers can make better decisions concerning the patients. It should also help in hospital inventory management.

Other benefits that the app should give to providers are:

  • It should offer telemedicine services, thus helping with virtual consultations with patients.
  • It should have chat options that will enable healthcare providers to collaborate when necessary.
  • It should contain basic medical information on different drugs and diseases.
  1. A process solution to insurance companies:

A well-developed mobile insurance app will be a dream come true for many insurance companies. This is because it is developed to make their job processes easier. Here are the benefits of a health insurance mobile app to the insurers:

  • A means of automating the insurance business process.
  • Enhanced customer management.
  • Superior customer experience with the integration of chatbots and AI technology.

Challenges you would encounter building an insurance app

Despite the many solutions it brings, insurance mobile app development is no breeze. Here are the challenges usually faced when developing one:

  1. Security and privacy concerns:

As with everything that requires users’ data to function effectively, there is usually concern about the privacy of information shared on the app. Due to these concerns, The Health Insurance Portability and Accountability Act (HIPAA) was established in the US in 1996. 

It contains rules that protect sensitive patient data. Considering that health insurance apps will be dealing with PHI, i.e., protected health information, your app must be HIPAA compliant. Any failure on your part can lead to hefty fines and loss of credibility with users.

There are 3 HIPAA rules to protect patient health information:

  • The Privacy Rule
  • The Security Rule
  • The Breach Disclosure Rule

You have to ensure that your insurance app is not breaking any of them. You can do this by following the HIPAA compliance checklist. The four primary requirements of the list are:

  • You must put encryptions in place to protect patient health information.
  • Limit the use and sharing of PHI to the lowest necessary level
  • Have Business Associate Agreements (BAAs) in place with healthcare providers that perform covered functions. Covered functions are simply the activities these organizations carry out that makes them healthcare providers
  • Carry out training on PHI protection and place limitations on who can access patient health information.

Another way of complying with HIPAA is by enabling multi-factor authentication to keep patient information safe.

  1. Regulations:

Besides HIPAA, your mobile insurance app must follow other regulations depending on the region where it is active.

Other regulations exist, such as:

  • The Health Information Technology for Economic and Clinical Health (HITECH) Act:

This is simply more additions to HIPAA in the United States. It was adopted in 2009 when more and more healthcare software was being created. The purpose is to ensure the meaningful use of electronic health records (EHRs). 

  • The General Data Protection Rules(GDPR)

This is the regulation used by the European Union to protect patient data. It doesn’t matter if your mobile insurance app operates outside the EU. as long as you have access to data from citizens of the European Union, you have to ensure your app is GCPR- compliant.

Thus during the insurance mobile app development, take note that:

  • Your app can process information only with the consent of the patient (the personal insurance app user); 
  • Data processing companies must inform the supervisory body and store data during the necessary time only; 
  • All data must be correct, or it will have to be removed or fixed; and 
  • Sensitive data has to be protected from damage or illegal processing. 
  1. Data sharing among patients, healthcare providers, and insurance business app:

Interoperability between healthcare providers and the insurance app has to be seamless. Interoperability in Healthcare Mobile App Development refers to the ability of healthcare organizations to communicate and share medical data in a secure environment.

During the mobile insurance app development, a digital healthcare ecosystem has to be developed by the software team. This would go a long way in providing a holistic healthcare model that all parties can benefit from.

How to Build Health Insurance Software With Appvales

  1. Commence Engagement Process:

This is the preliminary stage, where your company indicates interest in a mobile insurance app. Appvales will provide you with a high-estimate quote, and the purchase agreement is signed.

  1. Formal Commitment to Proceed:

At this point, Appvales explains the requirements for the app to your organization. A project execution plan and schedule are both drafted.

  1. Formal Commencement of Project:

Appvales begins to design and develop the mobile app. Later in this stage, a prototype is ready, and system tests are carried out.

  1. Post-launch Period Commencement:

The app has undergone every test and is almost ready for launch. Finally, both companies agree on acceptance criteria, and a go-forward plan is drafted.

  1. Formal Maintenance and Support Agreement:

Both parties vet and sign the support agreement, and a maintenance request register is opened for the app.

How We Built a Health Insurance App for a Client

Appvales has in-depth experience with mobile insurance app development. Here is the breakdown of our work process:

The team of developers consisted of two standard front-end developers and two back-end developers.

We followed the processes as listed in the previous section on building a mobile health insurance app. We were hitting our goals for each stage and would have achieved the original release plan after five months.

However, the client reversed some aspects of his business model midway. This caused specific unforeseen challenges, which we eventually overcame.

The highlight of the application’s feature was that users were given the ability to create personalized insurance plans and could compare insurance policies. However, if they didn’t find a suitable one, the option to build their insurance plan was made available.

This way, customers didn’t have to plan their funds around an already developed insurance plan. In addition, this eliminates the likelihood of incurring extra costs assuming the plan that suits your budget doesn’t cover some specific features they want.

The app was built with React and Redux and started with a mobile-first style. However, later we also implemented a full-fledged mobile application using React Native.

The server-side and the database were built with NodeJS and MongoDB. We used NodeJS for the server-side because it uses an event-driven, non-blocking I/O model to be lightweight and efficient for server-side applications. We used MongoDB because of its flexibility which encourages scaling, and its built-in security features.

A convenient, practical approach always makes the development process more manageable and makes application support rarely needed.

Appvales: your trusted app development company

We trust that this guide has given you a better idea of insurance mobile app development and its requirements. If you need a trusted software team to develop your app, our talented team at Appvales will be happy to help. Contact us for a quote.

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Written By:

Max Litvinov

CEO at Appvales

IT enthusiast, investor, entrepreneur. Bringing the offshore mobile development to the next level.

Boutique Web and
Mobile App
Development Company

You have an app idea. We know how to build it. Let's talk.

Get project estimation