The health insurance market worldwide will hit an amazing $2.38 trillion by 2024.
These numbers tell an exciting story. Businesses now have a golden chance to build health insurance apps like Aetna and grab their share of this booming market. The health technology sector is racing toward $280 billion. Digital healthcare solutions aren't just popular - they've become a must-have.
Here's something interesting: Oscar pioneered the health insurance app concept and now helps over 520,000 users. Aetna has grown even bigger with 22 million members throughout the US. These success stories show why you should think over building an app like Aetna for your business or clients.
The numbers paint a clear picture. The count of uninsured Americans fell sharply from 48.6 million in 2010 to 30.4 million in 2018. On top of that, the US health insurance market reached roughly $1.3 trillion in 2022. The market grew steadily at 4.4% each year between 2017 and 2022.
Ready to build an app like Aetna but feeling stuck? This piece walks you through everything about building a health insurance app. We'll cover key features, compliance rules, and costs. Let's head over to the exciting world of health insurance app development!
The Growing Need for Health Insurance Apps
Health insurance companies are catching up faster to the digital revolution that has changed other industries. A remarkable 74% of policyholders report familiarity with their insurers' digital platforms. This shows a major change in how people handle their health coverage.
Digital transformation in healthcare
The health insurance world has changed from reactive care management to proactive health promotion. Mobile apps have become the main channel for this change. This isn't just another trend, it shows a basic change in healthcare delivery and access.
Mobile devices have already changed clinical practice completely. About 87% of healthcare professionals use smartphones or tablets at work. This widespread use creates ideal conditions to develop a health insurance app like Aetna.
Health insurers now treat mobile as their main channel instead of an afterthought. Numbers tell the story, industry average mobile scores jumped from 57 to 63 points (out of 100) in recent evaluations. Desktop scores showed a smaller improvement from 67 to 70 points.
"With today's technology, signing up for healthcare or paying a doctor's bill should be as easy as ordering a pizza," notes Chris Gay of Evry Health. His words capture why you should think about developing an app like Aetna, people now expect simplicity and convenience.
User expectations for mobile-first services
Today's consumers just need digital-first experiences from their health insurers. Two-thirds of policyholders choose digital channels over analog ones to handle their insurance concerns. Young people under 29 show an even stronger preference.
Americans' smartphone ownership stands at 77%. This makes health insurance app development more than just following a trend, it prepares you for the future. People expect to manage their health insurance through accessible mobile interfaces any time they want.
Users value these features most:
- Simple access to administrative tasks
- Easy appointment scheduling
- Clear benefit information
- Prescription management
- Secure communication with providers
Research shows 75% of users see electronic patient records as a good place to store documents and find personalized treatment information. Adding these records to your Aetna-like app could become a key selling point.
Benefits for patients, providers, and insurers
Health insurance apps offer real advantages to patients. They can access their health information from home and save time. A few taps let them refill prescriptions, schedule appointments, and talk to providers.
Healthcare providers gain benefits too. Mobile tools help them make better decisions with fewer errors. Better data management and access improves their practice's efficiency. They can spend more time on patient care instead of paperwork.
Insurers see impressive financial results. McKinsey's analysis shows that for every $10 billion of payer revenue, AI solutions could save $150-300 million in administrative costs and $380-970 million in medical costs. Revenue could increase by $260 million to $1.24 billion.
Insurance apps promote stronger customer relationships beyond saving money. They offer immediate interaction opportunities that old communication methods can't match. To name just one example, a health insurance program achieved an 82% recommendation rate through its mobile-first approach.
Companies rush to develop health insurance apps like Aetna because cost pressures need automation and digital solutions. These apps will likely become the main way insurers and members interact, making this the right time to enter this growing market.
Types of Health Insurance Apps You Can Build
Developers have diverse opportunities in the health insurance app marketplace. Building solutions that address specific healthcare ecosystem needs requires understanding different application types.
Patient-focused apps
Health insurance apps are changing how people manage their health coverage. These digital assistants help users connect with health plan features anywhere.
Modern apps give users access to digital ID cards, check coverage details, find in-network providers, compare treatment costs, and track deductible progress. UnitedHealthcare's app shows this approach by bringing together family medical information, 24/7 virtual care access, cost estimates before appointments, and simple prescription refills.
Members of Blue Shield of California receive tailored service through their app that includes ID card access, doctor search tools, and plan information. The Ambetter Health mobile app lets users quickly find in-network care, view their primary care provider, check plan details, track benefits and deductibles, and make payments directly.
Developers working on a health insurance app like Aetna should include telehealth scheduling, prescription management, and location-based provider search, features that increase user participation. HealthBird shows how patient apps make processes easier by letting users book doctor appointments, track medications, access digital ID cards, and upload important documents.
Provider-side apps
Medical professionals can manage care more efficiently with provider-focused applications. These tools blend healthcare delivery with patient engagement through integrated systems.
Healthcare teams can send updates and notifications directly to patients through these apps. They remind patients about appointments and tests, and follow up with post-diagnostic care instructions. AC Health's platform helps providers give patients tailored instructions through a mobile app, making discharge instruction reminders easier.
Mend delivers complete telemedicine and patient engagement features, while Practice Fusion offers cloud-based electronic health record management that connects physicians with their patients and data in one platform. These solutions make administrative tasks simpler while maintaining quality patient care.
Developers building an app like Aetna for providers should focus on connecting with hospital systems, pharmacy chains, and telehealth providers to create a complete care management solution. CVS Health's app demonstrates this integration by combining prescriptions, immunization scheduling, and access to health spending and benefit details for eligible CVS Caremark and Aetna members.
Admin and insurer dashboards
Administrative dashboards power health insurance operations. Executives and staff learn about performance metrics, claims processing, and fraud detection through these tools.
Healthcare dashboards gather information from financial applications, procurement systems, check-in platforms, electronic health records, and insurance claims databases. Administrators can see immediate data in user-friendly graphic formats about admission rates, treatment outcomes, staffing levels, and expenditures.
Complex data becomes actionable metrics about company health and performance through insurance dashboards. Organizations can spot patterns between customer demographics and claim frequencies, identify at-risk customers early, create better risk assessments, and improve pricing strategies.
Data security must work alongside functionality in these administrative tools. The investment brings better operational efficiency, less fraud, and smarter resource allocation.
Ready to Build Your Custom Health Insurance App?
From telehealth integration to claims management, let's turn your concept into a market-leading application like Aetna.
Must-Have Features for a Competitive App
Your health insurance app needs practical features that solve real user problems to compete in today's market. A J.D. Power study shows only 21% of health apps meet all criteria that make digital properties work well. Here are the important components that make users pick one health insurance app over others.
Plan comparison and selection tools
Finding the right insurance plan can feel like searching for a needle in a haystack. MatchFinder helps users by letting them input their doctors and medications to find plans that match their healthcare needs.
Healthee's improved plan comparison tool shows how AI can transform open enrollment:
- Shows all needed information clearly and visually
- Makes use of advanced AI systems for personalized plan suggestions
- Makes benefits easier for employees to understand
Claims submission and tracking
Insurance claims are nobody's favorite task. A streamlined claims process can make this stressful experience better. Modern health insurance apps should have:
- Immediate tracking where users see claim status right away (submitted, under review, approved, or denied)
- Automatic error checking that spots missing information before submission
- Document generation that creates claims reports automatically
AI-powered insights can spot potential fraud and flag problems before they grow. If you want to develop an app like Aetna, remember that 75% of Americans own smartphones. Mobile claim submission isn't just nice to have - it's essential.
Telemedicine and virtual care
The COVID-19 pandemic made telemedicine grow fast, and now health insurance apps must include it. Telemedicine lets patients get care from home and substantially improves healthcare provider capacity.
Your app like Aetna needs these telemedicine features:
- High-definition video conferencing for accurate diagnoses
- E-prescription capabilities so doctors can send prescriptions electronically
- Backup audio communication where internet is limited
- Store-and-forward functionality for specialties like dermatology
Telemedicine with artificial intelligence makes basic tasks simpler. This reduces doctor workloads and makes their jobs more satisfying. Research shows that scheduled follow-up visits through health apps make patients more likely to show up.
Medication and appointment reminders
Medication adherence problems are systemic. A 2017 study found adults delayed taking medications 80-85% of the time and completely forgot them 44-46% of the time. Daily text message reminders dropped the percentage who forgot medications from 46% to just 5%.
Good medication reminder features should have:
- Custom alerts at specific times
- Refill reminders when supplies run low
- Options to track health metrics like blood pressure or glucose levels
- Ways to share information with family members or caregivers
Medisafe shows these features at their best, with 4.7 and 4.6 stars on iOS and Android.
Secure messaging and document sharing
Secure communication is the life-blood of any health insurance app. Building an app like Aetna requires end-to-end encryption that protects messages during transmission and storage.
Secure messaging must include:
- Strong user authentication with two-factor options
- Audit trails showing who accessed information and when
- Remote wipe capability for lost or stolen devices
- Role-based access control that limits data exposure based on user roles
This protection keeps patient information safe and helps maintain HIPAA compliance. Secure messaging also improves clinical workflows by replacing inefficient pagers, emails, and faxes.
These essential features will help you create a competitive health insurance app that gives real value to everyone who uses it.
How to Develop an App Like Aetna: Key Stages
Building a health insurance app needs smart planning and careful execution through different phases. You must pay attention to both technical details and compliance rules when taking your app from concept to launch.
Planning and market research
A successful health insurance app starts with good market analysis. You need to know your target audience and what they want through complete research. This first step helps you set clear project boundaries and create a detailed development plan.
Good market research shows what customers want and helps you avoid getting things wrong that can get pricey. You need both primary and quantitative research methods to get accurate data:
- Secondary research looks at existing data to spot trends
- Primary research gets new information about your app idea
- Quantitative surveys help prove your findings
UI/UX design and prototyping
Health insurance app interfaces need to work well and feel comfortable to use. Most users are already worried about health issues or confused by insurance, so the design should help them feel at ease.
Build a prototype before full development to test how users move through the app. This approach helps you:
- Spot usability problems early
- Show investors how the app works
- Change features based on what users say
Your UI/UX design must work for both patients and providers, they have different needs. Patients want clear navigation and simple processes. Healthcare professionals want quick workflows and fast access to important information.
Backend development and integrations
The backend is what makes your health insurance app work. You'll need to build servers, databases, and APIs that run features like claims processing, policy management, and data security.
Start with an MVP that has just the basic features but can grow bigger. This lets you enter the market faster and get early feedback from users.
APIs are vital, your app needs to work smoothly with payment systems, medical networks, repair shops, and legal databases. Check if your partners are ready during planning because problems with third-party connections can ruin the user experience.
Testing and compliance checks
HIPAA compliance isn't optional for health insurance apps. Every app handling medical data of US citizens must follow these rules. When testing for HIPAA compliance, focus on:
- Access control (making sure only authorized users can see PHI)
- Encryption (checking data protection systems)
- Audit controls (reviewing complete logs)
- Data integrity (making sure PHI stays safe from changes)
Beyond compliance, you need complete quality checks through manual and automated testing. This includes security, performance, and testing how well the app works with labs, pharmacies, and other systems.
Quality testing isn't just about finding bugs, it helps spot weak points before they cause data breaches or break compliance rules. Yes, it is important that good QA testing protects PHI and builds user trust.
Ensuring Compliance and Data Security
Security and compliance are the foundations of health insurance applications. Healthcare data breaches cost $10.93 million on average in 2023. We need to protect sensitive information.
HIPAA, GDPR, and other regulations
Many people think all health apps must follow HIPAA regulations. That's not true. HIPAA only applies to covered entities (healthcare providers, health plans, and healthcare clearinghouses) and their business associates. Your health insurance app like Aetna must implement HIPAA safeguards if it handles Protected Health Information (PHI).
HIPAA compliance needs three main protections:
- Privacy Rule: Controls how PHI can be used and disclosed
- Security Rule: Sets standards for electronic PHI protection
- Breach Notification Rule: Mandates timely notification if data is compromised
GDPR adds more requirements for apps targeting European users. GDPR differs from HIPAA's focus on covered entities. Whatever your company's location, GDPR applies if you process EU residents' data. Your health insurance app needs both compliances to serve international users.
GDPR requires Data Protection Impact Assessments (DPIAs) before launching projects with high-risk data processing, like new health records systems. GDPR also needs incident response plans with 72-hour breach notification timelines.
Encryption and secure authentication
Data encryption protects against unauthorized access.
Strong encryption protocols include:
- AES-256 encryption for stored data
- TLS 1.2 or higher for data transmission
- End-to-end encryption for messaging features
Simple passwords aren't enough for authentication. You need multi-factor authentication, especially for remote access or privileged accounts. Cybersecurity experts say never store passwords in clear text. Use "salted" hashed passwords and slow hash functions instead.
Different mobile platforms handle security differently. You should learn each platform's APIs and security features. Then adapt your code to maintain consistent protection across operating systems.
Data access controls and audit logs
Role-based access control (RBAC) protects patient privacy. It restricts what information each user can view or modify based on their job function. Healthcare professionals still get access to information they need.
IBM's research shows internal misuse leads to most data breaches. Your health app should include:
- Least privilege principles limiting access to minimum necessary information
- Regular access reviews and privilege audits
- User verification protocols for authentication
Full audit logging tracks who accessed what information, when, and from where. These logs help with investigations and show accountability during regulatory audits. The Security Rule requires "hardware, software, and procedural mechanisms to record and examine activity in information systems containing ePHI".
Mobile devices can get lost. Your app should include remote wipe features to delete sensitive data if someone steals the device. Your development team should also create clear data retention policies about when to delete unnecessary information.
Build a Fortified Healthcare App with Zero Loopholes
Secure your users' data with end-to-end encryption and role-based access controls designed by security experts.
Monetization Strategies for Long-Term Growth
Your app needs to make money after meeting compliance requirements. A good monetization strategy will keep your health insurance app profitable for years. Many developers find it hard to balance user experience and profitability while building an app like Aetna.
Freemium and premium tiers
Health insurance apps commonly use the freemium model. Users get simple features for free and pay to access premium features. This lets users see the value before spending money.
Your health insurance app could have a tiered structure:
- Free tier: Simple plan comparison and claim tracking
- Premium tier: Extended coverage details, faster claims processing, and priority support
This model brings steady revenue through subscriptions and lets users upgrade as needed. The freemium approach works because it draws many users with free entry.
In-app purchases and services
In-app purchases create extra revenue streams beyond subscriptions. Users buy more consultation time with healthcare experts or get specialized services. This method brings in significant money, worldwide, users spend $380 billion on in-app purchases.
Your app like Aetna could offer these purchasing options:
- Health appointment bookings
- Medication refills
- Premium health analytics
- Virtual doctor consultations
Advertising and sponsored listings
Healthcare apps need careful ad implementation. Too many ads hurt user experience and make people leave. The focus should be on relevant, local advertising from healthcare providers, pharmaceutical companies, and wellness brands.
Sponsorship works well too, 25% of medical app entrepreneurs choose this path. Your app can show sponsor logos or include sponsored content from insurance companies and pharmaceutical brands targeting similar audiences.
Affiliate and referral programs
Affiliate marketing builds valuable partnerships with healthcare providers. You earn commissions from users who buy services through your app's tracked links. Knew Health pays $500 for each referred member, while eHealthInsurance offers $50 commissions with 120-day cookies.
A user referral program rewards existing users who bring new customers. Rewards might include:
- Discounts on premium subscriptions
- Credits toward in-app purchases
- Free trial extensions
- Exclusive content access
The best way to make money often combines several of these approaches based on your users and business goals.
Cost to Build an App Like Aetna
Health insurance app development needs careful financial planning. The investment varies based on several factors that affect your project budget.
Factors affecting development cost
Your health insurance app's complexity affects development costs by a lot. A simple app with basic features costs less than an advanced solution that includes AI integration or up-to-the-minute tracking. The design quality is a vital component, apps with superior user experiences need more investment but create better user involvement.
Your development team's location makes a big difference in pricing. North American developers charge premium rates compared to Eastern European or Asian teams. These elements also affect your budget:
- Software licensing fees (both upfront and ongoing)
- Implementation and development expenses
- Infrastructure costs for hosting and databases
- Maintenance requirements after launch
Security implementation adds more expenses, healthcare apps with sensitive data need strong protection mechanisms that raise development costs.
Budget ranges for different app types
A health insurance app's price tag ranges between USD 32,610 and USD 44,810, based on feature complexity. Different sources suggest varied ranges:
Basic App: USD 20,000-50,000 with core features like policy management and simple claims filing. Development takes 2-3 months.
Mid-Level App: USD 50,000-120,000 includes payment integration, notifications, and analytics. These projects need 4-6 months to complete.
Advanced App: USD 200,000+ for apps with AI chatbots, blockchain security, and complex integrations. Development takes 6-10+ months.
Cross-platform development cuts costs by maintaining a single codebase instead of building separately for iOS and Android.
Cost-saving tips for startups
You can minimize expenses while building an app like Aetna with these practical approaches:
Start with an MVP that focuses on essential features. This strategy helps you enter the market faster and gather valuable user feedback before additional investment. You can also outsource development to regions with competitive labor rates without compromising quality.
Use existing frameworks and APIs instead of building everything from scratch. This approach saves time and money while letting you focus resources on your app's unique features.
Your annual maintenance costs will be 15-20% of your original development budget. Plan these continuing expenses from the start to avoid financial surprises after launch.
Why Choose CISIN as Your Development Partner
Selecting the right partner to build a health insurance app like Aetna could make or break your project. CISIN stands out among competitors, and with good reason too.
Proven track record in healthcare apps
CISIN has spent over two decades working with clients ranging from startups to Fortune 500 companies. Their successful healthcare projects and impressive credentials speak volumes:
- CMMI Level 5 appraisal - the highest process maturity rating possible
- ISO 27001 certification - guaranteeing rigorous security protocols
- 100% in-house team of 1000+ experts - zero contractors or freelancers
Custom solutions tailored to your needs
Healthcare providers face unique challenges that generic developers often miss. CISIN mobile app development company creates solutions that align perfectly with your specific goals. They begin with an MVP that has core functionality, so you can test your app concept quickly before full development.
Support from planning to post-launch
The partnership with software development company like CISIN extends beyond development. They stay committed from your first discovery call through post-launch support. Their healthcare development expertise shows in their:
- AI-enabled software solutions since 2003
- Secure cloud architecture and interoperability expertise
- Flexible engagement models like dedicated healthcare PODs
When you need to build an app like Aetna, CISIN brings both technical excellence and strategic guidance throughout your project lifecycle.
Partner with a CMMI Level 5 Healthcare App Expert
Leverage 20+ years of experience and a team of 1000+ in-house developers to build your Aetna-like app tailored to your needs.
Conclusion
Creating a health insurance app like Aetna presents a huge chance in the thriving healthcare technology market. This piece explores key components you need to build a successful health insurance app that meets user expectations and compliance requirements.
Mobile apps have evolved from optional features to essential platforms in healthcare's digital world. People want easy access to their health information, claims processing, appointment scheduling, and provider communication from their smartphones. This explains why companies like Aetna heavily invest in their digital presence.
Your app must balance functionality with security above everything else. HIPAA compliance remains mandatory when handling protected health information. Strong authentication, data encryption, and access controls create the foundation of a trusted health insurance application. These security measures shield users and businesses from data breaches that can get pricey.
Your app's success depends on feature selection. Core capabilities should include plan comparison tools, claims tracking, and secure messaging. User feedback helps expand features to include telemedicine integration and medication reminders. Successful apps solve actual problems for patients, providers, and insurers.
App costs vary based on complexity, features, and development team location. Simple apps might cost $20,000-50,000. Advanced solutions with AI integration could reach $200,000. Many startups choose an MVP approach - they build essential features first before expanding.
Your monetization strategy needs careful planning from the start. Health insurance apps work well with the freemium model. Users try simple features before upgrading to premium services. On top of that, in-app purchases, relevant advertising, and mutually beneficial alliances can create steady revenue.
The right development partner makes a huge difference in your project's outcome. CISIN stands out with its healthcare app expertise and complete support throughout development. Their mobile app development team brings healthcare regulation knowledge and technical skills needed to build secure, user-focused applications.
Building an app like Aetna needs careful planning, compliance awareness, and user-focused design. The challenge brings substantial rewards - both financially and in how it helps healthcare access. Your app can simplify complex insurance processes, boost health outcomes, and build meaningful connections between patients and providers. Now is the perfect time to enter this growing market.
