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Market share of health insurance gross premiums in Europe 2018, by country

With a third of domestic health insurance gross direct premiums written in Europe, the Netherlands has by far the highest share of total premiums. In the Netherlands, private health insurance is mandatory. Insurance companies in the Netherlands must offer a universal healthcare package at a fixed price for all ages and status of health. In 2018, health benefit gross premiums on the insurance market in the Netherlands amounted to almost 47 billion euros.

Germany, which has the oldest social health care system in the world runs a statutory health insurance plan. Those employed pay 50 percent of their insurance directly from their wages, with the company picking up the rest of the bill. Those who are self employed must pay for the complete cover. In 2018, the market share of the German health insurance market was 28.4 percent.

Health insurance: market share of gross direct premiums written on the domestic market in 2018, by country

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Release date

September 2019



Survey time period


Supplementary notes

Domestic market.
Bulgaria, Estonia, Hungary, Latvia and Malta total premiums written amounting to less than 0.1 percent of the market share and were therefore not included.

Iceland and Lithuania did not provide 2018 data.

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