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Health Insurance Software Development Services

Since 2012, ScienceSoft develops secure digital solutions that help health insurers automate their service operations and leverage advanced technologies for faster and more accurate insurance workflows

Health Insurance Software Development Services - ScienceSoft
Health Insurance Software Development Services - ScienceSoft

Health insurance software development services are meant to help insurance companies and healthcare providers improve the efficiency of their insurance-associated workflows and boost customer experience via digital software solutions.

Having decades of experience in insurance software development and healthcare IT, ScienceSoft understands the unique requirements of the meticulous, highly regulated health insurance industry and knows how to meet them pragmatically and safely. We provide comprehensive services from software design and development to testing and compliance to deliver quality software that brings long-term value and enables innovative business models.

Whom We Serve

Health insurance carriers

Health insurance agencies

Health insurance brokers

Health reinsurers

Healthcare providers partnering with insurers

Enterprises offering health insurance for their employees

Insurtech startups

Health insurance software product companies

Explore ScienceSoft’s Featured Success Stories

Software to Transform the Entire Health Insurance Cycle

Depending on your needs, we can develop a multi-functional system to digitally transform the entire medical insurance process or a specialized solution to automate a particular operational area. The examples of health insurance software we create include:

Health information exchange (HIE) software

HIPAA-compliant electronic data interchange (EDI) software that enables automated exchange of protected health information between insurers and healthcare providers.

Software that automates customer risk assessment and offers analytics-based calculation of personalized health insurance premiums.

Software that automates the entire health insurance policy cycle, from issuing through updating to renewal or termination.

Software that provides automated calculation of due payment amounts and deductibles, invoice generation, and processing of the received digital payments.

Software that enables automated claim capture, validation, triaging, and payment. It can provide automated remote damage assessment using AI and IoT technologies.

Eligibility verification software

Healthcare provider software that offers automated verification of policyholder eligibility for particular medical services against the insurance coverage.

Web portals that provide self-service options, secure access to the required data, and instant multi-party communication for insurers' customers, brokers, agents, internal teams, and external partners.

Web and mobile apps that enable prompt insurer-client interaction, convenient application creation, payment, claim filing, and access to health insurance data for customers.

Health insurance marketplaces

Software that helps individuals and businesses find the best-fitting health insurance products among multiple options available with different insurers.

Compliance monitoring systems

Solutions used to control service compliance with insurers' internal policies and relevant legal frameworks: FIO, NAIC, NICB, IFRS17, HIPAA, CCPA, AML/KYC, GDPR (for the EU), NYDFS (for NYC), IA and SAMA (for the KSA),​​​​​​​ etc.

Intelligent virtual assistants

AI-powered chatbots that help companies participating in the health insurance process (agents, insurance carriers, healthcare providers, etc.) automate customer communication and provide 24/7 support.

Software that offers immutable recordkeeping, full traceability, and secure sharing of health insurance data. It can provide complete automation of multi-party workflows using smart contracts.

Software to Support Your Unique Health Insurance Processes

ScienceSoft delivers custom solutions that enable standard and tailor-made health insurance plans and support both conventional and innovative health insurance models.

Health insurance types

  • Individual health insurance.
  • Family floater health insurance.
  • Senior citizen health insurance.
  • Children’s health insurance.
  • Group health insurance.

Health insurance plans

  • Health maintenance organization (HMO).
  • Preferred provider organization (PPO).
  • Exclusive provider organization (EPO).
  • Point-of-service (POS).
  • High-deductible health plan (HDHP).
  • Gap insurance plans for critical illness insurance, accident insurance, dental and vision insurance, etc.

Health insurance models

  • Traditional long- and mid-term health insurance.
  • Short-term health insurance.
  • Medical microinsurance.
  • Pay-as-you-live health insurance.
  • P2P health insurance.

Benefit from Robust Software Tailored to Your Needs

ScienceSoft’s team is ready to design and build a secure health insurance solution to boost the efficiency of your specific processes and unlock new opportunities for business growth.

Why Build Health Insurance Software with ScienceSoft

  • Since 2012 in insurance IT.
  • Compliance experts with 5–20 years of experience to guarantee software adherence to the necessary legal standards.
  • Since 2003 in cybersecurity to ensure world-class protection of health insurance solutions.
  • Since 1999 in web development and since 2005 in mobile to deliver health insurance apps that provide convenient and intuitive user journeys.
  • Proficiency in AI/ML, big data, blockchain, IoT, AR to build innovative insurtech solutions.
  • In-house project management office to manage large-scale health insurance projects.
  • A quality-first approach based on an ISO 9001-certified quality management system.
  • Robust security management supported by ISO 27001 certification.

ScienceSoft USA Corporation Is a 3-Year Champion in the Financial Times Rating

Three years in a row (2022–2024), the Financial Times has included ScienceSoft USA Corporation in the list of 500 fastest-growing American companies. This is the result of our dedication to driving project success despite any constraints and disruptions.

Our Practices to Succeed in Health Insurance Software Projects

ScienceSoft’s teams drive each project to its goals by keeping within the agreed cost and timeframe, quickly responding to emerging risks, and maintaining transparent cooperation flows.

Follow the links to discover the software development and project management practices underpinning our approach.

Cost control and optimization

  • Flexible pricing models for each project.
  • Accurate project scoping to prevent budget leaks.
  • Using platform-based development, pre-built app components, and open APIs where applicable to reduce the share of costly custom code.

Agile development

  • Quick project start (1–2 weeks).
  • An MVP of health insurance software in 3+ months.
  • Frequent releases (every 2–4 weeks).
  • Well-established Lean, Agile, and DevOps cultures.
  • On-demand team upscaling to speed up development.


Risk management

Establishing software security

  • Designing secure architectures for health insurance solutions.
  • Implementing advanced security mechanisms: AI-supported UBA, biometric authentication, health insurance data hashing, and more.
  • Applying a mature DevSecOps approach.

Ensuring software longevity and interoperability

  • Using modern cloud-centered architectures (microservices, serverless) to ensure high scalability and easy evolution of the software.
  • Building custom APIs to enable seamless software integration with all required systems.

Want to Learn More About How We Work?

ScienceSoft’s consultants will gladly share any required information to prove our domain experience and showcase how we would apply our practices in your particular project.

Our BFSI Customers on ScienceSoft’s Approach to Development

ScienceSoft demonstrated a deep understanding of our requirements, and their developers needed minimal supervision. What stood out was ScienceSoft's proactive suggestions for cost-saving architecture design and tech stack solutions. Their input ensured we stayed within budget without compromising on software quality. The value we derived from partnering with ScienceSoft is definitely worth the investment.

We relied on ScienceSoft to bring functionality and form to our scope, filling in the blanks with their development experience in this space. When challenges arose, they problem-solved and elicited maximum potential with every system improvement. Ultimately, they took this project to heights I never expected it to reach.

We are impressed with ScienceSoft’s pragmatic project management, quality-first mindset, and transparent communication. Their solution architects, developers, and QA engineers are true experts in their fields and have always readily shared their knowledge. They are strongly motivated to deliver maximum value with their services and went above and beyond for us.

Technologies and Tools ScienceSoft Relies On

Advanced Techs to Power Your Health Insurance Solution

Click on the cards below to explore the advanced technologies ScienceSoft implements to bring additional value across health insurance workflows.

ScienceSoft’s Insurance IT Consultant and Business Analyst

McKinsey predicts that by 2030, almost all insurance underwriting tasks and more than half of claims settlement workflows will be automated, mainly thanks to AI. Although over 90% of insurers are already using or planning to use AI, most deployments are small-scale, single-purpose tools like chatbots or standalone analytics components. This means that insurers that commit to AI-driven automation at the enterprise scale can still significantly outpace their competitors.

However, to succeed in AI initiatives, you first need secure, standardized data acquisition pipelines and a high-performing data processing environment capable of running AI-supported operations at scale. At ScienceSoft, we start insurance AI projects with an all-around audit of your data management framework, define the missing components critical for the seamless AI system functioning, and help establish a secure and compliant data infrastructure.

Health Insurance Software Development Cost

Pricing Information

Based on ScienceSoft’s past insurance software projects, the cost of health insurance software development may range from $120,000 to 3,000,000+, depending on solution scale and complexity, the number of integrations, as well as performance, scalability, security, and compliance requirements.

Want to know how much your health insurance software will cost?

Get a free estimate

Learn the Cost of Your Health Insurance Solution

Please answer a few simple questions about your needs to help our experts calculate your quote quicker.


*What type of company do you represent?

*What is the expected number of software users?

How many health insurance policies do you plan to issue monthly?

*How many organizations do you plan to target with your software?

*How many end users (individuals from all organizations) will use your software?

*What capabilities should your health insurance software provide?

*What health insurance models should your solution support?

*Should your software provide complex analytics and reports?

*Which software version do you need?

*Which platforms should your health insurance software support?

*Do you have any preferences for the deployment model?

*Would you require any integrations?


With other corporate solutions, partner systems, medical IoT devices, insurance marketplaces, third-party services (user authentication, payment, messaging), etc.

Do you need to migrate data from legacy software?

*Do you have any tech stack preferences?


Particular programming languages, software platforms, cloud services, etc.

*Are there any compliance requirements for your health insurance software? Choose all that apply.

Your contact data

Preferred way of communication:

We will not share your information with third parties or use it in marketing campaigns. Check our Privacy Policy for more details.

Our team is on it!

ScienceSoft's experts will study your case and get back to you with the details within 24 hours.

Our team is on it!

FAQ About Health Insurance Software Development

Do we really need custom health insurance software when there are ready-made tools on the market?

Based on what we heard from our clients in the insurance field, these are the six most widespread limitations of OOTB software that caused them to go for custom development:

  • The inability to introduce custom automation rules (e.g., for risk scoring, claim approval) and automate highly specific tasks like medical image analysis for loss adjustment and fraud detection.
  • The lack of support for innovative insurance models like parametric health insurance and health microinsurance.
  • The excessive cost or technical impossibility of integrating OOTB software with legacy business systems.
  • The lack of software compliance with region-specific regulations like NYDFS, CCPA, GDPR.
  • Limited or costly software scalability.
  • The need to purchase individual user subscriptions for large teams, resulting in high software TCO in the long run.

At ScienceSoft, we analyze the feasibility of custom health insurance software development on a case-by-case basis to guarantee the expected economic value for our clients. If off-the-shelf software appears to be a better fit for our client’s case, we are ready to assist with selecting and implementing the optimal solution.

What are your cooperation models for health insurance software projects?

Depending on the client’s needs, ScienceSoft can provide full outsourcing of health insurance software development, a dedicated team to take over a part of the development project, or staff augmentation with our best talents. Explore the detailed comparison table composed by our consultants to understand the specifics of each sourcing approach.

How do you ensure regulatory compliance?

We design custom health insurance solutions with HIPAA, GDPR, NYDFS, and other legal requirements in mind, ensure 95%+ test coverage for the coded compliance rules, and run compliance pre-audit before the software launch. If you are entering an emerging market, we go the extra mile to investigate its health insurance regulations and determine the relevant compliance requirements to cover. We can also take over ongoing compliance maintenance. Visit our dedicated page to learn how we ensure BFSI software compliance at each SDLC stage.

Will you sign an NDA?

Sure. We are ready to sign an NDA before an introductory call to legally protect your sensitive data from the onset.

Choose the Service Option that Best Suits Your Needs

Health insurance software consulting

We design the optimal functionality, architecture, UI, and tech stack for your solution and provide expert advice on security and compliance. You also get a detailed project roadmap for smooth implementation.

I’m interested

Health insurance software development

We develop your solution end to end, from software design to integration and QA. We can also conduct user training in a convenient format and provide ongoing support. You benefit from superb software quality and prompt implementation.

I’m interested

Health insurance software modernization

We upgrade your legacy software's architecture, codebase, and tech stack and add new automation features. You get a modern solution at an optimal cost and with minimal disruption to your business operations.

I’m interested