Healthcare has a significant impact on human capital anywhere. Countries usually allocate financial resources to manage healthcare, which might impose a substantial financial burden on the scope of healthcare coverage. Thus, the healthcare sector must provide the best possible services at the lowest cost. This significant challenge can only be achieved through applying appropriate policies and technologies, including those used by healthcare insurance policy providers. This paper proposes an innovative, customer-centric, sustainable healthcare insurance policy model. The main objective of this model is to sustain wellness by applying technologies to avoid illness and provide wellbeing for patients by empowering self-care remotely. The proposed solution uses an adaptive ontology-based knowledge management system to satisfy customers and market needs. The proposed system creates a customized policy that consists of various packages to match customers’ healthcare needs based on their health status. The system was tested and validated using a real dataset.