InsurancePlan (11)

#NameSourceVerDescription
1Formularyhl7.fhir.us.Davinci-drug-formulary#2.0.0R4The Formulary provides general information about a formulary and acts as an organizing construct that associated FormularyItem resources point to. The Formulary combined with its associated FormularyItem and FormularyDrug resources represent a formulary list that includes the set of drugs covered and the requirements and limitations of the coverage.
2InsurancePlanndhm.in#currentR4This Profile describes a health insurance offering comprised of a list of covered benefits (i.e. the product), costs associated with those benefits (i.e. the plan), and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc.
3NatDir InsurancePlanhl7.fhir.us.directory-attestation#currentR4An InsurancePlan is a discrete package of health insurance coverage benefits that are offered under a particular network type. A given payer’s products typically differ by network type and/or covered benefits. A plan pairs a product’s covered benefits with the particular cost sharing structure offered to a consumer. A given product may comprise multiple plans (i.e. each plan offers different cost sharing requirements for the same set of covered benefits).
4National Directory Endpoint Qry Exchange InsurancePlanhl7.fhir.us.directory-query#currentR4An InsurancePlan is a discrete package of health insurance coverage benefits that are offered under a particular network type. A given payer’s products typically differ by network type and/or covered benefits. A plan pairs a product’s covered benefits with the particular cost sharing structure offered to a consumer. A given product may comprise multiple plans (i.e. each plan offers different cost sharing requirements for the same set of covered benefits). InsurancePlan describes a health insurance offering comprised of a list of covered benefits (i.e. the product), costs associated with those benefits (i.e. the plan), and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc.
5National Directory InsurancePlanhl7.fhir.us.directory-exchange#currentR4An InsurancePlan is a discrete package of health insurance coverage benefits that are offered under a particular network type. A given payer’s products typically differ by network type and/or covered benefits. A plan pairs a product’s covered benefits with the particular cost sharing structure offered to a consumer. A given product may comprise multiple plans (i.e. each plan offers different cost sharing requirements for the same set of covered benefits).
6NDH Base InsurancePlan Profilehl7.fhir.us.ndh#currentR4An InsurancePlan is a discrete package of health insurance coverage benefits that are offered under a particular network type. A given payer’s products typically differ by network type and/or covered benefits. A plan pairs a product’s covered benefits with the particular cost sharing structure offered to a consumer. A given product may comprise multiple plans (i.e. each plan offers different cost sharing requirements for the same set of covered benefits). InsurancePlan describes a health insurance offering comprised of a list of covered benefits (i.e. the product), costs associated with those benefits (i.e. the plan), and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc.
7NDH Exchange InsurancePlan Profilehl7.fhir.us.ndh#currentR4An InsurancePlan is a discrete package of health insurance coverage benefits that are offered under a particular network type. A given payer’s products typically differ by network type and/or covered benefits. A plan pairs a product’s covered benefits with the particular cost sharing structure offered to a consumer. A given product may comprise multiple plans (i.e. each plan offers different cost sharing requirements for the same set of covered benefits). InsurancePlan describes a health insurance offering comprised of a list of covered benefits (i.e. the product), costs associated with those benefits (i.e. the plan), and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc.
8Payer Insurance Planhl7.fhir.us.Davinci-drug-formulary#2.0.0R4The Payer InsurancePlan that defines the health insurance product, which include coverage benefits that are offered, and additional information about the offering, such as a coverage area, contact information, brochure locations, etc. The health insurance product offers one or more types of coverage, each of which may define a plan of covered benefits with the particular cost sharing structure offered to a consumer. Health insurance plans that include drug coverage reference a formulary that provides details about drugs that are covered under the plan including requirements and limitations of the coverage specific to each drug.
9Payer Provider Network Query InsurancePlan Profilehl7.fhir.us.ndh#currentR4An InsurancePlan is a discrete package of health insurance coverage benefits that are offered under a particular network type. A given payer’s products typically differ by network type and/or covered benefits. A plan pairs a product’s covered benefits with the particular cost sharing structure offered to a consumer. A given product may comprise multiple plans (i.e. each plan offers different cost sharing requirements for the same set of covered benefits). InsurancePlan describes a health insurance offering comprised of a list of covered benefits (i.e. the product), costs associated with those benefits (i.e. the plan), and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc.
10Plan-Net InsurancePlanhl7.fhir.us.davinci-pdex-plan-net#currentR4An InsurancePlan is a discrete package of health insurance coverage benefits that are offered under a particular network type. A given payer’s products typically differ by network type and/or covered benefits. A plan pairs a product’s covered benefits with the particular cost sharing structure offered to a consumer. A given product may comprise multiple plans (i.e. each plan offers different cost sharing requirements for the same set of covered benefits). InsurancePlan describes a health insurance offering comprised of a list of covered benefits (i.e. the product), costs associated with those benefits (i.e. the plan), and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc.
11VhDir Insurance Planhl7.fhir.uv.vhdir#currentR4The details of a health insurance product/plan
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InsurancePlan I I I I I
InsurancePlan.meta
InsurancePlan.meta.profile C
InsurancePlan.meta.lastUpdated C C C C C
InsurancePlan.implicitRules
InsurancePlan.language
InsurancePlan.text
InsurancePlan.contained
InsurancePlan.extension S C (3) S C (2) S C D (2)
InsurancePlan.modifierExtension
InsurancePlan.identifier C C C
InsurancePlan.identifier.period
InsurancePlan.identifier.value
InsurancePlan.identifier.system
InsurancePlan.identifier.type
InsurancePlan.identifier.use
InsurancePlan.identifier.assigner
InsurancePlan.identifier.extension S C S C (2) S C (2)
InsurancePlan.status C C C F C F C C F C
InsurancePlan.type C F C B M C B M C B M C B M C B M
InsurancePlan.name C
InsurancePlan.alias
InsurancePlan.period C
InsurancePlan.ownedBy C C C C C
InsurancePlan.administeredBy C C C C C
InsurancePlan.coverageArea
InsurancePlan.contact
InsurancePlan.contact.address
InsurancePlan.contact.name
InsurancePlan.contact.name.period
InsurancePlan.contact.name.suffix
InsurancePlan.contact.name.prefix
InsurancePlan.contact.name.given C
InsurancePlan.contact.name.family C
InsurancePlan.contact.name.text
InsurancePlan.contact.name.use
InsurancePlan.contact.purpose B M
InsurancePlan.contact.telecom
InsurancePlan.contact.telecom.period
InsurancePlan.contact.telecom.rank
InsurancePlan.contact.telecom.use
InsurancePlan.contact.telecom.value C
InsurancePlan.contact.telecom.system C
InsurancePlan.contact.telecom.extension S C (2) S (2) S C (3)
InsurancePlan.endpoint
InsurancePlan.network
InsurancePlan.coverage C S C (2)
InsurancePlan.coverage.extension S C (2)
InsurancePlan.coverage.modifierExtension
InsurancePlan.coverage.type B M B M F (2) B M
InsurancePlan.coverage.network
InsurancePlan.coverage.benefit S C (2)
InsurancePlan.coverage.benefit.extension
InsurancePlan.coverage.benefit.modifierExtension
InsurancePlan.coverage.benefit.type B M F B M (2) B M
InsurancePlan.coverage.benefit.requirement
InsurancePlan.coverage.benefit.limit
InsurancePlan.coverage.benefit.limit.extension
InsurancePlan.coverage.benefit.limit.modifierExtension
InsurancePlan.coverage.benefit.limit.value
InsurancePlan.coverage.benefit.limit.code B M
InsurancePlan.plan C S C (2)
InsurancePlan.plan.extension
InsurancePlan.plan.modifierExtension
InsurancePlan.plan.identifier
InsurancePlan.plan.identifier.period
InsurancePlan.plan.identifier.value
InsurancePlan.plan.identifier.system
InsurancePlan.plan.identifier.use
InsurancePlan.plan.identifier.assigner
InsurancePlan.plan.identifier.extension S C S S C (2)
InsurancePlan.plan.identifier.type
InsurancePlan.plan.type C F C B M B M B M C F B M (2) B M B M
InsurancePlan.plan.coverageArea
InsurancePlan.plan.network
InsurancePlan.plan.generalCost
InsurancePlan.plan.generalCost.extension
InsurancePlan.plan.generalCost.modifierExtension
InsurancePlan.plan.generalCost.type B M
InsurancePlan.plan.generalCost.groupSize
InsurancePlan.plan.generalCost.cost
InsurancePlan.plan.generalCost.comment
InsurancePlan.plan.specificCost C
InsurancePlan.plan.specificCost.extension
InsurancePlan.plan.specificCost.modifierExtension
InsurancePlan.plan.specificCost.category B M B M B M B M
InsurancePlan.plan.specificCost.benefit C
InsurancePlan.plan.specificCost.benefit.extension
InsurancePlan.plan.specificCost.benefit.modifierExtension
InsurancePlan.plan.specificCost.benefit.type B M B M B M
InsurancePlan.plan.specificCost.benefit.cost S C (3)
InsurancePlan.plan.specificCost.benefit.cost.extension
InsurancePlan.plan.specificCost.benefit.cost.modifierExtension
InsurancePlan.plan.specificCost.benefit.cost.type F B M (3) B M
InsurancePlan.plan.specificCost.benefit.cost.applicability
InsurancePlan.plan.specificCost.benefit.cost.qualifiers C B M (3) B M
InsurancePlan.plan.specificCost.benefit.cost.value (2)
InsurancePlan.plan.specificCost.benefit.cost.value.code F (2)
InsurancePlan.plan.specificCost.benefit.cost.value.system F (2)
InsurancePlan.plan.specificCost.benefit.cost.value.value C
S: There is slicing defined in the element(s)
C: There is cardinality erstrictions defined in the element(s)
I: There is invariants defined in the element(s)
F: There is a fixed or pattern value defined in the element(s)
D: There is document provided in the element(s)
B: There is terminology bindings defined in the element(s)
M: At least one of the element(s) has must-support = true
(N): The number of elements if > 1

Produced 08 Sep 2023