CodeSystem-InsurancePlanTypeCS

Sourcehl7.fhir.us.ndh#current:National Directory of Healthcare Providers & Services (NDH) Implementation Guide (v4.0.1)
resourceTypeCodeSystem
idInsurancePlanTypeCS
canonicalhttp://hl7.org/fhir/us/ndh/CodeSystem/InsurancePlanTypeCS
version1.0.0-ballot
statusactive
publisherHL7 International - Patient Administration Work Group
nameInsurancePlanTypeCS
titleInsurance Plan Type Code System
date2023-07-29T19:27:44+00:00
experimentalfalse
descriptionCategories of cost-sharing used by plans
jurisdictionsus
caseSensitivetrue
contentcomplete
Usages

This case-sensitive code system http://hl7.org/fhir/us/ndh/CodeSystem/InsurancePlanTypeCS defines the following codes:

Code Display Definition
platinum Platinum-QHP Plan with highest monthly premium and lowest costs when you need care A Qualified Health Plan with the highest monthly premiums and smallest out-of-pocket costs for the member in comparison to other metal-category plans
gold Gold-QHP Plan with high monthly premium and low costs when you need care A Qualified Health Plan with the higher monthly premiums and smaller out-of-pocket costs for the member in comparison to other metal-category plans
silver Silver-QHP Plan with moderate monthly premium and moderate costs when you need care A Qualified Health Plan with the lower monthly premiums and larger out-of-pocket costs for the member in comparison to other metal-category plans
bronze Bronze-QHP Plan with lowest monthly premium and highest costs when you need care A Qualified Health Plan with the lowest monthly premiums and largest out-of-pocket costs for the member in comparison to other metal-category plans
catastrophic Catastrophic-QHP A plan with low monthly premiums and very high deductibles and are available only to those under 30 or with certain special exemptions.
lowdeductible Low Deductible A plan that requires the insured to pay out of pocket a smaller proportion of incurred health care costs than a traditional insurance plan.
highdeductible High Deductible A plan that requires the insured to pay out of pocket a larger proportion of incurred health care costs than a traditional insurance plan.
catastrophicplan Catastrophic Plan A plan that requires the insured to pay out of pocket a much larger proportion of incurred health care costs than a traditional insurance plan.

Produced 08 Sep 2023