InsurancePlan - FHIR Resource (r4)


This InsurancePlan Resource uses the FHIR API standard for access and structure.

Validate an InsurancePlan FHIR Resource (r4)



Resource Attributes

AttributeField is listTypeDescription
administeredByfalseReference# Product administrator
aliastruestring# Alternate names
contacttrueData Type# Contact for the product
coveragetrueData Type# Coverage details
coverageAreatrueReference# Where product applies
endpointtrueReference# Technical endpoint
identifiertrueIdentifier# C? Business Identifier for Product
namefalsestring# C? Official name
networktrueReference# What networks are Included
ownedByfalseReference# Plan issuer
periodfalsePeriod# When the product is available
plantrueData Type# Plan details
statusfalsecode# draft | active | retired | unknown
typetrueCodeableConcept# Kind of product

InsurancePlan Example

{
  "resourceType": "InsurancePlan",
  "id": "example",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: example</p><p><b>name</b>: foo</p></div>"
  },
  "name": "foo"
}

InsurancePlan Structure

{
  "resourceType" : "InsurancePlan",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // C? Business Identifier for Product
  "status" : "<code>", // draft | active | retired | unknown
  "type" : [{ CodeableConcept }], // Kind of product
  "name" : "<string>", // C? Official name
  "alias" : ["<string>"], // Alternate names
  "period" : { Period }, // When the product is available
  "ownedBy" : { Reference(Organization) }, // Plan issuer
  "administeredBy" : { Reference(Organization) }, // Product administrator
  "coverageArea" : [{ Reference(Location) }], // Where product applies
  "contact" : [{ // Contact for the product
    "purpose" : { CodeableConcept }, // The type of contact
    "name" : { HumanName }, // A name associated with the contact
    "telecom" : [{ ContactPoint }], // Contact details (telephone, email, etc.)  for a contact
    "address" : { Address } // Visiting or postal addresses for the contact
  }],
  "endpoint" : [{ Reference(Endpoint) }], // Technical endpoint
  "network" : [{ Reference(Organization) }], // What networks are Included
  "coverage" : [{ // Coverage details
    "type" : { CodeableConcept }, // R!  Type of coverage
    "network" : [{ Reference(Organization) }], // What networks provide coverage
    "benefit" : [{ // R!  List of benefits
      "type" : { CodeableConcept }, // R!  Type of benefit
      "requirement" : "<string>", // Referral requirements
      "limit" : [{ // Benefit limits
        "value" : { Quantity }, // Maximum value allowed
        "code" : { CodeableConcept } // Benefit limit details
      }]
    }]
  }],
  "plan" : [{ // Plan details
    "identifier" : [{ Identifier }], // Business Identifier for Product
    "type" : { CodeableConcept }, // Type of plan
    "coverageArea" : [{ Reference(Location) }], // Where product applies
    "network" : [{ Reference(Organization) }], // What networks provide coverage
    "generalCost" : [{ // Overall costs
      "type" : { CodeableConcept }, // Type of cost
      "groupSize" : "<positiveInt>", // Number of enrollees
      "cost" : { Money }, // Cost value
      "comment" : "<string>" // Additional cost information
    }],
    "specificCost" : [{ // Specific costs
      "category" : { CodeableConcept }, // R!  General category of benefit
      "benefit" : [{ // Benefits list
        "type" : { CodeableConcept }, // R!  Type of specific benefit
        "cost" : [{ // List of the costs
          "type" : { CodeableConcept }, // R!  Type of cost
          "applicability" : { CodeableConcept }, // in-network | out-of-network | other
          "qualifiers" : [{ CodeableConcept }], // Additional information about the cost
          "value" : { Quantity } // The actual cost value
        }]
      }]
    }]
  }]
}

InsurancePlan Search Parameters

The following search parameters can be used to query InsurancePlan resources. Just submit them like so:

https://api.1up.health/fhir/r4/InsurancePlan?query-param=queryvalue
Search ParameterField TypeResource Fields Searched
addresstextcontact.address
address-citytextcontact.address.city
address-countrytextcontact.address.country
address-postalcodetextcontact.address.postalCode
address-statetextcontact.address.state
address-usetextcontact.address.use
administered-byreferenceadministeredBy
endpointreferenceendpoint
identifiertextidentifier
nametextname | alias
owned-byreferenceownedBy
phonetictextname
statustextstatus
typetexttype