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InsurancePlan

PropertyValue
Publisher
NameInsurancePlan
URLhttp://hl7.org/fhir/StructureDefinition/InsurancePlan
Statusdraft
Description
Abstractfalse

Structure

PathCardinalityTypeDescription
InsurancePlan0..*InsurancePlanDetails of a Health Insurance product/plan provided by an organization.
InsurancePlan.id0..1http://hl7.org/fhirpath/System.StringThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
InsurancePlan.meta0..1MetaThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
InsurancePlan.implicitRules0..1uriA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
InsurancePlan.language0..1codeThe base language in which the resource is written.
InsurancePlan.text0..1NarrativeA human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
InsurancePlan.contained0..*ResourceThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
InsurancePlan.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
InsurancePlan.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
InsurancePlan.identifier0..*IdentifierBusiness identifiers assigned to this health insurance product which remain constant as the resource is updated and propagates from server to server.
InsurancePlan.status0..1codeThe current state of the health insurance product.
InsurancePlan.type0..*CodeableConceptThe kind of health insurance product.
InsurancePlan.name0..1stringOfficial name of the health insurance product as designated by the owner.
InsurancePlan.alias0..*stringA list of alternate names that the product is known as, or was known as in the past.
InsurancePlan.period0..1PeriodThe period of time that the health insurance product is available.
InsurancePlan.ownedBy0..1ReferenceThe entity that is providing the health insurance product and underwriting the risk. This is typically an insurance carriers, other third-party payers, or health plan sponsors comonly referred to as 'payers'.
InsurancePlan.administeredBy0..1ReferenceAn organization which administer other services such as underwriting, customer service and/or claims processing on behalf of the health insurance product owner.
InsurancePlan.coverageArea0..*ReferenceThe geographic region in which a health insurance product's benefits apply.
InsurancePlan.contact0..*BackboneElementThe contact for the health insurance product for a certain purpose.
InsurancePlan.contact.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
InsurancePlan.contact.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
InsurancePlan.contact.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
InsurancePlan.contact.purpose0..1CodeableConceptIndicates a purpose for which the contact can be reached.
InsurancePlan.contact.name0..1HumanNameA name associated with the contact.
InsurancePlan.contact.telecom0..*ContactPointA contact detail (e.g. a telephone number or an email address) by which the party may be contacted.
InsurancePlan.contact.address0..1AddressVisiting or postal addresses for the contact.
InsurancePlan.endpoint0..*ReferenceThe technical endpoints providing access to services operated for the health insurance product.
InsurancePlan.network0..*ReferenceReference to the network included in the health insurance product.
InsurancePlan.coverage0..*BackboneElementDetails about the coverage offered by the insurance product.
InsurancePlan.coverage.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
InsurancePlan.coverage.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
InsurancePlan.coverage.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
InsurancePlan.coverage.type1..1CodeableConceptType of coverage (Medical; Dental; Mental Health; Substance Abuse; Vision; Drug; Short Term; Long Term Care; Hospice; Home Health).
InsurancePlan.coverage.network0..*ReferenceReference to the network that providing the type of coverage.
InsurancePlan.coverage.benefit1..*BackboneElementSpecific benefits under this type of coverage.
InsurancePlan.coverage.benefit.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
InsurancePlan.coverage.benefit.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
InsurancePlan.coverage.benefit.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
InsurancePlan.coverage.benefit.type1..1CodeableConceptType of benefit (primary care; speciality care; inpatient; outpatient).
InsurancePlan.coverage.benefit.requirement0..1stringThe referral requirements to have access/coverage for this benefit.
InsurancePlan.coverage.benefit.limit0..*BackboneElementThe specific limits on the benefit.
InsurancePlan.coverage.benefit.limit.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
InsurancePlan.coverage.benefit.limit.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
InsurancePlan.coverage.benefit.limit.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
InsurancePlan.coverage.benefit.limit.value0..1QuantityThe maximum amount of a service item a plan will pay for a covered benefit. For examples. wellness visits, or eyeglasses.
InsurancePlan.coverage.benefit.limit.code0..1CodeableConceptThe specific limit on the benefit.
InsurancePlan.plan0..*BackboneElementDetails about an insurance plan.
InsurancePlan.plan.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
InsurancePlan.plan.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
InsurancePlan.plan.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
InsurancePlan.plan.identifier0..*IdentifierBusiness identifiers assigned to this health insurance plan which remain constant as the resource is updated and propagates from server to server.
InsurancePlan.plan.type0..1CodeableConceptType of plan. For example, "Platinum" or "High Deductable".
InsurancePlan.plan.coverageArea0..*ReferenceThe geographic region in which a health insurance plan's benefits apply.
InsurancePlan.plan.network0..*ReferenceReference to the network that providing the type of coverage.
InsurancePlan.plan.generalCost0..*BackboneElementOverall costs associated with the plan.
InsurancePlan.plan.generalCost.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
InsurancePlan.plan.generalCost.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
InsurancePlan.plan.generalCost.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
InsurancePlan.plan.generalCost.type0..1CodeableConceptType of cost.
InsurancePlan.plan.generalCost.groupSize0..1positiveIntNumber of participants enrolled in the plan.
InsurancePlan.plan.generalCost.cost0..1MoneyValue of the cost.
InsurancePlan.plan.generalCost.comment0..1stringAdditional information about the general costs associated with this plan.
InsurancePlan.plan.specificCost0..*BackboneElementCosts associated with the coverage provided by the product.
InsurancePlan.plan.specificCost.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
InsurancePlan.plan.specificCost.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
InsurancePlan.plan.specificCost.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
InsurancePlan.plan.specificCost.category1..1CodeableConceptGeneral category of benefit (Medical; Dental; Vision; Drug; Mental Health; Substance Abuse; Hospice, Home Health).
InsurancePlan.plan.specificCost.benefit0..*BackboneElementList of the specific benefits under this category of benefit.
InsurancePlan.plan.specificCost.benefit.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
InsurancePlan.plan.specificCost.benefit.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
InsurancePlan.plan.specificCost.benefit.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
InsurancePlan.plan.specificCost.benefit.type1..1CodeableConceptType of specific benefit (preventative; primary care office visit; speciality office visit; hospitalization; emergency room; urgent care).
InsurancePlan.plan.specificCost.benefit.cost0..*BackboneElementList of the costs associated with a specific benefit.
InsurancePlan.plan.specificCost.benefit.cost.id0..1http://hl7.org/fhirpath/System.StringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
InsurancePlan.plan.specificCost.benefit.cost.extension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
InsurancePlan.plan.specificCost.benefit.cost.modifierExtension0..*ExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
InsurancePlan.plan.specificCost.benefit.cost.type1..1CodeableConceptType of cost (copay; individual cap; family cap; coinsurance; deductible).
InsurancePlan.plan.specificCost.benefit.cost.applicability0..1CodeableConceptWhether the cost applies to in-network or out-of-network providers (in-network; out-of-network; other).
InsurancePlan.plan.specificCost.benefit.cost.qualifiers0..*CodeableConceptAdditional information about the cost, such as information about funding sources (e.g. HSA, HRA, FSA, RRA).
InsurancePlan.plan.specificCost.benefit.cost.value0..1QuantityThe actual cost value. (some of the costs may be represented as percentages rather than currency, e.g. 10% coinsurance).

Search Parameters

NameTypeDescriptionExpression
_textstringSearch on the narrative of the resource
_contentstringSearch on the entire content of the resource
_idtokenLogical id of this artifactResource.id
_lastUpdateddateWhen the resource version last changedResource.meta.lastUpdated
_profileuriProfiles this resource claims to conform toResource.meta.profile
_querytokenA custom search profile that describes a specific defined query operation
_securitytokenSecurity Labels applied to this resourceResource.meta.security
_sourceuriIdentifies where the resource comes fromResource.meta.source
_tagtokenTags applied to this resourceResource.meta.tag
addressstringA server defined search that may match any of the string fields in the Address, including line, city, district, state, country, postalCode, and/or textInsurancePlan.contact.address
address-citystringA city specified in an addressInsurancePlan.contact.address.city
address-countrystringA country specified in an addressInsurancePlan.contact.address.country
address-postalcodestringA postal code specified in an addressInsurancePlan.contact.address.postalCode
address-statestringA state specified in an addressInsurancePlan.contact.address.state
address-usetokenA use code specified in an addressInsurancePlan.contact.address.use
administered-byreferenceProduct administratorInsurancePlan.administeredBy
endpointreferenceTechnical endpointInsurancePlan.endpoint
identifiertokenAny identifier for the organization (not the accreditation issuer's identifier)InsurancePlan.identifier
namestringA portion of the organization's name or aliasname / alias
owned-byreferenceAn organization of which this organization forms a partInsurancePlan.ownedBy
phoneticstringA portion of the organization's name using some kind of phonetic matching algorithmInsurancePlan.name
statustokenIs the Organization record activeInsurancePlan.status
typetokenA code for the type of organizationInsurancePlan.type
_iguhealth-version-seqnumberThe version sequence of the resourceResource.meta.extension.where(url='https://iguhealth.app/version-sequence').value
_iguhealth-authorreferenceThe author of the resourceResource.meta.extension.where(url='https://iguhealth.app/author').value