Details of InsurancePlan describes the costs to the subscriber or beneficiary associated with benefits, as well as additional information about the offering, such as who administers the plan, a Health Insurance product/plan provided coverage area, contact information, etc. The specific benefits covered by an organization. the plan are described in the InsuranceProduct referenced in InsurancePlan.product .

Business identifiers assigned to this health insurance product which remain constant Identifiers, such as the resource is updated and propagates from server to server. plan ID and/or group ID associated with the insurance plan.

The current state of In some markets, the health insurance product. Short Display draft | active | retired | unknown Cardinality 0..1 Terminology Binding PublicationStatus ( Required ) Type code Is Modifier true (Reason: This element is labeled as a modifier because it is combination of a status element that contains codes which means that the resource should not be treated as valid) Meaning if Missing Default interpretation is active. Requirements Need plan ID and a flag group ID are needed to indicate uniquely identify an InsurancePlan. For example, if a record single plan (Bronze) is no longer offered to be used two employer groups (Boilermakers and should generally be hidden for the user in the UI. Aviation), you would represent that using two InsurancePlan resources, as shown below:

InsurancePlan.identifier  0..*  (Boilermakers)   InsurancePlan/bm
     [0].value = 1234   (bronze plan)
     [0].type = Plan
     [0].system = https://insurance-payer.com/plan-numbers

     [1].value = Boilermakers
     [1].type = Group
     [1].system = https:// insurance-payer.com /group-numbers

Summary

InsurancePlan.identifier  0..*  (Aviation)   InsurancePlan/av
     [0].value = 1234  (bronze plan)
     [0].type = Plan
     [0].system = https:// insurance-payer.com /plan-numbers

     [1].value = Aviation
     [1].type = Group
     [1].system = https:// insurance-payer.com /group-numbers

true

Official name Type of the health insurance product as designated by the owner. plan. For example, "Platinum" or "High Deductable".

The period of time that the health insurance product that this plan is available. available under.

The geographic region in which a health insurance product's plan's benefits apply.

Reference to the network that providing the type of coverage.

Networks are represented as a hierarchy of organization resources.

The specific limit on the benefit. Short Display Benefit limit details Cardinality 0..1 Type CodeableConcept Summary false Comments Use CodeableConcept.text element if Overall costs associated with the data is free (uncoded) text. InsurancePlan.plan Element Id InsurancePlan.plan Definition Details about an insurance plan.

Type of plan. For example, "Platinum" or "High Deductable". cost.

Number of participants enrolled in the plan.

Value of the cost.

Additional information about the general costs associated with this plan.

Costs associated with the coverage provided by the product. product-plan.

General category of benefit (Medical; Dental; Vision; Drug; Mental Health; Substance Abuse; Hospice, Home Health).

List of the specific benefits under this category of benefit.

Type of specific benefit (preventative; primary care office visit; speciality office visit; hospitalization; emergency room; urgent care).

List of the costs associated with a specific benefit.

Type of cost (copay; individual cap; family cap; coinsurance; deductible).

Whether the cost applies to in-network or out-of-network providers (in-network; out-of-network; other).

Additional information about the cost, such as information about funding sources (e.g. HSA, HRA, FSA, RRA).

The actual cost value. (some of the costs may be represented as percentages rather than currency, e.g. 10% coinsurance).