General Person Secondary Coverage Example

{
  "resourceType": "Coverage",
  "id": "7546D",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the coverage</div>"

  "resourceType" : "Coverage",
  "id" : "7546D",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the coverage</div>"

  },
  "identifier": [
    {
      "system": "http://xyz.com/codes/identifier",
      "value": "AB98761"
    }
  ],
  "status": "active",
  "type": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "EHCPOL",
        "display": "extended healthcare"
      }
    ]

  "identifier" : [{
    "system" : "http://xyz.com/codes/identifier",
    "value" : "AB98761"
  }],
  "status" : "active",
  "kind" : "insurance",
  "type" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
      "code" : "EHCPOL",
      "display" : "extended healthcare"
    }]

  },
  "subscriber": {
    "reference": "Patient/5"

  "subscriber" : {
    "reference" : "Patient/5"

  },
  "subscriberId": "AB9876",
  "beneficiary": {
    "reference": "Patient/5"

  "subscriberId" : [{
    "value" : "AB9876"
  }],
  "beneficiary" : {
    "reference" : "Patient/5"

  },
  "dependent": "1",
  "relationship": {
    "coding": [
      {
        "code": "self"
      }
    ]

  "dependent" : "1",
  "relationship" : {
    "coding" : [{
      "code" : "self"
    }]

  },
  "period": {
    "start": "2011-03-17",
    "end": "2012-03-17"

  "period" : {
    "start" : "2011-03-17",
    "end" : "2012-03-17"

  },
  "payor": [
    {
      "reference": "Organization/2"
    }
  ],
  "class": [
    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code": "group"
          }
        ]
      },
      "value": "WESTAIR",
      "name": "Western Airlines"

  "insurer" : {
    "reference" : "Organization/2"
  },
  "class" : [{
    "type" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
        "code" : "group"
      }]

    },
    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code": "plan"
          }
        ]
      },
      "value": "BG4352",
      "name": "Full Coverage: Medical, Dental, Pharmacy, Vision, EHC"

    "value" : {
      "value" : "WESTAIR"

    },
    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code": "subplan"
          }
        ]
      },
      "value": "D15C9",
      "name": "Platinum"
    }
  ],
  "order": 2,
  "network": "5",
  "costToBeneficiary": [
    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/coverage-copay-type",
            "code": "gpvisit"
          }
        ]
      },
      "valueMoney": {
        "value": 20.00,
        "currency": "USD"

    "name" : "Western Airlines"
  },
  {
    "type" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
        "code" : "plan"
      }]
    },
    "value" : {
      "value" : "BG4352"
    },
    "name" : "Full Coverage: Medical, Dental, Pharmacy, Vision, EHC"
  },
  {
    "type" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
        "code" : "subplan"
      }]
    },
    "value" : {
      "value" : "D15C9"
    },
    "name" : "Platinum"
  }],
  "order" : 2,
  "network" : "5",
  "costToBeneficiary" : [{
    "type" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/coverage-copay-type",
        "code" : "gpvisit"
      }]
    },
    "valueMoney" : {
      "value" : 20.00,
      "currency" : "USD"
    },
    "exception" : [{
      "type" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/ex-coverage-financial-exception",
          "code" : "retired"
        }]

      },
      "exception": [
        {
          "type": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/ex-coverage-financial-exception",
                "code": "retired"
              }
            ]
          },
          "period": {
            "start": "2018-01-01",
            "end": "2018-12-31"
          }
        }
      ]
    }
  ],
  "contract": [
    {
      "reference": "Contract/INS-101"
    }
  ]

      "period" : {
        "start" : "2018-01-01",
        "end" : "2018-12-31"
      }
    }]
  }],
  "contract" : [{
    "reference" : "Contract/INS-101"
  }]

}