http://hl7.org/fhir/StructureDefinition/InsurancePlan|5.0.0
Details of a Health Insurance product/plan provided by an organization.
| Name | Flags | Card | Type | Description & Constraints |
|---|---|---|---|---|
InsurancePlan | 0..* | Details of a Health Insurance product/plan provided by an organization | ||
Σ | 0..* | Identifier | Business Identifier for Product | |
?!Σ | 0..1 | code | draft | active | retired | unknown PublicationStatus (required) | |
Σ | 0..* | CodeableConcept | Kind of product InsurancePlanType (example) | |
Σ | 0..1 | string | Official name | |
| 0..* | string | Alternate names | ||
| 0..1 | Period | When the product is available | ||
Σ | 0..1 | Reference | Product issuer | |
Σ | 0..1 | Reference | Product administrator | |
Σ | 0..* | Reference | Where product applies | |
| 0..* | ExtendedContactDetail | Official contact details relevant to the health insurance plan/product | ||
| 0..* | Reference | Technical endpoint | ||
| 0..* | Reference | What networks are Included | ||
| 0..* | BackboneElement | Coverage details | ||
| 1..1 | CodeableConcept | Type of coverage | ||
| 0..* | Reference | What networks provide coverage | ||
| 1..* | BackboneElement | List of benefits | ||
| 1..1 | CodeableConcept | Type of benefit | ||
| 0..1 | string | Referral requirements | ||
| 0..* | BackboneElement | Benefit limits | ||
| 0..1 | Quantity | Maximum value allowed | ||
| 0..1 | CodeableConcept | Benefit limit details | ||
| 0..* | BackboneElement | Plan details | ||
Σ | 0..* | Identifier | Business Identifier for Product | |
| 0..1 | CodeableConcept | Type of plan | ||
Σ | 0..* | Reference | Where product applies | |
| 0..* | Reference | What networks provide coverage | ||
| 0..* | BackboneElement | Overall costs | ||
| 0..1 | CodeableConcept | Type of cost | ||
| 0..1 | positiveInt | Number of enrollees | ||
| 0..1 | Money | Cost value | ||
| 0..1 | string | Additional cost information | ||
| 0..* | BackboneElement | Specific costs | ||
| 1..1 | CodeableConcept | General category of benefit | ||
| 0..* | BackboneElement | Benefits list | ||
| 1..1 | CodeableConcept | Type of specific benefit | ||
| 0..* | BackboneElement | List of the costs | ||
| 1..1 | CodeableConcept | Type of cost | ||
| 0..1 | CodeableConcept | in-network | out-of-network | other BenefitCostApplicability (required) | ||
| 0..* | CodeableConcept | Additional information about the cost | ||
| 0..1 | Quantity | The actual cost value |