<?xml version="1.0" encoding="UTF-8"?>
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/*
  Copyright (c) 2011+, HL7, Inc.
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  are permitted provided that the following conditions are met:
  
   * Redistributions of source code must retain the above copyright notice, this 
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   * Redistributions in binary form must reproduce the above copyright notice, 
     this list of conditions and the following disclaimer in the documentation 
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   * Neither the name of HL7 nor the names of its contributors may be used to 
     endorse or promote products derived from this software without specific 
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  ANY EXPRESS OR IMPLIED WARRANTIES, INCLUDING, BUT NOT LIMITED TO, THE IMPLIED 
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  IN NO EVENT SHALL THE COPYRIGHT HOLDER OR CONTRIBUTORS BE LIABLE FOR ANY DIRECT, 
  INDIRECT, INCIDENTAL, SPECIAL, EXEMPLARY, OR CONSEQUENTIAL DAMAGES (INCLUDING, BUT 
  NOT LIMITED TO, PROCUREMENT OF SUBSTITUTE GOODS OR SERVICES; LOSS OF USE, DATA, OR 
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  Generated on Mon, Mar 9, 2026 22:30+0000 for FHIR v6.0.0-ballot4 

  Note: the schemas &amp; schematrons do not contain all of the rules about what makes resources
  valid. Implementers will still need to be familiar with the content of the specification and with
  any profiles that apply to the resources in order to make a conformant implementation.

-->
<xs:schema xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns="http://hl7.org/fhir" xmlns:xhtml="http://www.w3.org/1999/xhtml" targetNamespace="http://hl7.org/fhir" elementFormDefault="qualified" version="1.0">
  <xs:include schemaLocation="fhir-base.xsd"/>
  <xs:element name="InsuranceProduct" type="InsuranceProduct">
    <xs:annotation>
      <xs:documentation xml:lang="en">A product is a discrete package of health insurance coverage benefits that are offered under a particular network, by an organization (payer) and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc.</xs:documentation>
    </xs:annotation>
  </xs:element>
  <xs:complexType name="InsuranceProduct">
    <xs:annotation>
      <xs:documentation xml:lang="en">A product is a discrete package of health insurance coverage benefits that are offered under a particular network, by an organization (payer) and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc.</xs:documentation>
      <xs:documentation xml:lang="en">If the element is present, it must have either a @value, an @id, or extensions</xs:documentation>
    </xs:annotation>
    <xs:complexContent>
      <xs:extension base="DomainResource">
        <xs:sequence>
          <xs:element name="identifier" minOccurs="0" maxOccurs="unbounded" type="Identifier">
            <xs:annotation>
              <xs:documentation xml:lang="en">Business identifiers assigned to this health insurance product which remain constant as the resource is updated and propagates from server to server.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="status" minOccurs="0" maxOccurs="1" type="PublicationStatus">
            <xs:annotation>
              <xs:documentation xml:lang="en">The current state of the health insurance product.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="type" minOccurs="0" maxOccurs="unbounded" type="CodeableConcept">
            <xs:annotation>
              <xs:documentation xml:lang="en">The kind of health insurance product.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="name" minOccurs="0" maxOccurs="1" type="string">
            <xs:annotation>
              <xs:documentation xml:lang="en">Official name of the health insurance product as designated by the owner.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="alias" minOccurs="0" maxOccurs="unbounded" type="string">
            <xs:annotation>
              <xs:documentation xml:lang="en">A list of alternate names that the product is known as, or was known as in the past.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="period" minOccurs="0" maxOccurs="1" type="Period">
            <xs:annotation>
              <xs:documentation xml:lang="en">The period of time that the health insurance product is available.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="ownedBy" minOccurs="0" maxOccurs="1" type="Reference">
            <xs:annotation>
              <xs:documentation xml:lang="en">The 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'.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="administeredBy" minOccurs="0" maxOccurs="1" type="Reference">
            <xs:annotation>
              <xs:documentation xml:lang="en">An organization which administer other services such as underwriting, customer service and/or claims processing on behalf of the health insurance product owner.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="coverageArea" minOccurs="0" maxOccurs="unbounded" type="Reference">
            <xs:annotation>
              <xs:documentation xml:lang="en">The geographic region in which a health insurance product's benefits apply.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="contact" minOccurs="0" maxOccurs="unbounded" type="ExtendedContactDetail">
            <xs:annotation>
              <xs:documentation xml:lang="en">The contact details of communication devices available relevant to the specific Insurance Product. This can include addresses, phone numbers, fax numbers, mobile numbers, email addresses and web sites.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="endpoint" minOccurs="0" maxOccurs="unbounded" type="Reference">
            <xs:annotation>
              <xs:documentation xml:lang="en">The technical endpoints providing access to services operated for the health insurance product.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="network" minOccurs="0" maxOccurs="unbounded" type="Reference">
            <xs:annotation>
              <xs:documentation xml:lang="en">Reference to the network included in the health insurance product.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="coverage" type="InsuranceProduct.Coverage" minOccurs="0" maxOccurs="unbounded">
            <xs:annotation>
              <xs:documentation xml:lang="en">Details about the coverage offered by the insurance product.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="related" type="InsuranceProduct.Related" minOccurs="0" maxOccurs="unbounded">
            <xs:annotation>
              <xs:documentation xml:lang="en">Another product that is related to this product. Often used to create relationships to parents or families of products.</xs:documentation>
           </xs:annotation>
          </xs:element>
        </xs:sequence>
      </xs:extension>
    </xs:complexContent>
  </xs:complexType>
  <xs:complexType name="InsuranceProduct.Coverage">
    <xs:annotation>
      <xs:documentation xml:lang="en">A product is a discrete package of health insurance coverage benefits that are offered under a particular network, by an organization (payer) and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc.</xs:documentation>
    </xs:annotation>
    <xs:complexContent>
      <xs:extension base="BackboneElement">
        <xs:sequence>
          <xs:element name="type" minOccurs="1" maxOccurs="1" type="CodeableConcept">
            <xs:annotation>
              <xs:documentation xml:lang="en">Type of coverage  (Medical; Dental; Mental Health; Substance Abuse; Vision; Drug; Short Term; Long Term Care; Hospice; Home Health).</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="network" minOccurs="0" maxOccurs="unbounded" type="Reference">
            <xs:annotation>
              <xs:documentation xml:lang="en">Reference to the network that providing the type of coverage.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="benefit" type="InsuranceProduct.Benefit" minOccurs="1" maxOccurs="unbounded">
            <xs:annotation>
              <xs:documentation xml:lang="en">Specific benefits under this type of coverage.</xs:documentation>
           </xs:annotation>
          </xs:element>
        </xs:sequence>
      </xs:extension>
    </xs:complexContent>
  </xs:complexType>
  <xs:complexType name="InsuranceProduct.Benefit">
    <xs:annotation>
      <xs:documentation xml:lang="en">A product is a discrete package of health insurance coverage benefits that are offered under a particular network, by an organization (payer) and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc.</xs:documentation>
    </xs:annotation>
    <xs:complexContent>
      <xs:extension base="BackboneElement">
        <xs:sequence>
          <xs:element name="type" minOccurs="1" maxOccurs="1" type="CodeableConcept">
            <xs:annotation>
              <xs:documentation xml:lang="en">Type of benefit (primary care; specialty care; inpatient; outpatient).</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="requirement" minOccurs="0" maxOccurs="1" type="string">
            <xs:annotation>
              <xs:documentation xml:lang="en">The referral requirements to have access/coverage for this benefit.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="limit" type="InsuranceProduct.Limit" minOccurs="0" maxOccurs="unbounded">
            <xs:annotation>
              <xs:documentation xml:lang="en">The specific limits on the benefit.</xs:documentation>
           </xs:annotation>
          </xs:element>
        </xs:sequence>
      </xs:extension>
    </xs:complexContent>
  </xs:complexType>
  <xs:complexType name="InsuranceProduct.Limit">
    <xs:annotation>
      <xs:documentation xml:lang="en">A product is a discrete package of health insurance coverage benefits that are offered under a particular network, by an organization (payer) and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc.</xs:documentation>
    </xs:annotation>
    <xs:complexContent>
      <xs:extension base="BackboneElement">
        <xs:sequence>
          <xs:element name="value" minOccurs="0" maxOccurs="1" type="Quantity">
            <xs:annotation>
              <xs:documentation xml:lang="en">The maximum amount of a service item a plan will pay for a covered benefit.  For examples. wellness visits, or eyeglasses.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="code" minOccurs="0" maxOccurs="1" type="CodeableConcept">
            <xs:annotation>
              <xs:documentation xml:lang="en">The specific limit on the benefit.</xs:documentation>
           </xs:annotation>
          </xs:element>
        </xs:sequence>
      </xs:extension>
    </xs:complexContent>
  </xs:complexType>
  <xs:complexType name="InsuranceProduct.Related">
    <xs:annotation>
      <xs:documentation xml:lang="en">A product is a discrete package of health insurance coverage benefits that are offered under a particular network, by an organization (payer) and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc.</xs:documentation>
    </xs:annotation>
    <xs:complexContent>
      <xs:extension base="BackboneElement">
        <xs:sequence>
          <xs:element name="product" minOccurs="0" maxOccurs="1" type="Reference">
            <xs:annotation>
              <xs:documentation xml:lang="en">The Related Product reference.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="relationship" minOccurs="0" maxOccurs="1" type="CodeableConcept">
            <xs:annotation>
              <xs:documentation xml:lang="en">The relationship of this product to the related product. an example would be 'sub-plan' where this product is a sub-plan of the related.product.</xs:documentation>
           </xs:annotation>
          </xs:element>
          <xs:element name="period" minOccurs="0" maxOccurs="1" type="Period">
            <xs:annotation>
              <xs:documentation xml:lang="en">Period of time that the product relationship is valid. The start and/or end dates can be empty if this is an open ended relationship.</xs:documentation>
           </xs:annotation>
          </xs:element>
        </xs:sequence>
      </xs:extension>
    </xs:complexContent>
  </xs:complexType>
</xs:schema>
