HL7 FHIR® Validated Healthcare Directory Implementation Guide STU 1

Validated Healthcare Directory, published by HL7 International - Patient Admistration Working Group. This is not an authorized publication; it is the continuous build for version 0.2.0). This version is based on the current content of https://github.com/HL7/VhDir/ and changes regularly. See the Directory of published versions

Defining URL:http://hl7.org/fhir/uv/vhdir/ValueSet/plan-type
Version:0.2.0
Name:VhDirPlanType
Status:Active
Title:VhDir Plan Type
Definition:

This value set defines a set of codes that indicate the type of a plan.

Publisher:HL7 International
Source Resource:XML / JSON / Turtle

VhDir Plan Type

This value set defines a set of codes that indicate the type of a plan.

This value set includes codes from the following code systems:

  • Include these codes as defined in http://hl7.org/fhir/uv/vhdir/CodeSystem/payercharacteristics
    CodeDisplay
    catCatastrophic'Catastrophic' health insurance plans have low monthly premiums and very high deductibles. They may cover worst-case scenarios, like getting seriously sick or injured. Patient pays most routine medical expenses.
    bronzeBronze'Bronze' type plan defines the estimated split costs of the plan, where patient is responsible for 40% of their healthcare cost while 60% is covered by the plan.
    bronzeexpExpanded BronzeThe 'extended bronze' plan is an addition to the bronze metal level which establishes the de minimis variation range for the actuarial value (AV) level of coverage to allow variation in the AV to -4/+2 percentage points.
    silverSilver'Silver' type plan defines the estimated split costs of the plan, where patient is responsible for 30% of their healthcare cost while 70% is covered by the plan.
    goldGold'Gold' type plan defines the estimated split costs of the plan, where patient is responsible for 20% of their healthcare cost while 80% is covered by the plan.
    platinumPlatinum'Platinum' type plan defines the estimated split costs of the plan, where patient is responsible for 10% of their healthcare cost while 90% is covered by the plan.
    lowdedLow deductibleA health insurance plan with higher premiums and lower out of pocket cost than a traditional health plan.
    highdedHigh deductibleA health insurance plan with lower premiums and higher out of pocket cost than a traditional health plan.

Expansion

This value set contains 8 concepts

Expansion based on http://hl7.org/fhir/uv/vhdir/CodeSystem/payercharacteristics version 0.2.0

All codes from system http://hl7.org/fhir/uv/vhdir/CodeSystem/payercharacteristics

CodeDisplayDefinition
catCatastrophic'Catastrophic' health insurance plans have low monthly premiums and very high deductibles. They may cover worst-case scenarios, like getting seriously sick or injured. Patient pays most routine medical expenses.
bronzeBronze'Bronze' type plan defines the estimated split costs of the plan, where patient is responsible for 40% of their healthcare cost while 60% is covered by the plan.
bronzeexpExpanded BronzeThe 'extended bronze' plan is an addition to the bronze metal level which establishes the de minimis variation range for the actuarial value (AV) level of coverage to allow variation in the AV to -4/+2 percentage points.
silverSilver'Silver' type plan defines the estimated split costs of the plan, where patient is responsible for 30% of their healthcare cost while 70% is covered by the plan.
goldGold'Gold' type plan defines the estimated split costs of the plan, where patient is responsible for 20% of their healthcare cost while 80% is covered by the plan.
platinumPlatinum'Platinum' type plan defines the estimated split costs of the plan, where patient is responsible for 10% of their healthcare cost while 90% is covered by the plan.
lowdedLow deductibleA health insurance plan with higher premiums and lower out of pocket cost than a traditional health plan.
highdedHigh deductibleA health insurance plan with lower premiums and higher out of pocket cost than a traditional health plan.