Validated Healthcare Directory
0.2.0 - CI Build

Validated Healthcare Directory, published by HL7 International - Patient Administration Work 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

ValueSet: VhDir Plan Type

Summary

Defining URL:http://hl7.org/fhir/uv/vhdir/ValueSet/plan-type
Version:0.2.0
Name:VhDirPlanType
Title:VhDir Plan Type
Status:Active as of 2018-02-21
Definition:

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

Publisher:HL7 International - Patient Administration Work Group
Copyright:

Used by permission of HL7 International all rights reserved Creative Commons License

Source Resource:XML / JSON / Turtle

References

Logical Definition (CLD)

  • Include these codes as defined in 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.

 

Expansion

This value set contains 8 concepts

Expansion based on VhDir Payer Characteristics Code System v0.2.0 (CodeSystem)

All codes in this table are from the 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.

Explanation of the columns that may appear on this page:

Level A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
Source The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code The code (used as the code in the resource instance)
Display The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition An explanation of the meaning of the concept
Comments Additional notes about how to use the code