DaVinci PDEX Plan Net
1.1.0 - STU1 United States of America flag

DaVinci PDEX Plan Net, published by HL7 Financial Management Working Group. This is not an authorized publication; it is the continuous build for version 1.1.0). This version is based on the current content of https://github.com/HL7/davinci-pdex-plan-net/ and changes regularly. See the Directory of published versions

CodeSystem: Insurance Product Type

Official URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/InsuranceProductTypeCS Version: 1.1.0
Active as of 2022-04-04 Computable Name: InsuranceProductTypeCS

A distinct package of health insurance coverage benefits that are offered using a particular product network type.

This Code system is referenced in the content logical definition of the following value sets:

This code system http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/InsuranceProductTypeCS defines the following codes:

CodeDisplayDefinition
commppo Commercial PPOHealth insurance provided through a Preferred Provider Organization (PPO).
commhdhp Commercial HDHPHealth insurance provided through a High Deductible Health Plan (HDHP).
commpos Commercial POSHealth insurance provided through a Point-of-Service (POS) Plan.
commhmo Commercial HMOHealth insurance provided through a Health Maintenance Organization (HMO).
commepo Commercial EPOHealth insurance provided through a Exclusive Provider Organization(EPO).
medi MedicaidHealth insurance provided to eligible adults and children under the Federal Medicaid program
medihmo Medicaid HMOHealth insurance provided to eligible adults and children under the Federal Medicaid program through a Health Maintenance Organization (HMO).
mediadv Medicare AdvantageHealth insurance provided by a private company that contracts with Medicare to provide all Medicare Part A and Part B benefits.
mediadvhmo Medicare Advantage HMOHealth insurance offered by a private company that contracts with Medicare to provide all Medicare Part A and Part B benefits through a Health Maintenance Organization (HMO).
media Medicare Part AHealth insurance provided under the Federal Medicare program covering inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
medib Medicare Part BHealth insurance provided under the Federal Medicfare program covering certain doctors' services, outpatient care, medical supplies, and preventive services.
medid Medicare Part DHealth insurance provided under the Federal Medicare program covering prescription drugs.
mediab Medicare A/BHealth insurance provided under the Federal Medicare program covering inpatient hospital stays, care in a skilled nursing facility, hospice care, some home health care, certain doctors' services, outpatient care, medical supplies, and preventive services.
qhp Qualified Health PlanHealth insurance provided through and certified by the Health Insurance Marketplace that provides essential health benefits (EHBs), follows established limits on cost sharing, and meets other requirements outlined within the application process.
ihs Indian Health ServiceHealth care program provided to United States American Indians and Alaska Natives.
fep Federal Employee ProgramHealth insurance provided to employees of the Federal government.
tri TRICAREHealth care program provided to uniformed service members, retirees, and their families around the world.
va Veterans Affairs PlanHealth care program provided to eligible veterans.
dent Dental PlanHealth insurance provided to cover services related to the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the oral cavity.
denthmo Dental HMOHealth insurance provided to cover services related to the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the oral cavity provided through a Health Maintenance Organization (HMO).
vis Vision PlanHealth insurance provided to cover services related to the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the eyes.
vishmo Vision HMOHealth insurance provided to cover services related to the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the eyes provided through a Health Maintenance Organization (HMO).