National Healthcare Directory Query
1.0.0-ballot - ballot

National Healthcare Directory Query, published by HL7 International - Patient Administration Work Group. This is not an authorized publication; it is the continuous build for version 1.0.0-ballot). This version is based on the current content of https://github.com/HL7/fhir-directory-query/ and changes regularly. See the Directory of published versions

## ValueSet: Insurance Plan Type Value Set

Official URL: http://hl7.org/fhir/us/directory-query/ValueSet/InsurancePlanTypeVS | Version: 1.0.0-ballot
Active as of 2022-12-08 | Computable Name: InsurancePlanTypeVS

Categories of cost-sharing used by plans.

References

- National Directory Endpoint Qry Exchange InsurancePlan

### Logical Definition (CLD)

- Include all codes defined in `http://hl7.org/fhir/us/directory-query/CodeSystem/InsurancePlanTypeCS`

### Expansion

This value set contains 8 concepts

Expansion based on Insurance Plan Type Code System v1.0.0-ballot (CodeSystem)

Code | System | Display | Definition
platinum | http://hl7.org/fhir/us/directory-query/CodeSystem/InsurancePlanTypeCS | Platinum-QHP | Plan with highest monthly premium and lowest costs when you need care A Qualified Health Plan with the highest monthly premiums and smallest out-of-pocket costs for the member in comparison to other metal-category plans
gold | http://hl7.org/fhir/us/directory-query/CodeSystem/InsurancePlanTypeCS | Gold-QHP | Plan with high monthly premium and low costs when you need care A Qualified Health Plan with the higher monthly premiums and smaller out-of-pocket costs for the member in comparison to other metal-category plans
silver | http://hl7.org/fhir/us/directory-query/CodeSystem/InsurancePlanTypeCS | Silver-QHP | Plan with moderate monthly premium and moderate costs when you need care A Qualified Health Plan with the lower monthly premiums and larger out-of-pocket costs for the member in comparison to other metal-category plans
bronze | http://hl7.org/fhir/us/directory-query/CodeSystem/InsurancePlanTypeCS | Bronze-QHP | Plan with lowest monthly premium and highest costs when you need care A Qualified Health Plan with the lowest monthly premiums and largest out-of-pocket costs for the member in comparison to other metal-category plans
catastrophic | http://hl7.org/fhir/us/directory-query/CodeSystem/InsurancePlanTypeCS | Catastrophic-QHP | A plan with low monthly premiums and very high deductibles and are available only to those under 30 or with certain special exemptions.
lowdeductible | http://hl7.org/fhir/us/directory-query/CodeSystem/InsurancePlanTypeCS | Low Deductible | A plan that requires the insured to pay out of pocket a smaller proportion of incurred health care costs than a traditional insurance plan.
highdeductible | http://hl7.org/fhir/us/directory-query/CodeSystem/InsurancePlanTypeCS | High Deductible | A plan that requires the insured to pay out of pocket a larger proportion of incurred health care costs than a traditional insurance plan.
catastrophicplan | http://hl7.org/fhir/us/directory-query/CodeSystem/InsurancePlanTypeCS | Catastrophic Plan | A plan that requires the insured to pay out of pocket a much larger proportion of incurred health care costs than a traditional insurance 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
System | 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