National Directory of Healthcare Providers & Services (NDH) Implementation Guide
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National Directory of Healthcare Providers & Services (NDH) Implementation Guide, published by HL7 International / Patient Administration. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-us-ndh/ and changes regularly. See the Directory of published versions

ValueSet: Insurance Product Type Value Set

Official URL: http://hl7.org/fhir/us/ndh/ValueSet/InsuranceProductTypeVS Version: 1.0.0-ballot
Active as of 2024-06-17 Computable Name: InsuranceProductTypeVS

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

References

Logical Definition (CLD)

 

Expansion

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

This value set contains 22 concepts

CodeSystemDisplayDefinition
  commppohttp://hl7.org/fhir/us/ndh/CodeSystem/InsuranceProductTypeCSCommercial PPO

Health insurance provided through a Preferred Provider Organization (PPO).

  commhdhphttp://hl7.org/fhir/us/ndh/CodeSystem/InsuranceProductTypeCSCommercial HDHP

Health insurance provided through a High Deductible Health Plan (HDHP).

  commposhttp://hl7.org/fhir/us/ndh/CodeSystem/InsuranceProductTypeCSCommercial POS

Health insurance provided through a Point-of-Service (POS) Plan.

  commhmohttp://hl7.org/fhir/us/ndh/CodeSystem/InsuranceProductTypeCSCommercial HMO

Health insurance provided through a Health Maintenance Organization (HMO).

  commepohttp://hl7.org/fhir/us/ndh/CodeSystem/InsuranceProductTypeCSCommercial EPO

Health insurance provided through a Exclusive Provider Organization(EPO).

  medihttp://hl7.org/fhir/us/ndh/CodeSystem/InsuranceProductTypeCSMedicaid

Health insurance provided to eligible adults and children under the Federal Medicaid program

  medihmohttp://hl7.org/fhir/us/ndh/CodeSystem/InsuranceProductTypeCSMedicaid HMO

Health insurance provided to eligible adults and children under the Federal Medicaid program through a Health Maintenance Organization (HMO).

  mediadvhttp://hl7.org/fhir/us/ndh/CodeSystem/InsuranceProductTypeCSMedicare Advantage

Health insurance provided by a private company that contracts with Medicare to provide all Medicare Part A and Part B benefits.

  mediadvhmohttp://hl7.org/fhir/us/ndh/CodeSystem/InsuranceProductTypeCSMedicare Advantage HMO

Health 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).

  mediahttp://hl7.org/fhir/us/ndh/CodeSystem/InsuranceProductTypeCSMedicare Part A

Health insurance provided under the Federal Medicare program covering inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

  medibhttp://hl7.org/fhir/us/ndh/CodeSystem/InsuranceProductTypeCSMedicare Part B

Health insurance provided under the Federal Medicfare program covering certain doctors' services, outpatient care, medical supplies, and preventive services.

  medidhttp://hl7.org/fhir/us/ndh/CodeSystem/InsuranceProductTypeCSMedicare Part D

Health insurance provided under the Federal Medicare program covering prescription drugs.

  mediabhttp://hl7.org/fhir/us/ndh/CodeSystem/InsuranceProductTypeCSMedicare A/B

Health 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.

  qhphttp://hl7.org/fhir/us/ndh/CodeSystem/InsuranceProductTypeCSQualified Health Plan

Health 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.

  ihshttp://hl7.org/fhir/us/ndh/CodeSystem/InsuranceProductTypeCSIndian Health Service

Health care program provided to United States American Indians and Alaska Natives.

  fephttp://hl7.org/fhir/us/ndh/CodeSystem/InsuranceProductTypeCSFederal Employee Program

Health insurance provided to employees of the Federal government.

  trihttp://hl7.org/fhir/us/ndh/CodeSystem/InsuranceProductTypeCSTRICARE

Health care program provided to uniformed service members, retirees, and their families around the world.

  vahttp://hl7.org/fhir/us/ndh/CodeSystem/InsuranceProductTypeCSVeterans Affairs Plan

Health care program provided to eligible veterans.

  denthttp://hl7.org/fhir/us/ndh/CodeSystem/InsuranceProductTypeCSDental Plan

Health insurance provided to cover services related to the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the oral cavity.

  denthmohttp://hl7.org/fhir/us/ndh/CodeSystem/InsuranceProductTypeCSDental HMO

Health 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).

  vishttp://hl7.org/fhir/us/ndh/CodeSystem/InsuranceProductTypeCSVision Plan

Health insurance provided to cover services related to the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the eyes.

  vishmohttp://hl7.org/fhir/us/ndh/CodeSystem/InsuranceProductTypeCSVision HMO

Health 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).


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