HL7 Terminology (THO)
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HL7 Terminology (THO), published by HL7 International - Vocabulary Work Group. This guide is not an authorized publication; it is the continuous build for version 7.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/UTG/ and changes regularly. See the Directory of published versions

CodeSystem: Insuranceplan Plan Type

Official URL: http://terminology.hl7.org/CodeSystem/insuranceplan-plan-type Version: 1.0.0
Maturity Level: 1 Responsible: Health Level Seven International Computable Name: InsuranceplanPlanType

Copyright/Legal: This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license

This code system defines a set of codes for Insuranceplan Plan Type.

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

Last updated: 2020-04-09 21:10:28+0000; Language: en

Profile: Shareable CodeSystem

This case-sensitive code system http://terminology.hl7.org/CodeSystem/insuranceplan-plan-type defines the following codes:

CodeDisplayDefinition
platinum 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 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 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 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 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 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 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 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.

Description of the above table(s).

History

DateActionAuthorCustodianComment
2024-11-15createMing DunajickpaCreate the InsurancePlan Plan Type Code System and InsurancePlan Plan Type Value Set; up-501