Administrative Incubator
0.1.0 - STU 1 World

Administrative Incubator, published by HL7 International / Patient Administration. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/admin-incubator/ and changes regularly. See the Directory of published versions

Resource: Insurance Plan - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 1

Definitions for the InsurancePlan resource

Guidance on how to interpret the contents of this table can be foundhere

0. InsurancePlan
Definition

InsurancePlan describes the costs to the subscriber or beneficiary associated with benefits, as well as additional information about the offering, such as who administers the plan, a coverage area, contact information, etc. The specific benefits covered by the plan are described in the InsuranceProduct referenced in InsurancePlan.product.


A resource that includes narrative, extensions, and contained resources.

ShortPlan detailsA resource with narrative, extensions, and contained resources
Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id.trace('id') in %resource.descendants().select(reference | as(uri))) or descendants().where(reference='#' | as(uri)='#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. InsurancePlan.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortLogical id of this artifact
Comments

Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resource id depends on the given use case.

Control0..1
Typeid
Is Modifierfalse
Must Supportfalse
Summarytrue
4. InsurancePlan.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

ShortMetadata about the resource
Control0..1
TypeMeta
Is Modifierfalse
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. InsurancePlan.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. For DomainResources, if more than one implicitRules policy applies, additional policies may be conveyed using the additionalImplicitRules extension.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. InsurancePlan.language
Definition

The base language in which the resource is written.

ShortLanguage of the resource content
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Control0..1
BindingThe codes SHALL be taken from AllLanguageshttp://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot5
(required to http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot5)

IETF language tag for a human language

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. InsurancePlan.text
Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

ShortText summary of the resource, for human interpretation
Comments

Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Control0..1
This element is affected by the following invariants: dom-6
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. InsurancePlan.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

ShortContained, inline Resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels. Contained resources may be a resource type defined in the FHIR specification, or an additional resource.

Control0..*
This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
TypeResource
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
14. InsurancePlan.extension
Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on InsurancePlan.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 16. InsurancePlan.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Must Supportfalse
    Summarytrue
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on InsurancePlan.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 18. InsurancePlan.identifier
      Definition

      Identifiers, such as the plan ID and/or group ID associated with the insurance plan.

      ShortBusiness Identifier for Plan
      Comments

      In some markets, the combination of a plan ID and a group ID are needed to uniquely identify an InsurancePlan. For example, if a single plan (Bronze) is offered to two employer groups (Boilermakers and Aviation), you would represent that using two InsurancePlan resources, as shown below:

      InsurancePlan.identifier  0..*  (Boilermakers)   InsurancePlan/bm
           [0].value = 1234   (bronze plan)
           [0].type = Plan
           [0].system = https://insurance-payer.com/plan-numbers
      
           [1].value = Boilermakers
           [1].type = Group
           [1].system = https:// insurance-payer.com /group-numbers
      
      InsurancePlan.identifier  0..*  (Aviation)   InsurancePlan/av
           [0].value = 1234  (bronze plan)
           [0].type = Plan
           [0].system = https:// insurance-payer.com /plan-numbers
      
           [1].value = Aviation
           [1].type = Group
           [1].system = https:// insurance-payer.com /group-numbers
      
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      Summarytrue
      20. InsurancePlan.type
      Definition

      Type of plan. For example, "Platinum" or "High Deductable".

      ShortClassification of Plan
      Control0..1
      TypeCodeableConcept
      22. InsurancePlan.product
      Definition

      The product that this plan is available under.

      ShortThe product that this plan is available under
      Control0..1
      TypeReference(Insurance Product)
      Summarytrue
      24. InsurancePlan.coverageArea
      Definition

      The geographic region in which a health insurance plan's benefits apply.

      ShortWhere product-plan applies
      Control0..*
      TypeReference(Location)
      Summarytrue
      26. InsurancePlan.network
      Definition

      Reference to the network that providing the type of coverage.

      ShortWhat networks provide coverage
      Comments

      Networks are represented as a hierarchy of organization resources.

      Control0..*
      TypeReference(Organization)
      28. InsurancePlan.generalCost
      Definition

      Overall costs associated with the plan.

      ShortOverall costs
      Control0..*
      TypeBackboneElement
      Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
      30. InsurancePlan.generalCost.id
      Definition

      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      ShortUnique id for inter-element referencing
      Control0..1
      This element is affected by the following invariants: ele-1
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      32. InsurancePlan.generalCost.extension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on InsurancePlan.generalCost.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 34. InsurancePlan.generalCost.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on InsurancePlan.generalCost.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 36. InsurancePlan.generalCost.type
          Definition

          Type of cost.

          ShortClassification of specific cost
          Control0..1
          TypeCodeableConcept
          38. InsurancePlan.generalCost.groupSize
          Definition

          Number of participants enrolled in the plan.

          ShortNumber of enrollees
          Control0..1
          TypepositiveInt
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          40. InsurancePlan.generalCost.cost
          Definition

          Value of the cost.

          ShortCost value
          Control0..1
          TypeMoney
          42. InsurancePlan.generalCost.comment
          Definition

          Additional information about the general costs associated with this plan.

          ShortAdditional cost information
          Control0..1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          44. InsurancePlan.specificCost
          Definition

          Costs associated with the coverage provided by the product-plan.

          ShortIndividual cost elements
          Control0..*
          TypeBackboneElement
          Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
          46. InsurancePlan.specificCost.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          This element is affected by the following invariants: ele-1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          48. InsurancePlan.specificCost.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on InsurancePlan.specificCost.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 50. InsurancePlan.specificCost.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on InsurancePlan.specificCost.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 52. InsurancePlan.specificCost.category
              Definition

              General category of benefit (Medical; Dental; Vision; Drug; Mental Health; Substance Abuse; Hospice, Home Health).

              ShortGeneral category of benefit
              Control1..1
              TypeCodeableConcept
              54. InsurancePlan.specificCost.benefit
              Definition

              List of the specific benefits under this category of benefit.

              ShortBenefits list
              Control0..*
              TypeBackboneElement
              Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
              56. InsurancePlan.specificCost.benefit.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              This element is affected by the following invariants: ele-1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              58. InsurancePlan.specificCost.benefit.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              SlicingThis element introduces a set of slices on InsurancePlan.specificCost.benefit.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 60. InsurancePlan.specificCost.benefit.modifierExtension
                Definition

                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                ShortExtensions that cannot be ignored even if unrecognized
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..*
                TypeExtension
                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                Summarytrue
                Requirements

                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                Alternate Namesextensions, user content, modifiers
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                SlicingThis element introduces a set of slices on InsurancePlan.specificCost.benefit.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 62. InsurancePlan.specificCost.benefit.type
                  Definition

                  Type of specific benefit (preventative; primary care office visit; speciality office visit; hospitalization; emergency room; urgent care).

                  ShortClassification of benefit provided
                  Control1..1
                  TypeCodeableConcept
                  64. InsurancePlan.specificCost.benefit.cost
                  Definition

                  List of the costs associated with a specific benefit.

                  ShortList of the costs
                  Control0..*
                  TypeBackboneElement
                  Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
                  66. InsurancePlan.specificCost.benefit.cost.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  68. InsurancePlan.specificCost.benefit.cost.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  SlicingThis element introduces a set of slices on InsurancePlan.specificCost.benefit.cost.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 70. InsurancePlan.specificCost.benefit.cost.modifierExtension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                    ShortExtensions that cannot be ignored even if unrecognized
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                    Summarytrue
                    Requirements

                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                    Alternate Namesextensions, user content, modifiers
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    SlicingThis element introduces a set of slices on InsurancePlan.specificCost.benefit.cost.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 72. InsurancePlan.specificCost.benefit.cost.type
                      Definition

                      Type of cost (copay; individual cap; family cap; coinsurance; deductible).

                      ShortClassification of specific cost
                      Control1..1
                      TypeCodeableConcept
                      74. InsurancePlan.specificCost.benefit.cost.applicability
                      Definition

                      Whether the cost applies to in-network or out-of-network providers (in-network; out-of-network; other).

                      Shortin-network | out-of-network | other
                      Control0..1
                      BindingThe codes SHALL be taken from BenefitCostApplicabilityhttp://hl7.org/fhir/ValueSet/insuranceplan-applicability
                      (required to http://hl7.org/fhir/ValueSet/insuranceplan-applicability)

                      Whether the cost applies to in-network or out-of-network providers.

                      TypeCodeableConcept
                      76. InsurancePlan.specificCost.benefit.cost.qualifier
                      Definition

                      Additional information about the cost, such as information about funding sources (e.g. HSA, HRA, FSA, RRA).

                      ShortAdditional information about the cost
                      Control0..*
                      TypeCodeableConcept
                      78. InsurancePlan.specificCost.benefit.cost.value
                      Definition

                      The actual cost value. (some of the costs may be represented as percentages rather than currency, e.g. 10% coinsurance).

                      ShortThe actual cost value
                      Control0..1
                      TypeQuantity

                      Guidance on how to interpret the contents of this table can be foundhere

                      0. InsurancePlan
                      Definition

                      InsurancePlan describes the costs to the subscriber or beneficiary associated with benefits, as well as additional information about the offering, such as who administers the plan, a coverage area, contact information, etc. The specific benefits covered by the plan are described in the InsuranceProduct referenced in InsurancePlan.product.

                      ShortPlan details
                      Control0..*
                      2. InsurancePlan.identifier
                      Definition

                      Identifiers, such as the plan ID and/or group ID associated with the insurance plan.

                      ShortBusiness Identifier for Plan
                      Comments

                      In some markets, the combination of a plan ID and a group ID are needed to uniquely identify an InsurancePlan. For example, if a single plan (Bronze) is offered to two employer groups (Boilermakers and Aviation), you would represent that using two InsurancePlan resources, as shown below:

                      InsurancePlan.identifier  0..*  (Boilermakers)   InsurancePlan/bm
                           [0].value = 1234   (bronze plan)
                           [0].type = Plan
                           [0].system = https://insurance-payer.com/plan-numbers
                      
                           [1].value = Boilermakers
                           [1].type = Group
                           [1].system = https:// insurance-payer.com /group-numbers
                      
                      InsurancePlan.identifier  0..*  (Aviation)   InsurancePlan/av
                           [0].value = 1234  (bronze plan)
                           [0].type = Plan
                           [0].system = https:// insurance-payer.com /plan-numbers
                      
                           [1].value = Aviation
                           [1].type = Group
                           [1].system = https:// insurance-payer.com /group-numbers
                      
                      NoteThis is a business identifier, not a resource identifier (see discussion)
                      Control0..*
                      TypeIdentifier
                      4. InsurancePlan.type
                      Definition

                      Type of plan. For example, "Platinum" or "High Deductable".

                      ShortClassification of Plan
                      Control0..1
                      TypeCodeableConcept
                      6. InsurancePlan.product
                      Definition

                      The product that this plan is available under.

                      ShortThe product that this plan is available under
                      Control0..1
                      TypeReference(Insurance Product)
                      8. InsurancePlan.coverageArea
                      Definition

                      The geographic region in which a health insurance plan's benefits apply.

                      ShortWhere product-plan applies
                      Control0..*
                      TypeReference(Location)
                      10. InsurancePlan.network
                      Definition

                      Reference to the network that providing the type of coverage.

                      ShortWhat networks provide coverage
                      Comments

                      Networks are represented as a hierarchy of organization resources.

                      Control0..*
                      TypeReference(Organization)
                      12. InsurancePlan.generalCost
                      Definition

                      Overall costs associated with the plan.

                      ShortOverall costs
                      Control0..*
                      TypeBackboneElement
                      14. InsurancePlan.generalCost.type
                      Definition

                      Type of cost.

                      ShortClassification of specific cost
                      Control0..1
                      TypeCodeableConcept
                      16. InsurancePlan.generalCost.groupSize
                      Definition

                      Number of participants enrolled in the plan.

                      ShortNumber of enrollees
                      Control0..1
                      TypepositiveInt
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      18. InsurancePlan.generalCost.cost
                      Definition

                      Value of the cost.

                      ShortCost value
                      Control0..1
                      TypeMoney
                      20. InsurancePlan.generalCost.comment
                      Definition

                      Additional information about the general costs associated with this plan.

                      ShortAdditional cost information
                      Control0..1
                      Typestring
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      22. InsurancePlan.specificCost
                      Definition

                      Costs associated with the coverage provided by the product-plan.

                      ShortIndividual cost elements
                      Control0..*
                      TypeBackboneElement
                      24. InsurancePlan.specificCost.category
                      Definition

                      General category of benefit (Medical; Dental; Vision; Drug; Mental Health; Substance Abuse; Hospice, Home Health).

                      ShortGeneral category of benefit
                      Control1..1
                      TypeCodeableConcept
                      26. InsurancePlan.specificCost.benefit
                      Definition

                      List of the specific benefits under this category of benefit.

                      ShortBenefits list
                      Control0..*
                      TypeBackboneElement
                      28. InsurancePlan.specificCost.benefit.type
                      Definition

                      Type of specific benefit (preventative; primary care office visit; speciality office visit; hospitalization; emergency room; urgent care).

                      ShortClassification of benefit provided
                      Control1..1
                      TypeCodeableConcept
                      30. InsurancePlan.specificCost.benefit.cost
                      Definition

                      List of the costs associated with a specific benefit.

                      ShortList of the costs
                      Control0..*
                      TypeBackboneElement
                      32. InsurancePlan.specificCost.benefit.cost.type
                      Definition

                      Type of cost (copay; individual cap; family cap; coinsurance; deductible).

                      ShortClassification of specific cost
                      Control1..1
                      TypeCodeableConcept
                      34. InsurancePlan.specificCost.benefit.cost.applicability
                      Definition

                      Whether the cost applies to in-network or out-of-network providers (in-network; out-of-network; other).

                      Shortin-network | out-of-network | other
                      Control0..1
                      BindingThe codes SHALL be taken from BenefitCostApplicability
                      (required to http://hl7.org/fhir/ValueSet/insuranceplan-applicability)

                      Whether the cost applies to in-network or out-of-network providers.

                      TypeCodeableConcept
                      36. InsurancePlan.specificCost.benefit.cost.qualifier
                      Definition

                      Additional information about the cost, such as information about funding sources (e.g. HSA, HRA, FSA, RRA).

                      ShortAdditional information about the cost
                      Control0..*
                      TypeCodeableConcept
                      38. InsurancePlan.specificCost.benefit.cost.value
                      Definition

                      The actual cost value. (some of the costs may be represented as percentages rather than currency, e.g. 10% coinsurance).

                      ShortThe actual cost value
                      Control0..1
                      TypeQuantity

                      Guidance on how to interpret the contents of this table can be foundhere

                      0. InsurancePlan
                      Definition

                      InsurancePlan describes the costs to the subscriber or beneficiary associated with benefits, as well as additional information about the offering, such as who administers the plan, a coverage area, contact information, etc. The specific benefits covered by the plan are described in the InsuranceProduct referenced in InsurancePlan.product.

                      ShortPlan details
                      Control0..*
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id.trace('id') in %resource.descendants().select(reference | as(uri))) or descendants().where(reference='#' | as(uri)='#').exists()).not()).trace('unmatched', id).empty())
                      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                      dom-6: A resource should have narrative for robust management (text.`div`.exists())
                      2. InsurancePlan.id
                      Definition

                      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                      ShortLogical id of this artifact
                      Comments

                      Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resource id depends on the given use case.

                      Control0..1
                      Typeid
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      4. InsurancePlan.meta
                      Definition

                      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                      ShortMetadata about the resource
                      Control0..1
                      TypeMeta
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      6. InsurancePlan.implicitRules
                      Definition

                      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. For DomainResources, if more than one implicitRules policy applies, additional policies may be conveyed using the additionalImplicitRules extension.

                      ShortA set of rules under which this content was created
                      Comments

                      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

                      Control0..1
                      Typeuri
                      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      8. InsurancePlan.language
                      Definition

                      The base language in which the resource is written.

                      ShortLanguage of the resource content
                      Comments

                      Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                      Control0..1
                      BindingThe codes SHALL be taken from AllLanguages
                      (required to http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot5)

                      IETF language tag for a human language

                      Typecode
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supportfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      10. InsurancePlan.text
                      Definition

                      A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                      ShortText summary of the resource, for human interpretation
                      Comments

                      Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                      Control0..1
                      This element is affected by the following invariants: dom-6
                      TypeNarrative
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Alternate Namesnarrative, html, xhtml, display
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      12. InsurancePlan.contained
                      Definition

                      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

                      ShortContained, inline Resources
                      Comments

                      This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels. Contained resources may be a resource type defined in the FHIR specification, or an additional resource.

                      Control0..*
                      This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
                      TypeResource
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Alternate Namesinline resources, anonymous resources, contained resources
                      14. InsurancePlan.extension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                      ShortAdditional content defined by implementations
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Alternate Namesextensions, user content
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      SlicingThis element introduces a set of slices on InsurancePlan.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 16. InsurancePlan.modifierExtension
                        Definition

                        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                        ShortExtensions that cannot be ignored
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                        Control0..*
                        TypeExtension
                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                        Must Supportfalse
                        Summarytrue
                        Requirements

                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        SlicingThis element introduces a set of slices on InsurancePlan.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 18. InsurancePlan.identifier
                          Definition

                          Identifiers, such as the plan ID and/or group ID associated with the insurance plan.

                          ShortBusiness Identifier for Plan
                          Comments

                          In some markets, the combination of a plan ID and a group ID are needed to uniquely identify an InsurancePlan. For example, if a single plan (Bronze) is offered to two employer groups (Boilermakers and Aviation), you would represent that using two InsurancePlan resources, as shown below:

                          InsurancePlan.identifier  0..*  (Boilermakers)   InsurancePlan/bm
                               [0].value = 1234   (bronze plan)
                               [0].type = Plan
                               [0].system = https://insurance-payer.com/plan-numbers
                          
                               [1].value = Boilermakers
                               [1].type = Group
                               [1].system = https:// insurance-payer.com /group-numbers
                          
                          InsurancePlan.identifier  0..*  (Aviation)   InsurancePlan/av
                               [0].value = 1234  (bronze plan)
                               [0].type = Plan
                               [0].system = https:// insurance-payer.com /plan-numbers
                          
                               [1].value = Aviation
                               [1].type = Group
                               [1].system = https:// insurance-payer.com /group-numbers
                          
                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control0..*
                          TypeIdentifier
                          Summarytrue
                          20. InsurancePlan.type
                          Definition

                          Type of plan. For example, "Platinum" or "High Deductable".

                          ShortClassification of Plan
                          Control0..1
                          TypeCodeableConcept
                          22. InsurancePlan.product
                          Definition

                          The product that this plan is available under.

                          ShortThe product that this plan is available under
                          Control0..1
                          TypeReference(Insurance Product)
                          Summarytrue
                          24. InsurancePlan.coverageArea
                          Definition

                          The geographic region in which a health insurance plan's benefits apply.

                          ShortWhere product-plan applies
                          Control0..*
                          TypeReference(Location)
                          Summarytrue
                          26. InsurancePlan.network
                          Definition

                          Reference to the network that providing the type of coverage.

                          ShortWhat networks provide coverage
                          Comments

                          Networks are represented as a hierarchy of organization resources.

                          Control0..*
                          TypeReference(Organization)
                          28. InsurancePlan.generalCost
                          Definition

                          Overall costs associated with the plan.

                          ShortOverall costs
                          Control0..*
                          TypeBackboneElement
                          Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
                          30. InsurancePlan.generalCost.id
                          Definition

                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          ShortUnique id for inter-element referencing
                          Control0..1
                          This element is affected by the following invariants: ele-1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          32. InsurancePlan.generalCost.extension
                          Definition

                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                          ShortAdditional content defined by implementations
                          Comments

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          SlicingThis element introduces a set of slices on InsurancePlan.generalCost.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 34. InsurancePlan.generalCost.modifierExtension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            TypeExtension
                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                            Summarytrue
                            Requirements

                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                            Alternate Namesextensions, user content, modifiers
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            SlicingThis element introduces a set of slices on InsurancePlan.generalCost.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 36. InsurancePlan.generalCost.type
                              Definition

                              Type of cost.

                              ShortClassification of specific cost
                              Control0..1
                              TypeCodeableConcept
                              38. InsurancePlan.generalCost.groupSize
                              Definition

                              Number of participants enrolled in the plan.

                              ShortNumber of enrollees
                              Control0..1
                              TypepositiveInt
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              40. InsurancePlan.generalCost.cost
                              Definition

                              Value of the cost.

                              ShortCost value
                              Control0..1
                              TypeMoney
                              42. InsurancePlan.generalCost.comment
                              Definition

                              Additional information about the general costs associated with this plan.

                              ShortAdditional cost information
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              44. InsurancePlan.specificCost
                              Definition

                              Costs associated with the coverage provided by the product-plan.

                              ShortIndividual cost elements
                              Control0..*
                              TypeBackboneElement
                              Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
                              46. InsurancePlan.specificCost.id
                              Definition

                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              ShortUnique id for inter-element referencing
                              Control0..1
                              This element is affected by the following invariants: ele-1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              48. InsurancePlan.specificCost.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              SlicingThis element introduces a set of slices on InsurancePlan.specificCost.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 50. InsurancePlan.specificCost.modifierExtension
                                Definition

                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                ShortExtensions that cannot be ignored even if unrecognized
                                Comments

                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                Control0..*
                                TypeExtension
                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                Summarytrue
                                Requirements

                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                Alternate Namesextensions, user content, modifiers
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                SlicingThis element introduces a set of slices on InsurancePlan.specificCost.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 52. InsurancePlan.specificCost.category
                                  Definition

                                  General category of benefit (Medical; Dental; Vision; Drug; Mental Health; Substance Abuse; Hospice, Home Health).

                                  ShortGeneral category of benefit
                                  Control1..1
                                  TypeCodeableConcept
                                  54. InsurancePlan.specificCost.benefit
                                  Definition

                                  List of the specific benefits under this category of benefit.

                                  ShortBenefits list
                                  Control0..*
                                  TypeBackboneElement
                                  Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
                                  56. InsurancePlan.specificCost.benefit.id
                                  Definition

                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  58. InsurancePlan.specificCost.benefit.extension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                  ShortAdditional content defined by implementations
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  SlicingThis element introduces a set of slices on InsurancePlan.specificCost.benefit.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 60. InsurancePlan.specificCost.benefit.modifierExtension
                                    Definition

                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                    ShortExtensions that cannot be ignored even if unrecognized
                                    Comments

                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                    Control0..*
                                    TypeExtension
                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                    Summarytrue
                                    Requirements

                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                    Alternate Namesextensions, user content, modifiers
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    SlicingThis element introduces a set of slices on InsurancePlan.specificCost.benefit.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 62. InsurancePlan.specificCost.benefit.type
                                      Definition

                                      Type of specific benefit (preventative; primary care office visit; speciality office visit; hospitalization; emergency room; urgent care).

                                      ShortClassification of benefit provided
                                      Control1..1
                                      TypeCodeableConcept
                                      64. InsurancePlan.specificCost.benefit.cost
                                      Definition

                                      List of the costs associated with a specific benefit.

                                      ShortList of the costs
                                      Control0..*
                                      TypeBackboneElement
                                      Invariantsele-1: All FHIR elements must have a @value or children or both (hasValue() or (children().count() > id.count()))
                                      66. InsurancePlan.specificCost.benefit.cost.id
                                      Definition

                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      68. InsurancePlan.specificCost.benefit.cost.extension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                      ShortAdditional content defined by implementations
                                      Comments

                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                      Control0..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      SlicingThis element introduces a set of slices on InsurancePlan.specificCost.benefit.cost.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 70. InsurancePlan.specificCost.benefit.cost.modifierExtension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                        ShortExtensions that cannot be ignored even if unrecognized
                                        Comments

                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                        Control0..*
                                        TypeExtension
                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                        Summarytrue
                                        Requirements

                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                        Alternate Namesextensions, user content, modifiers
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        SlicingThis element introduces a set of slices on InsurancePlan.specificCost.benefit.cost.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 72. InsurancePlan.specificCost.benefit.cost.type
                                          Definition

                                          Type of cost (copay; individual cap; family cap; coinsurance; deductible).

                                          ShortClassification of specific cost
                                          Control1..1
                                          TypeCodeableConcept
                                          74. InsurancePlan.specificCost.benefit.cost.applicability
                                          Definition

                                          Whether the cost applies to in-network or out-of-network providers (in-network; out-of-network; other).

                                          Shortin-network | out-of-network | other
                                          Control0..1
                                          BindingThe codes SHALL be taken from BenefitCostApplicability
                                          (required to http://hl7.org/fhir/ValueSet/insuranceplan-applicability)

                                          Whether the cost applies to in-network or out-of-network providers.

                                          TypeCodeableConcept
                                          76. InsurancePlan.specificCost.benefit.cost.qualifier
                                          Definition

                                          Additional information about the cost, such as information about funding sources (e.g. HSA, HRA, FSA, RRA).

                                          ShortAdditional information about the cost
                                          Control0..*
                                          TypeCodeableConcept
                                          78. InsurancePlan.specificCost.benefit.cost.value
                                          Definition

                                          The actual cost value. (some of the costs may be represented as percentages rather than currency, e.g. 10% coinsurance).

                                          ShortThe actual cost value
                                          Control0..1
                                          TypeQuantity