CARIN Digital Insurance Card
2.0.0 - STU 2.0 United States of America flag

CARIN Digital Insurance Card, published by HL7 International / Payer/Provider Information Exchange Work Group. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/carin-digital-insurance-card/ and changes regularly. See the Directory of published versions

ValueSet: SBC Plan Type Value Set (Experimental)

Official URL: http://hl7.org/fhir/us/insurance-card/ValueSet/sbc-plan-type Version: 2.0.0
Standards status: Informative Computable Name: SBCPlanTypeVS

Value set containing health insurance plan types for Summary of Benefits and Coverage documents

References

Logical Definition (CLD)

 

Expansion

Expansion performed internally based on codesystem SBC Plan Type Code System v2.0.0 (CodeSystem)

This value set contains 6 concepts

SystemCodeDisplay (en)DefinitionJSONXML
http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-plan-type  HMOHealth Maintenance Organization (HMO)A type of health insurance plan that requires members to get health care services from doctors and hospitals in the plan's network, except in an emergency
http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-plan-type  PPOPreferred Provider Organization (PPO)A type of health insurance plan where members pay less if they use providers in the plan's network, but can use out-of-network providers at higher cost
http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-plan-type  POSPoint of Service (POS)A type of health insurance plan where members pay less if they use doctors and hospitals in the plan's network and choose a primary care doctor to coordinate care
http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-plan-type  EPOExclusive Provider Organization (EPO)A type of health insurance plan where services are covered only if members use doctors and providers in the plan's network, except in an emergency
http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-plan-type  HDHPHigh Deductible Health Plan (HDHP)A health insurance plan with a higher deductible than traditional plans, often paired with a Health Savings Account
http://hl7.org/fhir/us/insurance-card/CodeSystem/sbc-plan-type  INDEMNITYIndemnity PlanA type of health insurance that allows members to see any doctor or hospital and pays a portion of the bill

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