CARIN Digital Insurance Card
2.0.0 - STU 2.0

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

## : Coverage Example 1 - JSON Representation

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    {
      "resourceType" : "Coverage",
      "id" : "Example-Coverage1",
      "meta" : {
        "versionId" : "1",
        "lastUpdated" : "2021-04-06T10:49:02.473+00:00",
        "profile" : [
          🔗 "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage"
        ]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">Acme Gold Plus</div>"
      },
      "extension" : [
        {
          "extension" : [
            {
              "url" : "memberId",
              "valueId" : "102345672-01"
            },
            {
              "url" : "name",
              "valueHumanName" : {
                "family" : "Doe",
                "given" : [
                  "John"
                ]
              }
            }
          ],
          "url" : "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-PlanBeneficiaries-extension"
        },
        {
          "extension" : [
            {
              "url" : "memberId",
              "valueId" : "102345672-02"
            },
            {
              "url" : "name",
              "valueHumanName" : {
                "family" : "Doe",
                "given" : [
                  "Jane"
                ]
              }
            }
          ],
          "url" : "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-PlanBeneficiaries-extension"
        },
        {
          "extension" : [
            {
              "url" : "memberId",
              "valueId" : "102345672-03"
            },
            {
              "url" : "name",
              "valueHumanName" : {
                "family" : "Doe",
                "given" : [
                  "Jimmy"
                ]
              }
            }
          ],
          "url" : "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-PlanBeneficiaries-extension"
        },
        {
          "extension" : [
            {
              "url" : "memberId",
              "valueId" : "102345672-04"
            },
            {
              "url" : "name",
              "valueHumanName" : {
                "family" : "Doe",
                "given" : [
                  "Ginny"
                ]
              }
            }
          ],
          "url" : "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-PlanBeneficiaries-extension"
        },
        {
          "url" : "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-AdditionalCardInformation-extension",
          "valueAnnotation" : {
            "text" : "If you use a TTY, call 711.\nYou may be asked to present this card when you receive care or fill a perscription. This card does not gaurentee coverage. Intentionally misusing this card may be considered fraud or a violation of the law.\nWe encourage you to use a primary care physician as a valuable resource and personal health advocate."
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-CardIssueDate-extension",
          "valueDate" : "2020-12-15"
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-BackgroundColor-extension",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/IECColourManagement",
                    "code" : "#00bfff"
                  }
                ]
              }
            },
            {
              "url" : "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-ForegroundColor-extension",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/IECColourManagement",
                    "code" : "#000000"
                  }
                ]
              }
            },
            {
              "url" : "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-HighlightColor-extension",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/IECColourManagement",
                    "code" : "#ceebf5"
                  }
                ]
              }
            }
          ],
          "url" : "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-ColorPalette-extension"
        },
        {
          "extension" : [
            {
              "url" : "label",
              "valueString" : "ACME Inc."
            },
            {
              "url" : "description",
              "valueString" : "Company logo"
            },
            {
              "url" : "image",
              "valueAttachment" : {
                "contentType" : "image/png",
                "data" : " "
              }
            }
          ],
          "url" : "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Logo-extension"
        },
        {
          "extension" : [
            {
              "url" : "label",
              "valueString" : "Some lable for this QR code"
            },
            {
              "url" : "description",
              "valueString" : "Usage text for this QR code for the end user"
            },
            {
              "url" : "image",
              "valueAttachment" : {
                "contentType" : "image/png",
                "data" : " "
              }
            }
          ],
          "url" : "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-QRCode-extension"
        },
        {
          "extension" : [
            {
              "url" : "label",
              "valueString" : "Some label for this Barcode"
            },
            {
              "url" : "description",
              "valueString" : "Usage text for this Barcode for the end user"
            },
            {
              "url" : "image",
              "valueAttachment" : {
                "contentType" : "image/png",
                "data" : " "
              }
            }
          ],
          "url" : "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Barcode-extension"
        },
        {
          "extension" : [
            {
              "url" : "label",
              "valueString" : "Some label text"
            },
            {
              "url" : "description",
              "valueString" : "Some text for the end user about the usage/meaning of this image"
            },
            {
              "url" : "image",
              "valueAttachment" : {
                "contentType" : "image/png",
                "data" : " "
              }
            }
          ],
          "url" : "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-SupportingImage-extension"
        }
      ],
      "identifier" : [
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                "code" : "MB",
                "display" : "Member Number"
              }
            ]
          },
          "system" : "https://www.acmeinsurance.com/glossary/memberid",
          "value" : "102345672-02",
          "assigner" : {
            "display" : "Acme Insurance Co"
          }
        }
      ],
      "status" : "active",
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
            "code" : "HIP",
            "display" : "health insurance plan policy"
          }
        ],
        "text" : "health insurance plan policy"
      },
      "subscriber" : {
        🔗 "reference" : "Patient/Example-Patient1",
        "display" : "John Doe"
      },
      "subscriberId" : "102345672-01",
      "beneficiary" : {
        🔗 "reference" : "Patient/Example-Patient2",
        "display" : "Jane Doe"
      },
      "dependent" : "02",
      "relationship" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
            "code" : "spouse",
            "display" : "Spouse"
          }
        ],
        "text" : "Spouse"
      },
      "period" : {
        "start" : "2021-01-01"
      },
      "payor" : [
        {
          🔗 "reference" : "Organization/Example-PayerOrganization1",
          "display" : "Acme Insurance Co"
        }
      ],
      "class" : [
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                "code" : "group"
              }
            ]
          },
          "value" : "993355",
          "name" : "Stars Inc"
        },
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                "code" : "plan"
              }
            ]
          },
          "value" : "11461128",
          "name" : "Acme Gold Plus"
        },
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/C4DICExtendedCoverageClassCS",
                "code" : "division"
              }
            ]
          },
          "value" : "11"
        },
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/C4DICExtendedCoverageClassCS",
                "code" : "network"
              }
            ]
          },
          "value" : "561490",
          "name" : "Acme Gold Plus South"
        },
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                "code" : "rxbin"
              }
            ]
          },
          "value" : "100045"
        },
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                "code" : "rxpcn"
              }
            ]
          },
          "value" : "1234000"
        }
      ],
      "costToBeneficiary" : [
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/C4DICExtendedCopayTypeCS",
                "code" : "FamOutDed",
                "display" : "Family Out of Network Deductible"
              }
            ]
          },
          "valueMoney" : {
            "value" : 10000.00,
            "currency" : "USD"
          }
        },
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/C4DICExtendedCopayTypeCS",
                "code" : "FamInDed",
                "display" : "Family In Network Deductible"
              }
            ]
          },
          "valueMoney" : {
            "value" : 8000.00,
            "currency" : "USD"
          }
        },
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/C4DICExtendedCopayTypeCS",
                "code" : "FamRxOutDed",
                "display" : "Family Pharmacy Out of Network Deductible"
              }
            ]
          },
          "valueMoney" : {
            "value" : 2000.00,
            "currency" : "USD"
          }
        },
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/C4DICExtendedCopayTypeCS",
                "code" : "FamRxInDed",
                "display" : "Family Pharmacy In Network Deductible"
              }
            ]
          },
          "valueMoney" : {
            "value" : 1500.00,
            "currency" : "USD"
          }
        },
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/C4DICExtendedCopayTypeCS",
                "code" : "FamOutMax",
                "display" : "Family Out of Network Out of Pocket Maximum"
              }
            ]
          },
          "valueMoney" : {
            "value" : 12000.00,
            "currency" : "USD"
          }
        },
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/C4DICExtendedCopayTypeCS",
                "code" : "FamInMax",
                "display" : "Family In Network Out of Pocket Maximum"
              }
            ]
          },
          "valueMoney" : {
            "value" : 10000.00,
            "currency" : "USD"
          }
        },
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/C4DICExtendedCopayTypeCS",
                "code" : "FamRxOutMax",
                "display" : "Family Pharmacy Out of Network Out of Pocket Maximum"
              }
            ]
          },
          "valueMoney" : {
            "value" : 3000.00,
            "currency" : "USD"
          }
        },
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/C4DICExtendedCopayTypeCS",
                "code" : "FamRxInMax",
                "display" : "Family Pharmacy In Network Out of Pocket Maximum"
              }
            ]
          },
          "valueMoney" : {
            "value" : 2000.00,
            "currency" : "USD"
          }
        },
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/coverage-copay-type",
                "code" : "gpvisit"
              }
            ]
          },
          "valueMoney" : {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-BeneficiaryCostString-extension",
                "valueString" : "N/A"
              }
            ]
          }
        },
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/coverage-copay-type",
                "code" : "spvisit"
              }
            ]
          },
          "valueMoney" : {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-BeneficiaryCostString-extension",
                "valueString" : "N/A"
              }
            ]
          }
        },
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/coverage-copay-type",
                "code" : "emergency"
              }
            ]
          },
          "valueMoney" : {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-BeneficiaryCostString-extension",
                "valueString" : "N/A"
              }
            ]
          }
        },
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/C4DICExtendedCopayTypeCS",
                "code" : "rx"
              }
            ]
          },
          "valueMoney" : {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-BeneficiaryCostString-extension",
                "valueString" : "DED THEN $10/$40/$70/25%"
              }
            ]
          }
        }
      ]
    }