# Benefit Limitation Extension - CARIN Digital Insurance Card v2.0.0

* [**Table of Contents**](toc.md)
* [**Artifacts Summary**](artifacts.md)
* **Benefit Limitation Extension**

## Extension: Benefit Limitation Extension (Experimental) 

| | |
| :--- | :--- |
| *Official URL*:http://hl7.org/fhir/us/insurance-card/StructureDefinition/benefit-limitation | *Version*:2.0.0 |
| * Standards status: *[Informative](http://hl7.org/fhir/R4/versions.html#std-process) | *Computable Name*:BenefitLimitation |

Extension for documenting limitations and exceptions that apply to specific benefits in the SBC

**Context of Use**

This extension may be used on the following element(s):

* Element ID InsurancePlan.coverage.benefit
* Element ID InsurancePlan.plan.specificCost.benefit

**Usage info**

**Usages:**

* Use this Extension: [SBC Insurance Plan Profile](StructureDefinition-sbc-insurance-plan.md)
* Examples for this Extension: [Sample Health HMO Gold Plan](InsurancePlan-SBCExampleHMO.md)

You can also check for [usages in the FHIR IG Statistics](https://packages2.fhir.org/xig/hl7.fhir.us.insurance-card|current/StructureDefinition/benefit-limitation)

### Formal Views of Extension Content

 [Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work](http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#structure-definitions). 

 

Other representations of profile: [CSV](StructureDefinition-benefit-limitation.csv), [Excel](StructureDefinition-benefit-limitation.xlsx), [Schematron](StructureDefinition-benefit-limitation.sch) 

#### Constraints



## Resource Content

```json
{
  "resourceType" : "StructureDefinition",
  "id" : "benefit-limitation",
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode" : "claims"
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode" : "informative",
    "_valueCode" : {
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical" : "http://hl7.org/fhir/us/insurance-card/ImplementationGuide/hl7.fhir.us.insurance-card"
      }]
    }
  }],
  "url" : "http://hl7.org/fhir/us/insurance-card/StructureDefinition/benefit-limitation",
  "version" : "2.0.0",
  "name" : "BenefitLimitation",
  "title" : "Benefit Limitation Extension",
  "status" : "draft",
  "experimental" : true,
  "date" : "2026-03-20T01:21:28+00:00",
  "publisher" : "HL7 International / Payer/Provider Information Exchange Work Group",
  "contact" : [{
    "name" : "HL7 International / Payer/Provider Information Exchange Work Group",
    "telecom" : [{
      "system" : "url",
      "value" : "http://www.hl7.org/Special/committees/claims"
    },
    {
      "system" : "email",
      "value" : "pie@lists.HL7.org"
    }]
  }],
  "description" : "Extension for documenting limitations and exceptions that apply to specific benefits in the SBC",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "urn:iso:std:iso:3166",
      "code" : "US"
    }]
  }],
  "fhirVersion" : "4.0.1",
  "mapping" : [{
    "identity" : "rim",
    "uri" : "http://hl7.org/v3",
    "name" : "RIM Mapping"
  }],
  "kind" : "complex-type",
  "abstract" : false,
  "context" : [{
    "type" : "element",
    "expression" : "InsurancePlan.coverage.benefit"
  },
  {
    "type" : "element",
    "expression" : "InsurancePlan.plan.specificCost.benefit"
  }],
  "type" : "Extension",
  "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/Extension",
  "derivation" : "constraint",
  "differential" : {
    "element" : [{
      "id" : "Extension",
      "path" : "Extension",
      "short" : "Benefit Limitation Extension",
      "definition" : "Extension for documenting limitations and exceptions that apply to specific benefits in the SBC"
    },
    {
      "id" : "Extension.extension",
      "path" : "Extension.extension",
      "max" : "0"
    },
    {
      "id" : "Extension.url",
      "path" : "Extension.url",
      "fixedUri" : "http://hl7.org/fhir/us/insurance-card/StructureDefinition/benefit-limitation"
    },
    {
      "id" : "Extension.value[x]",
      "path" : "Extension.value[x]",
      "short" : "Limitation or Exception",
      "definition" : "Text describing limitations, exceptions, or additional requirements that apply to this benefit",
      "type" : [{
        "code" : "string"
      }]
    }]
  }
}

```
