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

## Extension: Benefit Limitation Extension (Experimental)

Official URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/benefit-limitation | Version: 2.0.0
Standards status: Informative | 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
- Examples for this Extension: Sample Health HMO Gold Plan

You can also check for usages in the FHIR IG Statistics

### Formal Views of Extension Content

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

- Text Summary
- Differential Table
- Snapshot Table
- All

This structure is derived from Extension

Summary

Simple Extension with the type string: Extension for documenting limitations and exceptions that apply to specific benefits in the SBC

This structure is derived from Extension

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Benefit Limitation Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "http://hl7.org/fhir/us/insurance-card/StructureDefinition/benefit-limitation"
value[x] |  | 0..1 | string | Limitation or Exception
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Benefit Limitation Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/us/insurance-card/StructureDefinition/benefit-limitation"
value[x] |  | 0..1 | string | Limitation or Exception
Documentation for this format

This structure is derived from Extension

Summary

Simple Extension with the type string: Extension for documenting limitations and exceptions that apply to specific benefits in the SBC

Differential View

This structure is derived from Extension

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Benefit Limitation Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "http://hl7.org/fhir/us/insurance-card/StructureDefinition/benefit-limitation"
value[x] |  | 0..1 | string | Limitation or Exception
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Benefit Limitation Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/us/insurance-card/StructureDefinition/benefit-limitation"
value[x] |  | 0..1 | string | Limitation or Exception
Documentation for this format

Other representations of profile: CSV, Excel, Schematron

#### Constraints

Id | Grade | Path(s) | Description | Expression
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`