DaVinci PDEX Plan Net
0.3.0 - STU1

DaVinci PDEX Plan Net, published by HL7 Financial Management Working Group. This is not an authorized publication; it is the continuous build for version 0.3.0). This version is based on the current content of https://github.com/HL7/davinci-pdex-plan-net/ and changes regularly. See the Directory of published versions

ValueSet: Insurance Product Type

Summary

Defining URL:http://hl7.org/fhir/us/davinci-pdex-plan-net/ValueSet/InsuranceProductTypeVS
Version:0.3.0
Name:InsuranceProductTypeVS
Status:Active
Title:Insurance Product Type
Definition:

Valueset for InsurancePlan product types. Any set of plans that share a network type and a set of benefits is a product. Plans within a prouduct share coverage but differ in cost-sharing.

Publisher:HL7 Financial Management Working Group
Source Resource:XML / JSON / Turtle

References

Logical Definition (CLD)

 

Expansion

This value set contains 22 concepts

Expansion based on Insurance Product Type v0.3.0 (CodeSystem)

All codes from system http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/InsuranceProductTypeCS

CodeDisplayDefinition
CommercialPPOCommercial PPOHealth insurance provided through a Preferred Provider Organization (PPO)
CommercialHDHPCommercial HDHPHealth insurance provided through a High Deductible Health Plan (HDHP)
CommercialPOSCommercial POSHealth insurance provided through a Point-of-Service (POS) Plan
CommercialHMOCommercial HMOHealth insurance provided through a Health Maintenance Organization (HMO)
CommercialEPOCommercial EPOHealth insurance provided through a Exclusive Provider Organization(EPO)
MedicaidMedicaidHealth insurance provided to eligible adults and children under the Federal Medicaid program
MedicaidHMOMedicaid HMOHealth insurance provided to eligible adults and children under the Federal Medicaid program through a Health Maintenance Organization (HMO)
MedicareAdvantageMedicare AdvantageHealth insurance provided by a private company that contracts with Medicare to provide all Medicare Part A and Part B benefits.
MedicareAdvantageHMOMedicare Advantage HMOHealth insurance offered by a private company that contracts with Medicare to provide all Medicare Part A and Part B benefits through a Health Maintenance Organization (HMO)
MedicareAMedicare Part AHealth insurance provided under the Federal Medicare program covering inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
MedicareBMedicare Part BHealth insurance provided under the Federal Medicare program covering certain doctors' services, outpatient care, medical supplies, and preventive services.
MedicareDMedicare Part DHealth insurance provided under the Federal Medicare program covering prescription drugs.
MedicareABMedicare A/BHealth insurance provided under the Federal Medicare program covering inpatient hospital stays, care in a skilled nursing facility, hospice care, some home health care, certain doctors' services, outpatient care, medical supplies, and preventive services..
QHPQualified Health PlanHealth insurance provided through and certified by the Health Insurance Marketplace that provides essential health benefits (EHBs), follows established limits on cost sharing, and meets other requirements outlined within the application process.
IHSIndian Health ServiceHealth care program provided to United States American Indians and Alaska Natives.
FEPFederal Employee ProgramHealth insurance provided to employees of the Federal government.
TRICARETRICAREHealth care program provided to uniformed service members, retirees, and their families around the world.
VAVeterans Affairs PlanHealth care program provided to eligible veterans.
DentalDental PlanHealth insurance provided to cover services related to the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the oral cavity.
DentalHMODental HMOHealth insurance provided to cover services related to the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the oral cavity provided through a Health Maintenance Organization (HMO).
VisionVision PlanHealth insurance provided to cover services related to the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the eyes.
VisionHMOVision HMOHealth insurance provided to cover services related to the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the eyes provided through a Health Maintenance Organization (HMO).

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
Source 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