DaVinci PDEX Plan Net
1.1.0 - STU1 United States of America flag

DaVinci PDEX Plan Net, published by HL7 Financial Management Working Group. This is not an authorized publication; it is the continuous build for version 1.1.0). 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 VS

Official URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/ValueSet/InsuranceProductTypeVS Version: 1.1.0
Active as of 2022-04-04 Computable Name: InsuranceProductTypeVS

A distinct package of health insurance coverage benefits that are offered using a particular product network type.

References

Logical Definition (CLD)

 

Expansion

This value set contains 22 concepts

Expansion based on Insurance Product Type v1.1.0 (CodeSystem)

All codes in this table are from the system http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/InsuranceProductTypeCS

CodeDisplayDefinition
  commppoCommercial PPOHealth insurance provided through a Preferred Provider Organization (PPO).
  commhdhpCommercial HDHPHealth insurance provided through a High Deductible Health Plan (HDHP).
  commposCommercial POSHealth insurance provided through a Point-of-Service (POS) Plan.
  commhmoCommercial HMOHealth insurance provided through a Health Maintenance Organization (HMO).
  commepoCommercial EPOHealth insurance provided through a Exclusive Provider Organization(EPO).
  mediMedicaidHealth insurance provided to eligible adults and children under the Federal Medicaid program
  medihmoMedicaid HMOHealth insurance provided to eligible adults and children under the Federal Medicaid program through a Health Maintenance Organization (HMO).
  mediadvMedicare AdvantageHealth insurance provided by a private company that contracts with Medicare to provide all Medicare Part A and Part B benefits.
  mediadvhmoMedicare 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).
  mediaMedicare 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.
  medibMedicare Part BHealth insurance provided under the Federal Medicfare program covering certain doctors' services, outpatient care, medical supplies, and preventive services.
  medidMedicare Part DHealth insurance provided under the Federal Medicare program covering prescription drugs.
  mediabMedicare 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.
  triTRICAREHealth care program provided to uniformed service members, retirees, and their families around the world.
  vaVeterans Affairs PlanHealth care program provided to eligible veterans.
  dentDental PlanHealth insurance provided to cover services related to the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the oral cavity.
  denthmoDental 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).
  visVision PlanHealth insurance provided to cover services related to the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the eyes.
  vishmoVision 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
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