Da Vinci PDex Plan Net, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 1.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. 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
: Insurance Plan Type
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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
<http://hl7.org/fhir/CodeSystem/InsurancePlanTypeCS> a fhir:CodeSystem ;
fhir:nodeRole fhir:treeRoot ;
fhir:Resource.id [ fhir:value "InsurancePlanTypeCS"] ;
fhir:Resource.language [ fhir:value "en"] ;
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ] ;
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem InsurancePlanTypeCS</b></p><a name=\"InsurancePlanTypeCS\"> </a><a name=\"hcInsurancePlanTypeCS\"> </a><p>This case-sensitive code system <code>http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/InsurancePlanTypeCS</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\">platinum<a name=\"InsurancePlanTypeCS-platinum\"> </a></td><td>Platinum-QHP</td><td>Plan with highest monthly premium and lowest costs when you need care A Qualified Health Plan with the highest monthly premiums and smallest out-of-pocket costs for the member in comparison to other metal-category plans</td></tr><tr><td style=\"white-space:nowrap\">gold<a name=\"InsurancePlanTypeCS-gold\"> </a></td><td>Gold-QHP</td><td>Plan with high monthly premium and low costs when you need care A Qualified Health Plan with the higher monthly premiums and smaller out-of-pocket costs for the member in comparison to other metal-category plans</td></tr><tr><td style=\"white-space:nowrap\">silver<a name=\"InsurancePlanTypeCS-silver\"> </a></td><td>Silver-QHP</td><td>Plan with moderate monthly premium and moderate costs when you need care A Qualified Health Plan with the lower monthly premiums and larger out-of-pocket costs for the member in comparison to other metal-category plans</td></tr><tr><td style=\"white-space:nowrap\">bronze<a name=\"InsurancePlanTypeCS-bronze\"> </a></td><td>Bronze-QHP</td><td>Plan with lowest monthly premium and highest costs when you need care A Qualified Health Plan with the lowest monthly premiums and largest out-of-pocket costs for the member in comparison to other metal-category plans</td></tr><tr><td style=\"white-space:nowrap\">catastrophic<a name=\"InsurancePlanTypeCS-catastrophic\"> </a></td><td>Catastrophic-QHP</td><td>A plan with low monthly premiums and very high deductibles and are available only to those under 30 or with certain special exemptions.</td></tr><tr><td style=\"white-space:nowrap\">lowdeductible<a name=\"InsurancePlanTypeCS-lowdeductible\"> </a></td><td>Low Deductible</td><td>A plan that requires the insured to pay out of pocket a smaller proportion of incurred health care costs than a traditional insurance plan.</td></tr><tr><td style=\"white-space:nowrap\">highdeductible<a name=\"InsurancePlanTypeCS-highdeductible\"> </a></td><td>High Deductible</td><td>A plan that requires the insured to pay out of pocket a larger proportion of incurred health care costs than a traditional insurance plan.</td></tr><tr><td style=\"white-space:nowrap\">catastrophicplan<a name=\"InsurancePlanTypeCS-catastrophicplan\"> </a></td><td>Catastrophic Plan</td><td>A plan that requires the insured to pay out of pocket a much larger proportion of incurred health care costs than a traditional insurance plan.</td></tr></table></div>"
] ;
fhir:DomainResource.extension [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg" ] ;
fhir:Extension.valueCode [ fhir:value "fm" ]
], [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status" ] ;
fhir:Extension.valueCode [
fhir:value "trial-use" ;
fhir:Element.extension [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom" ] ;
fhir:Extension.valueCanonical [
fhir:value "http://hl7.org/fhir/us/davinci-pdex-plan-net/ImplementationGuide/hl7.fhir.us.davinci-pdex-plan-net" ;
fhir:link <http://hl7.org/fhir/us/davinci-pdex-plan-net/ImplementationGuide/hl7.fhir.us.davinci-pdex-plan-net>
]
]
]
] ;
fhir:CodeSystem.url [ fhir:value "http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/InsurancePlanTypeCS"] ;
fhir:CodeSystem.version [ fhir:value "1.2.0"] ;
fhir:CodeSystem.name [ fhir:value "InsurancePlanTypeCS"] ;
fhir:CodeSystem.title [ fhir:value "Insurance Plan Type"] ;
fhir:CodeSystem.status [ fhir:value "active"] ;
fhir:CodeSystem.experimental [ fhir:value "false"^^xsd:boolean] ;
fhir:CodeSystem.date [ fhir:value "2026-06-26T16:46:14+00:00"^^xsd:dateTime] ;
fhir:CodeSystem.publisher [ fhir:value "HL7 International / Financial Management"] ;
fhir:CodeSystem.contact [
fhir:index -1 ;
fhir:ContactDetail.name [ fhir:value "HL7 International / Financial Management" ] ;
fhir:ContactDetail.telecom [
fhir:index -1 ;
fhir:ContactPoint.system [ fhir:value "url" ] ;
fhir:ContactPoint.value [ fhir:value "http://www.hl7.org/Special/committees/fm" ]
], [
fhir:index -1 ;
fhir:ContactPoint.system [ fhir:value "email" ] ;
fhir:ContactPoint.value [ fhir:value "fm@lists.HL7.org" ]
]
] ;
fhir:CodeSystem.description [ fhir:value "Categories of cost-sharing used by plans"] ;
fhir:CodeSystem.jurisdiction [
fhir:index -1 ;
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "urn:iso:std:iso:3166" ] ;
fhir:Coding.code [ fhir:value "US" ]
]
] ;
fhir:CodeSystem.caseSensitive [ fhir:value "true"^^xsd:boolean] ;
fhir:CodeSystem.content [ fhir:value "complete"] ;
fhir:CodeSystem.count [ fhir:value "8"^^xsd:nonNegativeInteger] ;
fhir:CodeSystem.concept [
fhir:index -1 ;
fhir:CodeSystem.concept.code [ fhir:value "platinum" ] ;
fhir:CodeSystem.concept.display [ fhir:value "Platinum-QHP" ] ;
fhir:CodeSystem.concept.definition [ fhir:value "Plan with highest monthly premium and lowest costs when you need care A Qualified Health Plan with the highest monthly premiums and smallest out-of-pocket costs for the member in comparison to other metal-category plans" ]
], [
fhir:index -1 ;
fhir:CodeSystem.concept.code [ fhir:value "gold" ] ;
fhir:CodeSystem.concept.display [ fhir:value "Gold-QHP" ] ;
fhir:CodeSystem.concept.definition [ fhir:value "Plan with high monthly premium and low costs when you need care A Qualified Health Plan with the higher monthly premiums and smaller out-of-pocket costs for the member in comparison to other metal-category plans" ]
], [
fhir:index -1 ;
fhir:CodeSystem.concept.code [ fhir:value "silver" ] ;
fhir:CodeSystem.concept.display [ fhir:value "Silver-QHP" ] ;
fhir:CodeSystem.concept.definition [ fhir:value "Plan with moderate monthly premium and moderate costs when you need care A Qualified Health Plan with the lower monthly premiums and larger out-of-pocket costs for the member in comparison to other metal-category plans" ]
], [
fhir:index -1 ;
fhir:CodeSystem.concept.code [ fhir:value "bronze" ] ;
fhir:CodeSystem.concept.display [ fhir:value "Bronze-QHP" ] ;
fhir:CodeSystem.concept.definition [ fhir:value "Plan with lowest monthly premium and highest costs when you need care A Qualified Health Plan with the lowest monthly premiums and largest out-of-pocket costs for the member in comparison to other metal-category plans" ]
], [
fhir:index -1 ;
fhir:CodeSystem.concept.code [ fhir:value "catastrophic" ] ;
fhir:CodeSystem.concept.display [ fhir:value "Catastrophic-QHP" ] ;
fhir:CodeSystem.concept.definition [ fhir:value "A plan with low monthly premiums and very high deductibles and are available only to those under 30 or with certain special exemptions." ]
], [
fhir:index -1 ;
fhir:CodeSystem.concept.code [ fhir:value "lowdeductible" ] ;
fhir:CodeSystem.concept.display [ fhir:value "Low Deductible" ] ;
fhir:CodeSystem.concept.definition [ fhir:value "A plan that requires the insured to pay out of pocket a smaller proportion of incurred health care costs than a traditional insurance plan." ]
], [
fhir:index -1 ;
fhir:CodeSystem.concept.code [ fhir:value "highdeductible" ] ;
fhir:CodeSystem.concept.display [ fhir:value "High Deductible" ] ;
fhir:CodeSystem.concept.definition [ fhir:value "A plan that requires the insured to pay out of pocket a larger proportion of incurred health care costs than a traditional insurance plan." ]
], [
fhir:index -1 ;
fhir:CodeSystem.concept.code [ fhir:value "catastrophicplan" ] ;
fhir:CodeSystem.concept.display [ fhir:value "Catastrophic Plan" ] ;
fhir:CodeSystem.concept.definition [ fhir:value "A plan that requires the insured to pay out of pocket a much larger proportion of incurred health care costs than a traditional insurance plan." ]
] .
# - ontology header ------------------------------------------------------------
<http://hl7.org/fhir/CodeSystem/InsurancePlanTypeCS.ttl> a owl:Ontology ;
owl:imports fhir:fhir.ttl ;
owl:versionIRI <http://build.fhir.org/CodeSystem/InsurancePlanTypeCS.ttl> .
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