National Healthcare Directory Query
1.0.0-ballot - ballot United States of America flag

National Healthcare Directory Query, published by HL7 International - Patient Administration Work Group. This is not an authorized publication; it is the continuous build for version 1.0.0-ballot). This version is based on the current content of https://github.com/HL7/fhir-directory-query/ and changes regularly. See the Directory of published versions

Resource Profile: National Directory Endpoint Qry Exchange InsurancePlan

Official URL: http://hl7.org/fhir/us/directory-query/StructureDefinition/NatlDirEndpointQry-InsurancePlan Version: 1.0.0-ballot
Active as of 2022-12-08 Computable Name: NatlDirEndpointQryInsurancePlan

An InsurancePlan is a discrete package of health insurance coverage benefits that are offered under a particular network type. A given payer’s products typically differ by network type and/or covered benefits. A plan pairs a product’s covered benefits with the particular cost sharing structure offered to a consumer. A given product may comprise multiple plans (i.e. each plan offers different cost sharing requirements for the same set of covered benefits).

InsurancePlan describes a health insurance offering comprised of a list of covered benefits (i.e. the product), costs associated with those benefits (i.e. the plan), and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc.

Usage:

Formal Views of Profile Content

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

This structure is derived from InsurancePlan

NameFlagsCard.TypeDescription & Constraintsdoco
.. InsurancePlan C0..*InsurancePlanDetails of a Health Insurance product/plan provided by an organization
network-or-NatlDirwork: If an insuranceplan does not define a network, then each plan must define one
plan-type-is-distinct: Each InsurancePlan.plan should have a distinct plan.type.
... meta
.... lastUpdated 1..1instantWhen the resource version last changed
... identifier S0..*IdentifierBusiness Identifier for Product
... status 1..1codedraft | active | retired | unknown
Fixed Value: active
... name S0..1stringOfficial name
... ownedBy S1..1Reference(National Directory Endpoint Qry Exchange Organization)Plan issuer
... administeredBy S1..1Reference(National Directory Endpoint Qry Exchange Organization)Product administrator
... coverageArea S0..*Reference(National Directory Endpoint Qry Exchange Location)Where product applies
... endpoint 0..*Reference(National Directory Endpoint Qry Exchange Endpoint)Technical endpoint
... network S0..*Reference(National Directory Endpoint Qry Exchange Network)What networks are Included
... coverage
.... network S0..*Reference(Organization)What networks provide coverage
.... benefit
..... type S1..1CodeableConceptType of benefit
... plan 0..*BackboneElementCost sharing details for the plan
.... type 0..1CodeableConceptCategorization of the cost sharing for the plan
Binding: Insurance Plan Type Value Set (extensible)
.... coverageArea 0..*Reference(National Directory Endpoint Qry Exchange Location)Where product applies
.... network 0..*Reference(National Directory Endpoint Qry Exchange Network)What networks provide coverage

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
InsurancePlan.typeextensibleInsuranceProductTypeVS (a valid code from Insurance Product Type Code System)
InsurancePlan.plan.typeextensibleInsurancePlanTypeVS (a valid code from Insurance Plan Type Code System)

Constraints

IdGradePath(s)DetailsRequirements
network-or-NatlDirworkerrorInsurancePlanIf an insuranceplan does not define a network, then each plan must define one
: network.exists() or plan.network.exists.allTrue()
plan-type-is-distincterrorInsurancePlanEach InsurancePlan.plan should have a distinct plan.type.
: plan.type.coding.code.isDistinct()
NameFlagsCard.TypeDescription & Constraintsdoco
.. InsurancePlan C0..*InsurancePlanDetails of a Health Insurance product/plan provided by an organization
network-or-NatlDirwork: If an insuranceplan does not define a network, then each plan must define one
plan-type-is-distinct: Each InsurancePlan.plan should have a distinct plan.type.
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier SΣC0..*IdentifierBusiness Identifier for Product
... type SΣ1..1CodeableConceptProduct Type
Binding: Insurance Product Type Value Set (extensible)
... name SΣC0..1stringOfficial name
... ownedBy SΣ1..1Reference(National Directory Endpoint Qry Exchange Organization)Plan issuer
... administeredBy SΣ1..1Reference(National Directory Endpoint Qry Exchange Organization)Product administrator
... coverageArea SΣ0..*Reference(National Directory Endpoint Qry Exchange Location)Where product applies
... endpoint 0..*Reference(National Directory Endpoint Qry Exchange Endpoint)Technical endpoint
... network S0..*Reference(National Directory Endpoint Qry Exchange Network)What networks are Included
... coverage 0..*BackboneElementCoverage details
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... type 1..1CodeableConceptType of coverage
.... network S0..*Reference(Organization)What networks provide coverage
.... benefit 1..*BackboneElementList of benefits
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... type S1..1CodeableConceptType of benefit
... plan 0..*BackboneElementCost sharing details for the plan
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... type 0..1CodeableConceptCategorization of the cost sharing for the plan
Binding: Insurance Plan Type Value Set (extensible)
.... coverageArea Σ0..*Reference(National Directory Endpoint Qry Exchange Location)Where product applies
.... network 0..*Reference(National Directory Endpoint Qry Exchange Network)What networks provide coverage

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
InsurancePlan.statusrequiredFixed Value: active
InsurancePlan.typeextensibleInsuranceProductTypeVS (a valid code from Insurance Product Type Code System)
InsurancePlan.plan.typeextensibleInsurancePlanTypeVS (a valid code from Insurance Plan Type Code System)

Constraints

IdGradePath(s)DetailsRequirements
network-or-NatlDirworkerrorInsurancePlanIf an insuranceplan does not define a network, then each plan must define one
: network.exists() or plan.network.exists.allTrue()
plan-type-is-distincterrorInsurancePlanEach InsurancePlan.plan should have a distinct plan.type.
: plan.type.coding.code.isDistinct()
NameFlagsCard.TypeDescription & Constraintsdoco
.. InsurancePlan C0..*InsurancePlanDetails of a Health Insurance product/plan provided by an organization
network-or-NatlDirwork: If an insuranceplan does not define a network, then each plan must define one
plan-type-is-distinct: Each InsurancePlan.plan should have a distinct plan.type.
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ0..1idVersion specific identifier
.... lastUpdated Σ1..1instantWhen the resource version last changed
.... source Σ0..1uriIdentifies where the resource comes from
.... profile Σ0..*canonical(StructureDefinition)Profiles this resource claims to conform to
.... security Σ0..*CodingSecurity Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... tag Σ0..*CodingTags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier SΣC0..*IdentifierBusiness Identifier for Product
... status ?!Σ1..1codedraft | active | retired | unknown
Binding: PublicationStatus (required): The lifecycle status of an artifact.


Fixed Value: active
... type SΣ1..1CodeableConceptProduct Type
Binding: Insurance Product Type Value Set (extensible)
... name SΣC0..1stringOfficial name
... alias 0..*stringAlternate names
... period 0..1PeriodWhen the product is available
... ownedBy SΣ1..1Reference(National Directory Endpoint Qry Exchange Organization)Plan issuer
... administeredBy SΣ1..1Reference(National Directory Endpoint Qry Exchange Organization)Product administrator
... coverageArea SΣ0..*Reference(National Directory Endpoint Qry Exchange Location)Where product applies
... contact 0..*BackboneElementContact for the product
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... purpose 0..1CodeableConceptThe type of contact
Binding: ContactEntityType (extensible): The purpose for which you would contact a contact party.

.... name 0..1HumanNameA name associated with the contact
.... telecom 0..*ContactPointContact details (telephone, email, etc.) for a contact
.... address 0..1AddressVisiting or postal addresses for the contact
... endpoint 0..*Reference(National Directory Endpoint Qry Exchange Endpoint)Technical endpoint
... network S0..*Reference(National Directory Endpoint Qry Exchange Network)What networks are Included
... coverage 0..*BackboneElementCoverage details
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... type 1..1CodeableConceptType of coverage
.... network S0..*Reference(Organization)What networks provide coverage
.... benefit 1..*BackboneElementList of benefits
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... type S1..1CodeableConceptType of benefit
..... requirement 0..1stringReferral requirements
..... limit 0..*BackboneElementBenefit limits
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
...... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
...... value 0..1QuantityMaximum value allowed
...... code 0..1CodeableConceptBenefit limit details
... plan 0..*BackboneElementCost sharing details for the plan
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... identifier Σ0..*IdentifierBusiness Identifier for Product
.... type 0..1CodeableConceptCategorization of the cost sharing for the plan
Binding: Insurance Plan Type Value Set (extensible)
.... coverageArea Σ0..*Reference(National Directory Endpoint Qry Exchange Location)Where product applies
.... network 0..*Reference(National Directory Endpoint Qry Exchange Network)What networks provide coverage
.... generalCost 0..*BackboneElementOverall costs
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... type 0..1CodeableConceptType of cost
..... groupSize 0..1positiveIntNumber of enrollees
..... cost 0..1MoneyCost value
..... comment 0..1stringAdditional cost information
.... specificCost 0..*BackboneElementSpecific costs
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... category 1..1CodeableConceptGeneral category of benefit
..... benefit 0..*BackboneElementBenefits list
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
...... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
...... type 1..1CodeableConceptType of specific benefit
...... cost 0..*BackboneElementList of the costs
....... id 0..1stringUnique id for inter-element referencing
....... extension 0..*ExtensionAdditional content defined by implementations
....... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
....... type 1..1CodeableConceptType of cost
....... applicability 0..1CodeableConceptin-network | out-of-network | other
Binding: BenefitCostApplicability (required): Whether the cost applies to in-network or out-of-network providers.

....... qualifiers 0..*CodeableConceptAdditional information about the cost
....... value 0..1QuantityThe actual cost value

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
InsurancePlan.meta.securityextensibleAll Security Labels
InsurancePlan.meta.tagexampleCommonTags
InsurancePlan.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
InsurancePlan.statusrequiredFixed Value: active
InsurancePlan.typeextensibleInsuranceProductTypeVS (a valid code from Insurance Product Type Code System)
InsurancePlan.contact.purposeextensibleContactEntityType
InsurancePlan.plan.typeextensibleInsurancePlanTypeVS (a valid code from Insurance Plan Type Code System)
InsurancePlan.plan.specificCost.benefit.cost.applicabilityrequiredBenefitCostApplicability

Differential View

This structure is derived from InsurancePlan

NameFlagsCard.TypeDescription & Constraintsdoco
.. InsurancePlan C0..*InsurancePlanDetails of a Health Insurance product/plan provided by an organization
network-or-NatlDirwork: If an insuranceplan does not define a network, then each plan must define one
plan-type-is-distinct: Each InsurancePlan.plan should have a distinct plan.type.
... meta
.... lastUpdated 1..1instantWhen the resource version last changed
... identifier S0..*IdentifierBusiness Identifier for Product
... status 1..1codedraft | active | retired | unknown
Fixed Value: active
... name S0..1stringOfficial name
... ownedBy S1..1Reference(National Directory Endpoint Qry Exchange Organization)Plan issuer
... administeredBy S1..1Reference(National Directory Endpoint Qry Exchange Organization)Product administrator
... coverageArea S0..*Reference(National Directory Endpoint Qry Exchange Location)Where product applies
... endpoint 0..*Reference(National Directory Endpoint Qry Exchange Endpoint)Technical endpoint
... network S0..*Reference(National Directory Endpoint Qry Exchange Network)What networks are Included
... coverage
.... network S0..*Reference(Organization)What networks provide coverage
.... benefit
..... type S1..1CodeableConceptType of benefit
... plan 0..*BackboneElementCost sharing details for the plan
.... type 0..1CodeableConceptCategorization of the cost sharing for the plan
Binding: Insurance Plan Type Value Set (extensible)
.... coverageArea 0..*Reference(National Directory Endpoint Qry Exchange Location)Where product applies
.... network 0..*Reference(National Directory Endpoint Qry Exchange Network)What networks provide coverage

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
InsurancePlan.typeextensibleInsuranceProductTypeVS (a valid code from Insurance Product Type Code System)
InsurancePlan.plan.typeextensibleInsurancePlanTypeVS (a valid code from Insurance Plan Type Code System)

Constraints

IdGradePath(s)DetailsRequirements
network-or-NatlDirworkerrorInsurancePlanIf an insuranceplan does not define a network, then each plan must define one
: network.exists() or plan.network.exists.allTrue()
plan-type-is-distincterrorInsurancePlanEach InsurancePlan.plan should have a distinct plan.type.
: plan.type.coding.code.isDistinct()

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. InsurancePlan C0..*InsurancePlanDetails of a Health Insurance product/plan provided by an organization
network-or-NatlDirwork: If an insuranceplan does not define a network, then each plan must define one
plan-type-is-distinct: Each InsurancePlan.plan should have a distinct plan.type.
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier SΣC0..*IdentifierBusiness Identifier for Product
... type SΣ1..1CodeableConceptProduct Type
Binding: Insurance Product Type Value Set (extensible)
... name SΣC0..1stringOfficial name
... ownedBy SΣ1..1Reference(National Directory Endpoint Qry Exchange Organization)Plan issuer
... administeredBy SΣ1..1Reference(National Directory Endpoint Qry Exchange Organization)Product administrator
... coverageArea SΣ0..*Reference(National Directory Endpoint Qry Exchange Location)Where product applies
... endpoint 0..*Reference(National Directory Endpoint Qry Exchange Endpoint)Technical endpoint
... network S0..*Reference(National Directory Endpoint Qry Exchange Network)What networks are Included
... coverage 0..*BackboneElementCoverage details
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... type 1..1CodeableConceptType of coverage
.... network S0..*Reference(Organization)What networks provide coverage
.... benefit 1..*BackboneElementList of benefits
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... type S1..1CodeableConceptType of benefit
... plan 0..*BackboneElementCost sharing details for the plan
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... type 0..1CodeableConceptCategorization of the cost sharing for the plan
Binding: Insurance Plan Type Value Set (extensible)
.... coverageArea Σ0..*Reference(National Directory Endpoint Qry Exchange Location)Where product applies
.... network 0..*Reference(National Directory Endpoint Qry Exchange Network)What networks provide coverage

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
InsurancePlan.statusrequiredFixed Value: active
InsurancePlan.typeextensibleInsuranceProductTypeVS (a valid code from Insurance Product Type Code System)
InsurancePlan.plan.typeextensibleInsurancePlanTypeVS (a valid code from Insurance Plan Type Code System)

Constraints

IdGradePath(s)DetailsRequirements
network-or-NatlDirworkerrorInsurancePlanIf an insuranceplan does not define a network, then each plan must define one
: network.exists() or plan.network.exists.allTrue()
plan-type-is-distincterrorInsurancePlanEach InsurancePlan.plan should have a distinct plan.type.
: plan.type.coding.code.isDistinct()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. InsurancePlan C0..*InsurancePlanDetails of a Health Insurance product/plan provided by an organization
network-or-NatlDirwork: If an insuranceplan does not define a network, then each plan must define one
plan-type-is-distinct: Each InsurancePlan.plan should have a distinct plan.type.
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ0..1idVersion specific identifier
.... lastUpdated Σ1..1instantWhen the resource version last changed
.... source Σ0..1uriIdentifies where the resource comes from
.... profile Σ0..*canonical(StructureDefinition)Profiles this resource claims to conform to
.... security Σ0..*CodingSecurity Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... tag Σ0..*CodingTags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier SΣC0..*IdentifierBusiness Identifier for Product
... status ?!Σ1..1codedraft | active | retired | unknown
Binding: PublicationStatus (required): The lifecycle status of an artifact.


Fixed Value: active
... type SΣ1..1CodeableConceptProduct Type
Binding: Insurance Product Type Value Set (extensible)
... name SΣC0..1stringOfficial name
... alias 0..*stringAlternate names
... period 0..1PeriodWhen the product is available
... ownedBy SΣ1..1Reference(National Directory Endpoint Qry Exchange Organization)Plan issuer
... administeredBy SΣ1..1Reference(National Directory Endpoint Qry Exchange Organization)Product administrator
... coverageArea SΣ0..*Reference(National Directory Endpoint Qry Exchange Location)Where product applies
... contact 0..*BackboneElementContact for the product
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... purpose 0..1CodeableConceptThe type of contact
Binding: ContactEntityType (extensible): The purpose for which you would contact a contact party.

.... name 0..1HumanNameA name associated with the contact
.... telecom 0..*ContactPointContact details (telephone, email, etc.) for a contact
.... address 0..1AddressVisiting or postal addresses for the contact
... endpoint 0..*Reference(National Directory Endpoint Qry Exchange Endpoint)Technical endpoint
... network S0..*Reference(National Directory Endpoint Qry Exchange Network)What networks are Included
... coverage 0..*BackboneElementCoverage details
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... type 1..1CodeableConceptType of coverage
.... network S0..*Reference(Organization)What networks provide coverage
.... benefit 1..*BackboneElementList of benefits
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... type S1..1CodeableConceptType of benefit
..... requirement 0..1stringReferral requirements
..... limit 0..*BackboneElementBenefit limits
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
...... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
...... value 0..1QuantityMaximum value allowed
...... code 0..1CodeableConceptBenefit limit details
... plan 0..*BackboneElementCost sharing details for the plan
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... identifier Σ0..*IdentifierBusiness Identifier for Product
.... type 0..1CodeableConceptCategorization of the cost sharing for the plan
Binding: Insurance Plan Type Value Set (extensible)
.... coverageArea Σ0..*Reference(National Directory Endpoint Qry Exchange Location)Where product applies
.... network 0..*Reference(National Directory Endpoint Qry Exchange Network)What networks provide coverage
.... generalCost 0..*BackboneElementOverall costs
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... type 0..1CodeableConceptType of cost
..... groupSize 0..1positiveIntNumber of enrollees
..... cost 0..1MoneyCost value
..... comment 0..1stringAdditional cost information
.... specificCost 0..*BackboneElementSpecific costs
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... category 1..1CodeableConceptGeneral category of benefit
..... benefit 0..*BackboneElementBenefits list
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
...... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
...... type 1..1CodeableConceptType of specific benefit
...... cost 0..*BackboneElementList of the costs
....... id 0..1stringUnique id for inter-element referencing
....... extension 0..*ExtensionAdditional content defined by implementations
....... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
....... type 1..1CodeableConceptType of cost
....... applicability 0..1CodeableConceptin-network | out-of-network | other
Binding: BenefitCostApplicability (required): Whether the cost applies to in-network or out-of-network providers.

....... qualifiers 0..*CodeableConceptAdditional information about the cost
....... value 0..1QuantityThe actual cost value

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
InsurancePlan.meta.securityextensibleAll Security Labels
InsurancePlan.meta.tagexampleCommonTags
InsurancePlan.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
InsurancePlan.statusrequiredFixed Value: active
InsurancePlan.typeextensibleInsuranceProductTypeVS (a valid code from Insurance Product Type Code System)
InsurancePlan.contact.purposeextensibleContactEntityType
InsurancePlan.plan.typeextensibleInsurancePlanTypeVS (a valid code from Insurance Plan Type Code System)
InsurancePlan.plan.specificCost.benefit.cost.applicabilityrequiredBenefitCostApplicability

 

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