# AU Base Coverage - AU Base Implementation Guide v6.0.0-ci-build

* [**Table of Contents**](toc.md)
* [**FHIR Artefacts**](fhirartefacts.md)
* [**Artefacts Summary**](artifacts.md)
* **AU Base Coverage**

## Resource Profile: AU Base Coverage 

| | | |
| :--- | :--- | :--- |
| *Official URL*:http://hl7.org.au/fhir/StructureDefinition/au-coverage | *Version*:6.0.0-ci-build | |
| *Standards status:*[Trial-use](http://hl7.org/fhir/R4/versions.html#std-process) | [Maturity Level](generalguidance.md#maturity-levels): 1 | *Computable Name*:AUBaseCoverage |
| **Copyright/Legal**: HL7 Australia© 2018+; Licensed Under Creative Commons No Rights Reserved. | | |

 
This profile defines a coverage structure that localises core concepts, including terminology, for use in an Australian context. The purpose of this profile is to provide national level agreement on core localised concepts. This profile does not force conformance to core localised concepts. It enables implementers and modellers to make their own rules, i.e.[profiling](http://hl7.org/fhir/profiling.html), about how to support these concepts for specific implementation needs. 

### Usage Notes

**Profile specific implementation guidance:**

* See each Identifier profile page for guidance related to that identifier type.
* When populating the type: 
* **Medicare** coverage **SHOULD** be represented by sending the Coverage Type code "PUBLICPOL"
* **Australian public hospital** coverage **SHOULD** be represented by sending the Coverage Type code "AUPUBHOSP"
* **DVA** coverage **SHOULD** be represented by sending the V3 Value SetActCoverageTypeCode code "VET"
* **Private health insurance** coverage **SHOULD** be represented by sending the V3 Value SetActCoverageTypeCode code "HIP"
* **Workcover** coverage **SHOULD** be represented by sending the V3 Value SetActCoverageTypeCode code "WCBPOL"
* **Motor Accident** coverage **SHOULD** be represented by sending the V3 Value SetActCoverageTypeCode code "AUTOPOL"
* **Private (self funded)** coverage **SHOULD** be represented by sending the Coverage SelfPay Codes code "pay"
* **Concession** coverage, for example Health Care Card or Pensioner Concession Card, **SHOULD** be represented by sending the Coverage SelfPay Codes code "payconc"
 

**Usages:**

* Examples for this Profile: [Coverage/dva](Coverage-dva.md) and [Coverage/private](Coverage-private.md)

You can also check for [usages in the FHIR IG Statistics](https://packages2.fhir.org/xig/hl7.fhir.au.base|current/StructureDefinition/au-coverage)

**Changes since version 5.0.0:**

* New Content

### Formal Views of Profile Content

 [Description of Profiles, Differentials, Snapshots and how the different presentations work](http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#structure-definitions). 

 

Other representations of profile: [CSV](StructureDefinition-au-coverage.csv), [Excel](StructureDefinition-au-coverage.xlsx), [Schematron](StructureDefinition-au-coverage.sch) 



## Resource Content

```json
{
  "resourceType" : "StructureDefinition",
  "id" : "au-coverage",
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger" : 1
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode" : "trial-use",
      "_valueCode" : {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical" : "http://hl7.org.au/fhir/ImplementationGuide/hl7.fhir.au.base"
          }
        ]
      }
    }
  ],
  "url" : "http://hl7.org.au/fhir/StructureDefinition/au-coverage",
  "version" : "6.0.0-ci-build",
  "name" : "AUBaseCoverage",
  "title" : "AU Base Coverage",
  "status" : "active",
  "date" : "2025-12-16T23:57:12+00:00",
  "publisher" : "HL7 Australia",
  "contact" : [
    {
      "name" : "HL7 Australia FHIR Working Group",
      "telecom" : [
        {
          "system" : "url",
          "value" : "https://confluence.hl7.org/display/HAFWG",
          "use" : "work"
        }
      ]
    }
  ],
  "description" : "This profile defines a coverage structure that localises core concepts, including terminology, for use in an Australian context. The purpose of this profile is to provide national level agreement on core localised concepts. This profile does not force conformance to core localised concepts. It enables implementers and modellers to make their own rules, i.e. [profiling](http://hl7.org/fhir/profiling.html), about how to support these concepts for specific implementation needs.",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "AU"
        }
      ]
    }
  ],
  "copyright" : "HL7 Australia© 2018+; Licensed Under Creative Commons No Rights Reserved.",
  "fhirVersion" : "4.0.1",
  "mapping" : [
    {
      "identity" : "workflow",
      "uri" : "http://hl7.org/fhir/workflow",
      "name" : "Workflow Pattern"
    },
    {
      "identity" : "rim",
      "uri" : "http://hl7.org/v3",
      "name" : "RIM Mapping"
    },
    {
      "identity" : "w5",
      "uri" : "http://hl7.org/fhir/fivews",
      "name" : "FiveWs Pattern Mapping"
    },
    {
      "identity" : "cdanetv4",
      "uri" : "http://www.cda-adc.ca/en/services/cdanet/",
      "name" : "Canadian Dental Association eclaims standard"
    },
    {
      "identity" : "v2",
      "uri" : "http://hl7.org/v2",
      "name" : "HL7 v2 Mapping"
    },
    {
      "identity" : "cpha3pharm",
      "uri" : "http://www.pharmacists.ca/",
      "name" : "Canadian Pharmacy Associaiton eclaims standard"
    }
  ],
  "kind" : "resource",
  "abstract" : false,
  "type" : "Coverage",
  "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/Coverage",
  "derivation" : "constraint",
  "differential" : {
    "element" : [
      {
        "id" : "Coverage",
        "path" : "Coverage"
      },
      {
        "id" : "Coverage.identifier",
        "path" : "Coverage.identifier",
        "type" : [
          {
            "code" : "Identifier",
            "profile" : [
              "http://hl7.org/fhir/StructureDefinition/Identifier",
              "http://hl7.org.au/fhir/StructureDefinition/au-medicarecardnumber",
              "http://hl7.org.au/fhir/StructureDefinition/au-dvanumber",
              "http://hl7.org.au/fhir/StructureDefinition/au-insurancemembernumber",
              "http://hl7.org.au/fhir/StructureDefinition/au-pensionerconcessioncardnumber",
              "http://hl7.org.au/fhir/StructureDefinition/au-cwlthseniorshealthcardnumber",
              "http://hl7.org.au/fhir/StructureDefinition/au-healthcarecardnumber"
            ]
          }
        ]
      },
      {
        "id" : "Coverage.type",
        "path" : "Coverage.type",
        "binding" : {
          "strength" : "preferred",
          "valueSet" : "http://terminology.hl7.org.au/ValueSet/au-coverage-type-extended"
        }
      }
    ]
  }
}

```
