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FHIR IG Statistics: CodeSystem/InsurancePlanTypeCS

Packagehl7.fhir.us.directory-query
TypeCodeSystem
IdInsurancePlanTypeCS
FHIR VersionR4
Sourcehttp://hl7.org/fhir/us/directory-query/https://build.fhir.org/ig/HL7/fhir-directory-query/CodeSystem-InsurancePlanTypeCS.html
URLhttp://hl7.org/fhir/us/directory-query/CodeSystem/InsurancePlanTypeCS
Version1.0.0-ballot
Statusactive
Date2022-12-08T23:00:33+00:00
NameInsurancePlanTypeCS
TitleInsurance Plan Type Code System
Realmus
Authorityhl7
DescriptionCategories of cost-sharing used by plans
Contentcomplete

Resources that use this resource

ValueSet
InsurancePlanTypeVSInsurance Plan Type Value Set

Resources that this resource uses

No resources found


Narrative

Note: links and images are rebased to the (stated) source

This code system http://hl7.org/fhir/us/directory-query/CodeSystem/InsurancePlanTypeCS defines the following codes:

CodeDisplayDefinition
platinum Platinum-QHPPlan 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
gold Gold-QHPPlan 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
silver Silver-QHPPlan 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
bronze Bronze-QHPPlan 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
catastrophic Catastrophic-QHPA plan with low monthly premiums and very high deductibles and are available only to those under 30 or with certain special exemptions.
lowdeductible Low DeductibleA plan that requires the insured to pay out of pocket a smaller proportion of incurred health care costs than a traditional insurance plan.
highdeductible High DeductibleA plan that requires the insured to pay out of pocket a larger proportion of incurred health care costs than a traditional insurance plan.
catastrophicplan Catastrophic PlanA plan that requires the insured to pay out of pocket a much larger proportion of incurred health care costs than a traditional insurance plan.

Source

{
  "resourceType": "CodeSystem",
  "id": "InsurancePlanTypeCS",
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "url": "http://hl7.org/fhir/us/directory-query/CodeSystem/InsurancePlanTypeCS",
  "version": "1.0.0-ballot",
  "name": "InsurancePlanTypeCS",
  "title": "Insurance Plan Type Code System",
  "status": "active",
  "experimental": false,
  "date": "2022-12-08T23:00:33+00:00",
  "publisher": "HL7 International - Patient Administration Work Group",
  "contact": [
    {
      "name": "HL7 International - Patient Administration Work Group",
      "telecom": [
        {
          "system": "url",
          "value": "http://hl7.org/Special/committees/pafm"
        },
        {
          "system": "email",
          "value": "pafm@lists.hl7.org"
        }
      ]
    }
  ],
  "description": "Categories of cost-sharing used by plans",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "urn:iso:std:iso:3166",
          "code": "US"
        }
      ]
    }
  ],
  "caseSensitive": true,
  "content": "complete",
  "count": 8,
  "concept": [
    {
      "code": "platinum",
      "display": "Platinum-QHP",
      "definition": "Plan with highest monthly premium and lowest costs when you need care\tA Qualified Health Plan with the highest monthly premiums and smallest out-of-pocket costs for the member in comparison to other metal-category plans"
    },
    {
      "code": "gold",
      "display": "Gold-QHP",
      "definition": "Plan with high monthly premium and low costs when you need care\tA Qualified Health Plan with the higher monthly premiums and smaller out-of-pocket costs for the member in comparison to other metal-category plans"
    },
    {
      "code": "silver",
      "display": "Silver-QHP",
      "definition": "Plan with moderate monthly premium and moderate costs when you need care\tA Qualified Health Plan with the lower monthly premiums and larger out-of-pocket costs for the member in comparison to other metal-category plans"
    },
    {
      "code": "bronze",
      "display": "Bronze-QHP",
      "definition": "Plan with lowest monthly premium and highest costs when you need care\tA Qualified Health Plan with the lowest monthly premiums and largest out-of-pocket costs for the member in comparison to other metal-category plans"
    },
    {
      "code": "catastrophic",
      "display": "Catastrophic-QHP",
      "definition": "A plan with low monthly premiums and very high deductibles and are available only to those under 30 or with certain special exemptions."
    },
    {
      "code": "lowdeductible",
      "display": "Low Deductible",
      "definition": "A plan that requires the insured to pay out of pocket a smaller proportion of incurred health care costs than a traditional insurance plan."
    },
    {
      "code": "highdeductible",
      "display": "High Deductible",
      "definition": "A plan that requires the insured to pay out of pocket a larger proportion of incurred health care costs than a traditional insurance plan."
    },
    {
      "code": "catastrophicplan",
      "display": "Catastrophic Plan",
      "definition": "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."
    }
  ]
}