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Packagehl7.fhir.uv.xver-r5.r4b
Resource TypeValueSet
IdValueSet-R5-v3-ActInsurancePolicyCode-for-R4B.json
FHIR VersionR4B
Sourcehttp://hl7.org/fhir/uv/xver-r5.r4b/0.1.0/ValueSet-R5-v3-ActInsurancePolicyCode-for-R4B.html
URLhttp://hl7.org/fhir/uv/xver/ValueSet/R5-v3-ActInsurancePolicyCode-for-R4B
Version0.1.0
Statusactive
Date2026-03-17T21:02:03.8104715+00:00
NameR5V3ActInsurancePolicyCodeForR4B
TitleCross-version ValueSet R5.ActInsurancePolicyCode for use in FHIR R4B
Realmuv
Authorityhl7
DescriptionThis cross-version ValueSet represents content from `http://terminology.hl7.org/ValueSet/v3-ActInsurancePolicyCode|2.0.0` for use in FHIR R4B.
PurposeThis value set is part of the cross-version definitions generated to enable use of the value set `http://terminology.hl7.org/ValueSet/v3-ActInsurancePolicyCode|2.0.0` as defined in FHIR R5 in FHIR R4B. The source value set is bound to the following FHIR R5 elements: * Note that all concepts are included in this cross-version definition because no concepts have compatible representations Following are the generation technical comments: FHIR ValueSet `http://terminology.hl7.org/ValueSet/v3-ActInsurancePolicyCode|2.0.0`, defined in FHIR R5 does not have any mapping to FHIR R4B

Resources that use this resource

No resources found


Resources that this resource uses

CodeSystem
hl7.terminology#currentv3-ActCodeActCode

Narrative

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

Generated Narrative: ValueSet R5-v3-ActInsurancePolicyCode-for-R4B

This value set expansion contains 19 concepts.

SystemVersionCodeDisplayDefinition
http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  AUTOPOLautomobile

Insurance policy for injuries sustained in an automobile accident. Will also typically covered non-named parties to the policy, such as pedestrians and passengers.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  CANPRGwomen's cancer detection program

Definition: A program that provides low-income, uninsured, and underserved women access to timely, high-quality screening and diagnostic services, to detect breast and cervical cancer at the earliest stages.

Example: To improve women's access to screening for breast and cervical cancers, Congress passed the Breast and Cervical Cancer Mortality Prevention Act of 1990, which guided CDC in creating the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), which provides access to critical breast and cervical cancer screening services for underserved women in the United States. An estimated 7 to 10% of U.S. women of screening age are eligible to receive NBCCEDP services. Federal guidelines establish an eligibility baseline to direct services to uninsured and underinsured women at or below 250% of federal poverty level; ages 18 to 64 for cervical screening; ages 40 to 64 for breast screening.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  COLcollision coverage policy

Definition: An automobile insurance policy under which the insurance company will cover the cost of damages to an automobile owned by the named insured that are caused by accident or intentionally by another party.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  DENTPRGdental program

Definition: A public or government health program that administers and funds coverage for dental care to assist program eligible who meet financial and health status criteria.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  DISEASEPRGpublic health program

Definition: A public or government health program that administers and funds coverage for health and social services to assist program eligible who meet financial and health status criteria related to a particular disease.

Example: Reproductive health, sexually transmitted disease, and end renal disease programs.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  EHCPOLextended healthcare

Private insurance policy that provides coverage in addition to other policies (e.g. in addition to a Public Healthcare insurance policy).

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  ENDRENALend renal program

Definition: A public or government program that administers publicly funded coverage of kidney dialysis and kidney transplant services.

Example: In the U.S., the Medicare End-stage Renal Disease program (ESRD), the National Kidney Foundation (NKF) American Kidney Fund (AKF) The Organ Transplant Fund.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  HIVAIDSHIV-AIDS program

Definition: Government administered and funded HIV-AIDS program for beneficiaries meeting financial and health status criteria. Administration, funding levels, eligibility criteria, covered benefits, provider types, and financial participation are typically set by a regulatory process. Payer responsibilities for administering the program may be delegated to contractors.

Example: In the U.S., the Ryan White program, which is administered by the Health Resources and Services Administration.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  HSAPOLhealth spending account

Insurance policy that provides for an allotment of funds replenished on a periodic (e.g. annual) basis. The use of the funds under this policy is at the discretion of the covered party.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  MANDPOLmandatory health program
http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  MENTPRGmental health program

Definition: Government administered and funded mental health program for beneficiaries meeting financial and mental health status criteria. Administration, funding levels, eligibility criteria, covered benefits, provider types, and financial participation are typically set by a regulatory process. Payer responsibilities for administering the program may be delegated to contractors.

Example: In the U.S., states receive funding for substance use programs from the Substance Abuse Mental Health Administration (SAMHSA).

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  PUBLICPOLpublic healthcare

Insurance policy funded by a public health system such as a provincial or national health plan. Examples include BC MSP (British Columbia Medical Services Plan) OHIP (Ontario Health Insurance Plan), NHS (National Health Service).

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  SAFNETsafety net clinic program

Definition: Government administered and funded program to support provision of care to underserved populations through safety net clinics.

Example: In the U.S., safety net providers such as federally qualified health centers (FQHC) receive funding under PHSA Section 330 grants administered by the Health Resources and Services Administration.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  SUBPRGsubstance use program

Definition: Government administered and funded substance use program for beneficiaries meeting financial, substance use behavior, and health status criteria. Beneficiaries may be required to enroll as a result of legal proceedings. Administration, funding levels, eligibility criteria, covered benefits, provider types, and financial participation are typically set by a regulatory process. Payer responsibilities for administering the program may be delegated to contractors.

Example: In the U.S., states receive funding for substance use programs from the Substance Abuse Mental Health Administration (SAMHSA).

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  SUBSIDIZsubsidized health program

Definition: A government health program that provides coverage for health services to persons meeting eligibility criteria such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  SUBSIDMCsubsidized managed care program

Definition: A government health program that provides coverage through managed care contracts for health services to persons meeting eligibility criteria such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds.

Discussion: The structure and business processes for underwriting and administering a subsidized managed care program is further specified by the Underwriter and Payer Role.class and Role.code.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  SUBSUPPsubsidized supplemental health program

Definition: A government health program that provides coverage for health services to persons meeting eligibility criteria for a supplemental health policy or program such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds.

Example: Supplemental health coverage program may cover the cost of a health program or policy financial participations, such as the copays and the premiums, and may provide coverage for services in addition to those covered under the supplemented health program or policy. In the U.S., Medicaid programs may pay the premium for a covered party who is also covered under the Medicare program or a private health policy.

Discussion: The structure and business processes for underwriting and administering a subsidized supplemental retiree health program is further specified by the Underwriter and Payer Role.class and Role.code.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  UNINSMOTuninsured motorist policy

Definition: An automobile insurance policy under which the insurance company will indemnify a loss for which another motorist is liable if that motorist is unable to pay because he or she is uninsured. Coverage under the policy applies to bodily injury damages only. Injuries to the covered party caused by a hit-and-run driver are also covered.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  WCBPOLworker's compensation

Insurance policy for injuries sustained in the work place or in the course of employment.


Source1

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  "url": "http://hl7.org/fhir/uv/xver/ValueSet/R5-v3-ActInsurancePolicyCode-for-R4B",
  "version": "0.1.0",
  "name": "R5V3ActInsurancePolicyCodeForR4B",
  "title": "Cross-version ValueSet R5.ActInsurancePolicyCode for use in FHIR R4B",
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  "experimental": false,
  "date": "2026-03-17T21:02:03.8104715+00:00",
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  "compose": {
    "include": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "version": "8.0.0",
        "concept": [
          {
            "code": "AUTOPOL",
            "display": "automobile"
          },
          {
            "code": "CANPRG",
            "display": "women's cancer detection program"
          },
          {
            "code": "COL",
            "display": "collision coverage policy"
          },
          {
            "code": "DENTPRG",
            "display": "dental program"
          },
          {
            "code": "DISEASEPRG",
            "display": "public health program"
          },
          {
            "code": "EHCPOL",
            "display": "extended healthcare"
          },
          {
            "code": "ENDRENAL",
            "display": "end renal program"
          },
          {
            "code": "HIVAIDS",
            "display": "HIV-AIDS program"
          },
          {
            "code": "HSAPOL",
            "display": "health spending account"
          },
          {
            "code": "MANDPOL",
            "display": "mandatory health program"
          },
          {
            "code": "MENTPRG",
            "display": "mental health program"
          },
          {
            "code": "PUBLICPOL",
            "display": "public healthcare"
          },
          {
            "code": "SAFNET",
            "display": "safety net clinic program"
          },
          {
            "code": "SUBPRG",
            "display": "substance use program"
          },
          {
            "code": "SUBSIDIZ",
            "display": "subsidized health program"
          },
          {
            "code": "SUBSIDMC",
            "display": "subsidized managed care program"
          },
          {
            "code": "SUBSUPP",
            "display": "subsidized supplemental health program"
          },
          {
            "code": "UNINSMOT",
            "display": "uninsured motorist policy"
          },
          {
            "code": "WCBPOL",
            "display": "worker's compensation"
          }
        ]
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        "version": "8.0.0",
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        "display": "automobile"
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        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "version": "8.0.0",
        "code": "CANPRG",
        "display": "women's cancer detection program"
      },
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        "version": "8.0.0",
        "code": "COL",
        "display": "collision coverage policy"
      },
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "version": "8.0.0",
        "code": "DENTPRG",
        "display": "dental program"
      },
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        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "version": "8.0.0",
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      },
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        "version": "8.0.0",
        "code": "ENDRENAL",
        "display": "end renal program"
      },
      {
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        "version": "8.0.0",
        "code": "HIVAIDS",
        "display": "HIV-AIDS program"
      },
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        "version": "8.0.0",
        "code": "HSAPOL",
        "display": "health spending account"
      },
      {
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        "version": "8.0.0",
        "code": "MANDPOL",
        "display": "mandatory health program"
      },
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        "version": "8.0.0",
        "code": "MENTPRG",
        "display": "mental health program"
      },
      {
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        "version": "8.0.0",
        "code": "PUBLICPOL",
        "display": "public healthcare"
      },
      {
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        "version": "8.0.0",
        "code": "SAFNET",
        "display": "safety net clinic program"
      },
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "version": "8.0.0",
        "code": "SUBPRG",
        "display": "substance use program"
      },
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "version": "8.0.0",
        "code": "SUBSIDIZ",
        "display": "subsidized health program"
      },
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "version": "8.0.0",
        "code": "SUBSIDMC",
        "display": "subsidized managed care program"
      },
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "version": "8.0.0",
        "code": "SUBSUPP",
        "display": "subsidized supplemental health program"
      },
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "version": "8.0.0",
        "code": "UNINSMOT",
        "display": "uninsured motorist policy"
      },
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "version": "8.0.0",
        "code": "WCBPOL",
        "display": "worker's compensation"
      }
    ]
  }
}