8.34 Resource InsurancePlan - Content

Name	Flags	Card.	Type	Description & Constraints
InsurancePlan	TU		DomainResource	Plan details Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier	Σ	0..*	Identifier	Business Identifier for Plan
type		0..1	CodeableConcept	Classification of Plan
product	Σ	0..1	Reference(InsuranceProduct)	The product that this plan is available under
coverageArea	Σ	0..*	Reference(Location)	Where product-plan applies
network		0..*	Reference(Organization)	What networks provide coverage
generalCost		0..*	BackboneElement	Overall costs
type		0..1	CodeableConcept	Classification of specific cost
groupSize		0..1	positiveInt	Number of enrollees
cost		0..1	Money	Cost value
comment		0..1	string	Additional cost information
specificCost		0..*	BackboneElement	Individual cost elements
category		1..1	CodeableConcept	General category of benefit
benefit		0..*	BackboneElement	Benefits list
type		1..1	CodeableConcept	Classification of benefit provided
cost		0..*	BackboneElement	List of the costs
type		1..1	CodeableConcept	Classification of specific cost
applicability		0..1	CodeableConcept	in-network | out-of-network | other Binding: Benefit Cost Applicability (Required)
qualifier		0..*	CodeableConcept	Additional information about the cost
value		0..1	Quantity	The actual cost value
Documentation for this format

See the Extensions for this resource

<InsurancePlan xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business Identifier for Plan --></identifier>
 <type><!-- 0..1 CodeableConcept Classification of Plan --></type>
 <product><!-- 0..1 Reference(InsuranceProduct) The product that this plan is available under --></product>
 <coverageArea><!-- 0..* Reference(Location) Where product-plan applies --></coverageArea>
 <network><!-- 0..* Reference(Organization) What networks provide coverage --></network>
 <generalCost>  <!-- 0..* Overall costs -->
  <type><!-- 0..1 CodeableConcept Classification of specific cost --></type>
  <groupSize value="[positiveInt]"/><!-- 0..1 Number of enrollees -->
  <cost><!-- 0..1 Money Cost value --></cost>
  <comment value="[string]"/><!-- 0..1 Additional cost information -->
 </generalCost>
 <specificCost>  <!-- 0..* Individual cost elements -->
  <category><!-- 1..1 CodeableConcept General category of benefit --></category>
  <benefit>  <!-- 0..* Benefits list -->
   <type><!-- 1..1 CodeableConcept Classification of benefit provided --></type>
   <cost>  <!-- 0..* List of the costs -->
    <type><!-- 1..1 CodeableConcept Classification of specific cost --></type>
    <applicability><!-- 0..1 CodeableConcept in-network | out-of-network | other --></applicability>
    <qualifier><!-- 0..* CodeableConcept Additional information about the cost --></qualifier>
    <value><!-- 0..1 Quantity The actual cost value --></value>
   </cost>
  </benefit>
 </specificCost>
</InsurancePlan>

{
  "resourceType" : "InsurancePlan",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business Identifier for Plan
  "type" : { CodeableConcept }, // Classification of Plan
  "product" : { Reference(InsuranceProduct) }, // The product that this plan is available under
  "coverageArea" : [{ Reference(Location) }], // Where product-plan applies
  "network" : [{ Reference(Organization) }], // What networks provide coverage
  "generalCost" : [{ // Overall costs
    "type" : { CodeableConcept }, // Classification of specific cost
    "groupSize" : "<positiveInt>", // Number of enrollees
    "cost" : { Money }, // Cost value
    "comment" : "<string>" // Additional cost information
  }],
  "specificCost" : [{ // Individual cost elements
    "category" : { CodeableConcept }, // R!  General category of benefit
    "benefit" : [{ // Benefits list
      "type" : { CodeableConcept }, // R!  Classification of benefit provided
      "cost" : [{ // List of the costs
        "type" : { CodeableConcept }, // R!  Classification of specific cost
        "applicability" : { CodeableConcept }, // in-network | out-of-network | other
        "qualifier" : [{ CodeableConcept }], // Additional information about the cost
        "value" : { Quantity } // The actual cost value
      }]
    }]
  }]
}

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:InsurancePlan;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Business Identifier for Plan
  fhir:type [ CodeableConcept ] ; # 0..1 Classification of Plan
  fhir:product [ Reference(InsuranceProduct) ] ; # 0..1 The product that this plan is available under
  fhir:coverageArea  ( [ Reference(Location) ] ... ) ; # 0..* Where product-plan applies
  fhir:network  ( [ Reference(Organization) ] ... ) ; # 0..* What networks provide coverage
  fhir:generalCost ( [ # 0..* Overall costs
    fhir:type [ CodeableConcept ] ; # 0..1 Classification of specific cost
    fhir:groupSize [ positiveInt ] ; # 0..1 Number of enrollees
    fhir:cost [ Money ] ; # 0..1 Cost value
    fhir:comment [ string ] ; # 0..1 Additional cost information
  ] ... ) ;
  fhir:specificCost ( [ # 0..* Individual cost elements
    fhir:category [ CodeableConcept ] ; # 1..1 General category of benefit
    fhir:benefit ( [ # 0..* Benefits list
      fhir:type [ CodeableConcept ] ; # 1..1 Classification of benefit provided
      fhir:cost ( [ # 0..* List of the costs
        fhir:type [ CodeableConcept ] ; # 1..1 Classification of specific cost
        fhir:applicability [ CodeableConcept ] ; # 0..1 in-network | out-of-network | other
        fhir:qualifier  ( [ CodeableConcept ] ... ) ; # 0..* Additional information about the cost
        fhir:value [ Quantity ] ; # 0..1 The actual cost value
      ] ... ) ;
    ] ... ) ;
  ] ... ) ;
]

Changes from both R4 and R4B

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

Name	Flags	Card.	Type	Description & Constraints
InsurancePlan	TU		DomainResource	Plan details Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier	Σ	0..*	Identifier	Business Identifier for Plan
type		0..1	CodeableConcept	Classification of Plan
product	Σ	0..1	Reference(InsuranceProduct)	The product that this plan is available under
coverageArea	Σ	0..*	Reference(Location)	Where product-plan applies
network		0..*	Reference(Organization)	What networks provide coverage
generalCost		0..*	BackboneElement	Overall costs
type		0..1	CodeableConcept	Classification of specific cost
groupSize		0..1	positiveInt	Number of enrollees
cost		0..1	Money	Cost value
comment		0..1	string	Additional cost information
specificCost		0..*	BackboneElement	Individual cost elements
category		1..1	CodeableConcept	General category of benefit
benefit		0..*	BackboneElement	Benefits list
type		1..1	CodeableConcept	Classification of benefit provided
cost		0..*	BackboneElement	List of the costs
type		1..1	CodeableConcept	Classification of specific cost
applicability		0..1	CodeableConcept	in-network | out-of-network | other Binding: Benefit Cost Applicability (Required)
qualifier		0..*	CodeableConcept	Additional information about the cost
value		0..1	Quantity	The actual cost value
Documentation for this format

See the Extensions for this resource

<InsurancePlan xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business Identifier for Plan --></identifier>
 <type><!-- 0..1 CodeableConcept Classification of Plan --></type>
 <product><!-- 0..1 Reference(InsuranceProduct) The product that this plan is available under --></product>
 <coverageArea><!-- 0..* Reference(Location) Where product-plan applies --></coverageArea>
 <network><!-- 0..* Reference(Organization) What networks provide coverage --></network>
 <generalCost>  <!-- 0..* Overall costs -->
  <type><!-- 0..1 CodeableConcept Classification of specific cost --></type>
  <groupSize value="[positiveInt]"/><!-- 0..1 Number of enrollees -->
  <cost><!-- 0..1 Money Cost value --></cost>
  <comment value="[string]"/><!-- 0..1 Additional cost information -->
 </generalCost>
 <specificCost>  <!-- 0..* Individual cost elements -->
  <category><!-- 1..1 CodeableConcept General category of benefit --></category>
  <benefit>  <!-- 0..* Benefits list -->
   <type><!-- 1..1 CodeableConcept Classification of benefit provided --></type>
   <cost>  <!-- 0..* List of the costs -->
    <type><!-- 1..1 CodeableConcept Classification of specific cost --></type>
    <applicability><!-- 0..1 CodeableConcept in-network | out-of-network | other --></applicability>
    <qualifier><!-- 0..* CodeableConcept Additional information about the cost --></qualifier>
    <value><!-- 0..1 Quantity The actual cost value --></value>
   </cost>
  </benefit>
 </specificCost>
</InsurancePlan>

{
  "resourceType" : "InsurancePlan",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business Identifier for Plan
  "type" : { CodeableConcept }, // Classification of Plan
  "product" : { Reference(InsuranceProduct) }, // The product that this plan is available under
  "coverageArea" : [{ Reference(Location) }], // Where product-plan applies
  "network" : [{ Reference(Organization) }], // What networks provide coverage
  "generalCost" : [{ // Overall costs
    "type" : { CodeableConcept }, // Classification of specific cost
    "groupSize" : "<positiveInt>", // Number of enrollees
    "cost" : { Money }, // Cost value
    "comment" : "<string>" // Additional cost information
  }],
  "specificCost" : [{ // Individual cost elements
    "category" : { CodeableConcept }, // R!  General category of benefit
    "benefit" : [{ // Benefits list
      "type" : { CodeableConcept }, // R!  Classification of benefit provided
      "cost" : [{ // List of the costs
        "type" : { CodeableConcept }, // R!  Classification of specific cost
        "applicability" : { CodeableConcept }, // in-network | out-of-network | other
        "qualifier" : [{ CodeableConcept }], // Additional information about the cost
        "value" : { Quantity } // The actual cost value
      }]
    }]
  }]
}

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:InsurancePlan;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Business Identifier for Plan
  fhir:type [ CodeableConcept ] ; # 0..1 Classification of Plan
  fhir:product [ Reference(InsuranceProduct) ] ; # 0..1 The product that this plan is available under
  fhir:coverageArea  ( [ Reference(Location) ] ... ) ; # 0..* Where product-plan applies
  fhir:network  ( [ Reference(Organization) ] ... ) ; # 0..* What networks provide coverage
  fhir:generalCost ( [ # 0..* Overall costs
    fhir:type [ CodeableConcept ] ; # 0..1 Classification of specific cost
    fhir:groupSize [ positiveInt ] ; # 0..1 Number of enrollees
    fhir:cost [ Money ] ; # 0..1 Cost value
    fhir:comment [ string ] ; # 0..1 Additional cost information
  ] ... ) ;
  fhir:specificCost ( [ # 0..* Individual cost elements
    fhir:category [ CodeableConcept ] ; # 1..1 General category of benefit
    fhir:benefit ( [ # 0..* Benefits list
      fhir:type [ CodeableConcept ] ; # 1..1 Classification of benefit provided
      fhir:cost ( [ # 0..* List of the costs
        fhir:type [ CodeableConcept ] ; # 1..1 Classification of specific cost
        fhir:applicability [ CodeableConcept ] ; # 0..1 in-network | out-of-network | other
        fhir:qualifier  ( [ CodeableConcept ] ... ) ; # 0..* Additional information about the cost
        fhir:value [ Quantity ] ; # 0..1 The actual cost value
      ] ... ) ;
    ] ... ) ;
  ] ... ) ;
]

Changes from both R4 and R4B

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.