This page is part of the DaVinci PDEX Plan Net (v1.0.0: STU 1) based on FHIR R4. The current version which supercedes this version is 1.1.0. For a full list of available versions, see the Directory of published versions
CodeSystem: Insurance Plan Type
Summary
Defining URL: | http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/InsurancePlanTypeCS |
Version: | 1.0.0 |
Name: | InsurancePlanTypeCS |
Title: | Insurance Plan Type |
Status: | Active as of 2020-12-20T06:12:23+00:00 |
Definition: | Categories of cost-sharing used by plans
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Publisher: | HL7 Financial Management Working Group |
Content: | Complete: All the concepts defined by the code system are included in the code system resource |
Source Resource: | XML / JSON / Turtle |
This Code system is referenced in the content logical definition of the following value sets:
This code system http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/InsurancePlanTypeCS defines the following codes:
Code | Display | Definition |
platinum | Platinum-QHP | Plan 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-QHP | Plan 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-QHP | Plan 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-QHP | Plan 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 |
lowdeductible | Low Deductible | A plan that requires the insured to pay out of pocket a smaller proportion of incurred health care costs. |
highdeductible | High Deductible | A plan that requires the insured to pay out of pocket a larger proportion of incurred health care costs than a traditional insurance plan. |