National Healthcare Directory Query
1.0.0-ballot - ballot US

This page is part of the National Healthcare Query (v1.0.0-ballot: STU 1 Ballot 1) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

ValueSet: Insurance Plan Type Value Set

Official URL: http://hl7.org/fhir/us/directory-query/ValueSet/InsurancePlanTypeVS Version: 1.0.0-ballot
Active as of 2022-08-09 Computable Name: InsurancePlanTypeVS

Categories of cost-sharing used by plans.

References

Logical Definition (CLD)

 

Expansion

This value set contains 8 concepts

Expansion based on Insurance Plan Type Code System v1.0.0-ballot (CodeSystem)

All codes in this table are from the system http://hl7.org/fhir/us/directory-query/CodeSystem/InsurancePlanTypeCS

CodeDisplayDefinition
  platinumPlatinum-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
  goldGold-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
  silverSilver-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
  bronzeBronze-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
  catastrophicCatastrophic-QHPA plan with low monthly premiums and very high deductibles and are available only to those under 30 or with certain special exemptions.
  lowdeductibleLow DeductibleA plan that requires the insured to pay out of pocket a smaller proportion of incurred health care costs than a traditional insurance plan.
  highdeductibleHigh DeductibleA plan that requires the insured to pay out of pocket a larger proportion of incurred health care costs than a traditional insurance plan.
  catastrophicplanCatastrophic 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.

Explanation of the columns that may appear on this page:

Level A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
System The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code The code (used as the code in the resource instance)
Display The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition An explanation of the meaning of the concept
Comments Additional notes about how to use the code