This page is part of the Making EHR Data MOre available for Research and Public Health (MedMorph) Healthcare Surveys Reporting Content IG (v2.0.0-ballot: STU 2 Ballot) based on FHIR (HL7® FHIR® Standard) R4. This version is a pre-release. The current official version is 1.0.0. For a full list of available versions, see the Directory of published versions

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: Coverage Example - JSON Representation

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{
  "resourceType" : "Coverage",
  "id" : "coverage-example",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage|6.1.0"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Coverage coverage-example</b></p><a name=\"coverage-example\"> </a><a name=\"hccoverage-example\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-coverage.html\">US Core Coverage Profileversion: null6.1.0)</a></p></div><p><b>status</b>: Active</p><p><b>policyHolder</b>: <a href=\"Patient-patient-ledner.html\">Dominique369 Ledner144  Female, DoB: 1965-06-22 ( MRN:\u00a0Alaska Driver's License#abc123\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>subscriber</b>: <a href=\"Patient-patient-ledner.html\">Dominique369 Ledner144  Female, DoB: 1965-06-22 ( MRN:\u00a0Alaska Driver's License#abc123\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>subscriberId</b>: XYZ123456789</p><p><b>beneficiary</b>: <a href=\"Patient-patient-ledner.html\">Dominique369 Ledner144  Female, DoB: 1965-06-22 ( MRN:\u00a0Alaska Driver's License#abc123\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>dependent</b>: 0</p><p><b>relationship</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}\">Self</span></p><p><b>period</b>: 2025-01-01 --&gt; 2025-12-31</p><p><b>payor</b>: <a href=\"Organization-organization-payer-example.html\">Organization Blue Cross Blue Shield</a></p><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class group}\">Group</span></p><p><b>value</b>: ABC987</p><p><b>name</b>: Group Name</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class plan}\">Plan</span></p><p><b>value</b>: HMO</p><p><b>name</b>: Health Maintenance Organization</p></blockquote></div>"
  },
  "status" : "active",
  "policyHolder" : {
    🔗 "reference" : "Patient/patient-ledner"
  },
  "subscriber" : {
    🔗 "reference" : "Patient/patient-ledner"
  },
  "subscriberId" : "XYZ123456789",
  "beneficiary" : {
    🔗 "reference" : "Patient/patient-ledner"
  },
  "dependent" : "0",
  "relationship" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
        "code" : "self",
        "display" : "Self"
      }
    ]
  },
  "period" : {
    "start" : "2025-01-01",
    "end" : "2025-12-31"
  },
  "payor" : [
    {
      🔗 "reference" : "Organization/organization-payer-example"
    }
  ],
  "class" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code" : "group",
            "display" : "Group"
          }
        ]
      },
      "value" : "ABC987",
      "name" : "Group Name"
    },
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code" : "plan",
            "display" : "Plan"
          }
        ]
      },
      "value" : "HMO",
      "name" : "Health Maintenance Organization"
    }
  ]
}