This page is part of the Validated Healthcare Directory FHIR IG (v0.2.0: STU 1 Ballot 2) based on FHIR v3.5.0. . For a full list of available versions, see the Directory of published versions

• Narrative Content
• XML
• JSON

XML Format: ValueSet-valueset-plan-type

Raw xml

<ValueSet xmlns="http://hl7.org/fhir">
  <id value="valueset-plan-type"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><h2>VhDir Plan Type</h2><div><p>This value set defines a set of codes that indicate the type of a plan.</p>
</div><p>This value set includes codes from the following code systems:</p><ul><li>Include these codes as defined in <a href="CodeSystem-codesystem-payercharacteristics.html"><code>http://hl7.org/fhir/uv/vhdir/CodeSystem/codesystem-payercharacteristics</code></a><table class="none"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-cat">cat</a></td><td>Catastrophic</td><td>'Catastrophic' health insurance plans have low monthly premiums and very high deductibles. They may cover worst-case scenarios, like getting seriously sick or injured. Patient pays most routine medical expenses.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-bronze">bronze</a></td><td>Bronze</td><td>'Bronze' type plan defines the estimated split costs of the plan, where patient is responsible for 40% of their healthcare cost while 60% is covered by the plan.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-bronzeexp">bronzeexp</a></td><td>Expanded Bronze</td><td>The 'extended bronze' plan is an addition to the bronze metal level which establishes the de minimis variation range for the actuarial value (AV) level of coverage to allow variation in the AV to -4/+2 percentage points.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-silver">silver</a></td><td>Silver</td><td>'Silver' type plan defines the estimated split costs of the plan, where patient is responsible for 30% of their healthcare cost while 70% is covered by the plan.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-gold">gold</a></td><td>Gold</td><td>'Gold' type plan defines the estimated split costs of the plan, where patient is responsible for 20% of their healthcare cost while 80% is covered by the plan.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-platinum">platinum</a></td><td>Platinum</td><td>'Platinum' type plan defines the estimated  split costs of the plan, where patient is responsible for 10% of their healthcare cost while 90% is covered by the plan.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-lowded">lowded</a></td><td>Low deductible</td><td>A health insurance plan with higher premiums and lower out of pocket cost than a traditional health plan.</td></tr><tr><td><a href="CodeSystem-codesystem-payercharacteristics.html#codesystem-payercharacteristics-highded">highded</a></td><td>High deductible</td><td>A health insurance plan with lower premiums and higher out of pocket cost than a traditional health plan.</td></tr></table></li></ul></div>
  </text>
  <url value="http://hl7.org/fhir/uv/vhdir/ValueSet/valueset-plan-type"/>
  <version value="0.2.0"/>
  <name value="VhDirPlanType"/>
  <title value="VhDir Plan Type"/>
  <status value="active"/>
  <date value="2018-02-21"/>
  <publisher value="HL7 International"/>
  <contact>
    <telecom>
      <system value="other"/>
      <value value="http://hl7.org/fhir"/>
    </telecom>
  </contact>
  <description
               value="This value set defines a set of codes that indicate the type of a plan."/>
  <compose>
    <include>
      <system
              value="http://hl7.org/fhir/uv/vhdir/CodeSystem/codesystem-payercharacteristics"/>
      <concept>
        <code value="cat"/>
      </concept>
      <concept>
        <code value="bronze"/>
      </concept>
      <concept>
        <code value="bronzeexp"/>
      </concept>
      <concept>
        <code value="silver"/>
      </concept>
      <concept>
        <code value="gold"/>
      </concept>
      <concept>
        <code value="platinum"/>
      </concept>
      <concept>
        <code value="lowded"/>
      </concept>
      <concept>
        <code value="highded"/>
      </concept>
    </include>
  </compose>
</ValueSet>