This page is part of the National Directory of Healthcare Providers and Services (NDH) Implementation Guide (v1.0.0-ballot: STU1 Ballot 1) based on FHIR R4. . For a full list of available versions, see the Directory of published versions 
: Insurance Plan Type Code System - XML Representation
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<CodeSystem xmlns="http://hl7.org/fhir">
<id value="InsurancePlanTypeCS"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p>This code system <code>http://hl7.org/fhir/us/ndh/CodeSystem/InsurancePlanTypeCS</code> defines the following codes:</p><table class="codes"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style="white-space:nowrap">platinum<a name="InsurancePlanTypeCS-platinum"> </a></td><td>Platinum-QHP</td><td>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</td></tr><tr><td style="white-space:nowrap">gold<a name="InsurancePlanTypeCS-gold"> </a></td><td>Gold-QHP</td><td>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</td></tr><tr><td style="white-space:nowrap">silver<a name="InsurancePlanTypeCS-silver"> </a></td><td>Silver-QHP</td><td>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</td></tr><tr><td style="white-space:nowrap">bronze<a name="InsurancePlanTypeCS-bronze"> </a></td><td>Bronze-QHP</td><td>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</td></tr><tr><td style="white-space:nowrap">catastrophic<a name="InsurancePlanTypeCS-catastrophic"> </a></td><td>Catastrophic-QHP</td><td>A plan with low monthly premiums and very high deductibles and are available only to those under 30 or with certain special exemptions.</td></tr><tr><td style="white-space:nowrap">lowdeductible<a name="InsurancePlanTypeCS-lowdeductible"> </a></td><td>Low Deductible</td><td>A plan that requires the insured to pay out of pocket a smaller proportion of incurred health care costs than a traditional insurance plan.</td></tr><tr><td style="white-space:nowrap">highdeductible<a name="InsurancePlanTypeCS-highdeductible"> </a></td><td>High Deductible</td><td>A plan that requires the insured to pay out of pocket a larger proportion of incurred health care costs than a traditional insurance plan.</td></tr><tr><td style="white-space:nowrap">catastrophicplan<a name="InsurancePlanTypeCS-catastrophicplan"> </a></td><td>Catastrophic Plan</td><td>A plan that requires the insured to pay out of pocket a much larger proportion of incurred health care costs than a traditional insurance plan.</td></tr></table></div>
</text>
<url value="http://hl7.org/fhir/us/ndh/CodeSystem/InsurancePlanTypeCS"/>
<version value="1.0.0-ballot"/>
<name value="InsurancePlanTypeCS"/>
<title value="Insurance Plan Type Code System"/>
<status value="active"/>
<experimental value="false"/>
<date value="2023-07-30T14:53:07+00:00"/>
<publisher value="HL7 International - Patient Administration Work Group"/>
<contact>
<name value="HL7 International - Patient Administration Work Group"/>
<telecom>
<system value="url"/>
<value value="http://hl7.org/Special/committees/pafm"/>
</telecom>
<telecom>
<system value="email"/>
<value value="pafm@lists.hl7.org"/>
</telecom>
</contact>
<description value="Categories of cost-sharing used by plans"/>
<jurisdiction>
<coding>
<system value="urn:iso:std:iso:3166"/>
<code value="US"/>
<display value="United States of America"/>
</coding>
</jurisdiction>
<caseSensitive value="true"/>
<content value="complete"/>
<count value="8"/>
<concept>
<code value="platinum"/>
<display value="Platinum-QHP"/>
<definition
value="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"/>
</concept>
<concept>
<code value="gold"/>
<display value="Gold-QHP"/>
<definition
value="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"/>
</concept>
<concept>
<code value="silver"/>
<display value="Silver-QHP"/>
<definition
value="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"/>
</concept>
<concept>
<code value="bronze"/>
<display value="Bronze-QHP"/>
<definition
value="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"/>
</concept>
<concept>
<code value="catastrophic"/>
<display value="Catastrophic-QHP"/>
<definition
value="A plan with low monthly premiums and very high deductibles and are available only to those under 30 or with certain special exemptions."/>
</concept>
<concept>
<code value="lowdeductible"/>
<display value="Low Deductible"/>
<definition
value="A plan that requires the insured to pay out of pocket a smaller proportion of incurred health care costs than a traditional insurance plan."/>
</concept>
<concept>
<code value="highdeductible"/>
<display value="High Deductible"/>
<definition
value="A plan that requires the insured to pay out of pocket a larger proportion of incurred health care costs than a traditional insurance plan."/>
</concept>
<concept>
<code value="catastrophicplan"/>
<display value="Catastrophic Plan"/>
<definition
value="A plan that requires the insured to pay out of pocket a much larger proportion of incurred health care costs than a traditional insurance plan."/>
</concept>
</CodeSystem>
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