Cross-version VS for R5.ActHealthInsuranceTypeCode for use in FHIR R4 - TTL Representation - FHIR Cross-Version Extensions package for FHIR R4 from FHIR R5 v0.0.1-snapshot-2

FHIR Cross-Version Extensions package for FHIR R4 from FHIR R5 - Version 0.0.1-snapshot-2. See the Directory of published versions
: Cross-version VS for R5.ActHealthInsuranceTypeCode for use in FHIR R4 - TTL Representation

Page standards status: Informative
Maturity Level: 0
Raw ttl | Download
@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:ValueSet ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "R5-v3-ActHealthInsuranceTypeCode-for-R4"] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ValueSet R5-v3-ActHealthInsuranceTypeCode-for-R4</b></p><a name=\"R5-v3-ActHealthInsuranceTypeCode-for-R4\"> </a><a name=\"hcR5-v3-ActHealthInsuranceTypeCode-for-R4\"> </a><p>This value set expansion contains 14 concepts.</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>System</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActHealthInsuranceTypeCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-DENTAL\"> </a>  <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-DENTAL\">DENTAL</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>dental care policy</td><td><div><p><strong>Definition:</strong> A health insurance policy that that covers benefits for dental services.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActHealthInsuranceTypeCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-DISEASE\"> </a>  <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-DISEASE\">DISEASE</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>disease specific policy</td><td><div><p><strong>Definition:</strong> A health insurance policy that covers benefits for healthcare services provided for named conditions under the policy, e.g., cancer, diabetes, or HIV-AIDS.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActHealthInsuranceTypeCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-DRUGPOL\"> </a>  <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-DRUGPOL\">DRUGPOL</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>drug policy</td><td><div><p><strong>Definition:</strong> A health insurance policy that covers benefits for prescription drugs, pharmaceuticals, and supplies.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActHealthInsuranceTypeCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-EHCPOL\"> </a>  <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-EHCPOL\">EHCPOL</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>extended healthcare</td><td><div><p>Private insurance policy that provides coverage in addition to other policies (e.g. in addition to a Public Healthcare insurance policy).</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActHealthInsuranceTypeCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-HIP\"> </a>  <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-HIP\">HIP</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>health insurance plan policy</td><td><div><p><strong>Definition:</strong> A health insurance policy that covers healthcare benefits by protecting covered parties from medical expenses arising from health conditions, sickness, or accidental injury as well as preventive care. Health insurance policies explicitly exclude coverage for losses insured under a disability policy, workers' compensation program, liability insurance (including automobile insurance); or for medical expenses, coverage for on-site medical clinics or for limited dental or vision benefits when these are provided under a separate policy.</p>\n<p><em>Discussion:</em> Health insurance policies are offered by health insurance plans that typically reimburse providers for covered services on a fee-for-service basis, that is, a fee that is the allowable amount that a provider may charge. This is in contrast to managed care plans, which typically prepay providers a per-member/per-month amount or capitation as reimbursement for all covered services rendered. Health insurance plans include indemnity and healthcare services plans.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActHealthInsuranceTypeCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-HSAPOL\"> </a>  <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-HSAPOL\">HSAPOL</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>health spending account</td><td><div><p>Insurance policy that provides for an allotment of funds replenished on a periodic (e.g. annual) basis. The use of the funds under this policy is at the discretion of the covered party.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActHealthInsuranceTypeCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-LTC\"> </a>  <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-LTC\">LTC</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>long term care policy</td><td><div><p><strong>Definition:</strong> An insurance policy that covers benefits for long-term care services people need when they no longer can care for themselves. This may be due to an accident, disability, prolonged illness or the simple process of aging. Long-term care services assist with activities of daily living including:</p>\n<ul>\n<li>Help at home with day-to-day activities, such as cooking, cleaning, bathing and dressing</li>\n<li>Care in the community, such as in an adult day care facility</li>\n<li>Supervised care provided in an assisted living facility</li>\n<li>Skilled care provided in a nursing home</li>\n</ul>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActHealthInsuranceTypeCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-MCPOL\"> </a>  <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-MCPOL\">MCPOL</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>managed care policy</td><td><div><p><strong>Definition:</strong> Government mandated program providing coverage, disability income, and vocational rehabilitation for injuries sustained in the work place or in the course of employment. Employers may either self-fund the program, purchase commercial coverage, or pay a premium to a government entity that administers the program. Employees may be required to pay premiums toward the cost of coverage as well.</p>\n<p>Managed care policies specifically exclude coverage for losses insured under a disability policy, workers' compensation program, liability insurance (including automobile insurance); or for medical expenses, coverage for on-site medical clinics or for limited dental or vision benefits when these are provided under a separate policy.</p>\n<p><em>Discussion:</em> Managed care policies are offered by managed care plans that contract with selected providers or health care organizations to provide comprehensive health care at a discount to covered parties and coordinate the financing and delivery of health care. Managed care uses medical protocols and procedures agreed on by the medical profession to be cost effective, also known as medical practice guidelines. Providers are typically reimbursed for covered services by a capitated amount on a per member per month basis that may reflect difference in the health status and level of services anticipated to be needed by the member.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActHealthInsuranceTypeCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-POS\"> </a>  <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-POS\">POS</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>point of service policy</td><td><div><p><strong>Definition:</strong> A policy for a health plan that has features of both an HMO and a FFS plan. Like an HMO, a POS plan encourages the use its HMO network to maintain discounted fees with participating providers, but recognizes that sometimes covered parties want to choose their own provider. The POS plan allows a covered party to use providers who are not part of the HMO network (non-participating providers). However, there is a greater cost associated with choosing these non-network providers. A covered party will usually pay deductibles and coinsurances that are substantially higher than the payments when he or she uses a plan provider. Use of non-participating providers often requires the covered party to pay the provider directly and then to file a claim for reimbursement, like in an FFS plan.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActHealthInsuranceTypeCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-HMO\"> </a>  <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-HMO\">HMO</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>health maintenance organization policy</td><td><div><p><strong>Definition:</strong> A policy for a health plan that provides coverage for health care only through contracted or employed physicians and hospitals located in particular geographic or service areas. HMOs emphasize prevention and early detection of illness. Eligibility to enroll in an HMO is determined by where a covered party lives or works.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActHealthInsuranceTypeCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-PPO\"> </a>  <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-PPO\">PPO</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>preferred provider organization policy</td><td><div><p><strong>Definition:</strong> A network-based, managed care plan that allows a covered party to choose any health care provider. However, if care is received from a \"preferred\" (participating in-network) provider, there are generally higher benefit coverage and lower deductibles.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActHealthInsuranceTypeCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-MENTPOL\"> </a>  <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-MENTPOL\">MENTPOL</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>mental health policy</td><td><div><p><strong>Definition:</strong> A health insurance policy that covers benefits for mental health services and prescriptions.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActHealthInsuranceTypeCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-SUBPOL\"> </a>  <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-SUBPOL\">SUBPOL</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>substance use policy</td><td><div><p><strong>Definition:</strong> A health insurance policy that covers benefits for substance use services.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActHealthInsuranceTypeCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-VISPOL\"> </a>  <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-VISPOL\">VISPOL</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>vision care policy</td><td><div><p><strong>Definition:</strong> Set of codes for a policy that provides coverage for health care expenses arising from vision services.</p>\n<p>A health insurance policy that covers benefits for vision care services, prescriptions, and products.</p>\n</div></td></tr></table></div>"^^rdf:XMLLiteral
  ] ; # 
  fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"^^xsd:anyURI ] ;
fhir:value [
a fhir:code ;
fhir:v "fhir"     ]
  ] [
    ( fhir:extension [
fhir:url [ fhir:v "packageId"^^xsd:anyURI ] ;
fhir:value [
a fhir:id ;
fhir:v "hl7.fhir.uv.xver-r5.r4"       ]     ] [
fhir:url [ fhir:v "version"^^xsd:anyURI ] ;
fhir:value [
a fhir:string ;
fhir:v "0.0.1-snapshot-2"       ]     ] ) ;
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/package-source"^^xsd:anyURI ]
  ] [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"^^xsd:anyURI ] ;
fhir:value [
a fhir:integer ;
fhir:v 0 ;
      ( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom"^^xsd:anyURI ] ;
fhir:value [
a fhir:canonical ;
fhir:v "http://hl7.org/fhir/5.0/ImplementationGuide/hl7.fhir.uv.xver-r5.r4"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/5.0/ImplementationGuide/hl7.fhir.uv.xver-r5.r4>         ]       ] )     ]
  ] [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"^^xsd:anyURI ] ;
fhir:value [
a fhir:code ;
fhir:v "informative" ;
      ( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom"^^xsd:anyURI ] ;
fhir:value [
a fhir:canonical ;
fhir:v "http://hl7.org/fhir/5.0/ImplementationGuide/hl7.fhir.uv.xver-r5.r4"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/5.0/ImplementationGuide/hl7.fhir.uv.xver-r5.r4>         ]       ] )     ]
  ] ) ; # 
  fhir:url [ fhir:v "http://hl7.org/fhir/5.0/ValueSet/R5-v3-ActHealthInsuranceTypeCode-for-R4"^^xsd:anyURI] ; # 
  fhir:version [ fhir:v "0.0.1-snapshot-2"] ; # 
  fhir:name [ fhir:v "R5_v3_ActHealthInsuranceTypeCode_for_R4"] ; # 
  fhir:title [ fhir:v "Cross-version VS for R5.ActHealthInsuranceTypeCode for use in FHIR R4"] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:experimental [ fhir:v false] ; # 
  fhir:date [ fhir:v "2025-09-01T22:37:04.885943+10:00"^^xsd:dateTime] ; # 
  fhir:publisher [ fhir:v "FHIR Infrastructure"] ; # 
  fhir:contact ( [
fhir:name [ fhir:v "FHIR Infrastructure" ] ;
    ( fhir:telecom [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "http://www.hl7.org/Special/committees/fiwg" ]     ] )
  ] ) ; # 
  fhir:description [ fhir:v "This cross-version ValueSet represents concepts from http://terminology.hl7.org/ValueSet/v3-ActHealthInsuranceTypeCode|2.0.0 for use in FHIR R4. Concepts not present here have direct `equivalent` mappings crossing all versions from R5 to R4."] ; # 
  fhir:jurisdiction ( [
    ( fhir:coding [
fhir:system [ fhir:v "http://unstats.un.org/unsd/methods/m49/m49.htm"^^xsd:anyURI ] ;
fhir:code [ fhir:v "001" ] ;
fhir:display [ fhir:v "World" ]     ] )
  ] ) ; # 
  fhir:compose [
    ( fhir:include [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:version [ fhir:v "8.0.0" ] ;
      ( fhir:concept [
fhir:code [ fhir:v "DENTAL" ] ;
fhir:display [ fhir:v "dental care policy" ]       ] [
fhir:code [ fhir:v "DISEASE" ] ;
fhir:display [ fhir:v "disease specific policy" ]       ] [
fhir:code [ fhir:v "DRUGPOL" ] ;
fhir:display [ fhir:v "drug policy" ]       ] [
fhir:code [ fhir:v "EHCPOL" ] ;
fhir:display [ fhir:v "extended healthcare" ]       ] [
fhir:code [ fhir:v "HIP" ] ;
fhir:display [ fhir:v "health insurance plan policy" ]       ] [
fhir:code [ fhir:v "HSAPOL" ] ;
fhir:display [ fhir:v "health spending account" ]       ] [
fhir:code [ fhir:v "LTC" ] ;
fhir:display [ fhir:v "long term care policy" ]       ] [
fhir:code [ fhir:v "MCPOL" ] ;
fhir:display [ fhir:v "managed care policy" ]       ] [
fhir:code [ fhir:v "POS" ] ;
fhir:display [ fhir:v "point of service policy" ]       ] [
fhir:code [ fhir:v "HMO" ] ;
fhir:display [ fhir:v "health maintenance organization policy" ]       ] [
fhir:code [ fhir:v "PPO" ] ;
fhir:display [ fhir:v "preferred provider organization policy" ]       ] [
fhir:code [ fhir:v "MENTPOL" ] ;
fhir:display [ fhir:v "mental health policy" ]       ] [
fhir:code [ fhir:v "SUBPOL" ] ;
fhir:display [ fhir:v "substance use policy" ]       ] [
fhir:code [ fhir:v "VISPOL" ] ;
fhir:display [ fhir:v "vision care policy" ]       ] )     ] )
  ] ; # 
  fhir:expansion [
fhir:timestamp [ fhir:v "2025-09-01T22:37:04.885938+10:00"^^xsd:dateTime ] ;
    ( fhir:contains [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:version [ fhir:v "8.0.0" ] ;
fhir:code [ fhir:v "DENTAL" ] ;
fhir:display [ fhir:v "dental care policy" ]     ] [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:version [ fhir:v "8.0.0" ] ;
fhir:code [ fhir:v "DISEASE" ] ;
fhir:display [ fhir:v "disease specific policy" ]     ] [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:version [ fhir:v "8.0.0" ] ;
fhir:code [ fhir:v "DRUGPOL" ] ;
fhir:display [ fhir:v "drug policy" ]     ] [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:version [ fhir:v "8.0.0" ] ;
fhir:code [ fhir:v "EHCPOL" ] ;
fhir:display [ fhir:v "extended healthcare" ]     ] [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:version [ fhir:v "8.0.0" ] ;
fhir:code [ fhir:v "HIP" ] ;
fhir:display [ fhir:v "health insurance plan policy" ]     ] [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:version [ fhir:v "8.0.0" ] ;
fhir:code [ fhir:v "HSAPOL" ] ;
fhir:display [ fhir:v "health spending account" ]     ] [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:version [ fhir:v "8.0.0" ] ;
fhir:code [ fhir:v "LTC" ] ;
fhir:display [ fhir:v "long term care policy" ]     ] [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:version [ fhir:v "8.0.0" ] ;
fhir:code [ fhir:v "MCPOL" ] ;
fhir:display [ fhir:v "managed care policy" ]     ] [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:version [ fhir:v "8.0.0" ] ;
fhir:code [ fhir:v "POS" ] ;
fhir:display [ fhir:v "point of service policy" ]     ] [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:version [ fhir:v "8.0.0" ] ;
fhir:code [ fhir:v "HMO" ] ;
fhir:display [ fhir:v "health maintenance organization policy" ]     ] [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:version [ fhir:v "8.0.0" ] ;
fhir:code [ fhir:v "PPO" ] ;
fhir:display [ fhir:v "preferred provider organization policy" ]     ] [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:version [ fhir:v "8.0.0" ] ;
fhir:code [ fhir:v "MENTPOL" ] ;
fhir:display [ fhir:v "mental health policy" ]     ] [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:version [ fhir:v "8.0.0" ] ;
fhir:code [ fhir:v "SUBPOL" ] ;
fhir:display [ fhir:v "substance use policy" ]     ] [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:version [ fhir:v "8.0.0" ] ;
fhir:code [ fhir:v "VISPOL" ] ;
fhir:display [ fhir:v "vision care policy" ]     ] )
  ] . #