{
"description": "Categories of cost-sharing used by plans",
"_filename": "CodeSystem-InsurancePlanTypeCS.json",
"package_name": "hl7.fhir.us.ndh.r4b",
"date": "2023-07-30T14:53:07+00:00",
"publisher": "HL7 International - Patient Administration Work Group",
"jurisdiction": [ {
"coding": [ {
"code": "US",
"system": "urn:iso:std:iso:3166",
"display": "United States of America"
} ]
} ],
"content": "complete",
"name": "InsurancePlanTypeCS",
"type": null,
"experimental": "false",
"resourceType": "CodeSystem",
"title": "Insurance Plan Type Code System",
"package_version": "1.0.0-ballot",
"status": "active",
"id": "11c22554-9843-404f-8df9-d35db55492cc",
"kind": null,
"count": 8,
"url": "http://hl7.org/fhir/us/ndh/CodeSystem/InsurancePlanTypeCS",
"concept": [ {
"code": "platinum",
"display": "Platinum-QHP",
"definition": "Plan with highest monthly premium and lowest costs when you need care\tA Qualified Health Plan with the highest monthly premiums and smallest out-of-pocket costs for the member in comparison to other metal-category plans"
}, {
"code": "gold",
"display": "Gold-QHP",
"definition": "Plan with high monthly premium and low costs when you need care\tA Qualified Health Plan with the higher monthly premiums and smaller out-of-pocket costs for the member in comparison to other metal-category plans"
}, {
"code": "silver",
"display": "Silver-QHP",
"definition": "Plan with moderate monthly premium and moderate costs when you need care\tA Qualified Health Plan with the lower monthly premiums and larger out-of-pocket costs for the member in comparison to other metal-category plans"
}, {
"code": "bronze",
"display": "Bronze-QHP",
"definition": "Plan with lowest monthly premium and highest costs when you need care\tA Qualified Health Plan with the lowest monthly premiums and largest out-of-pocket costs for the member in comparison to other metal-category plans"
}, {
"code": "catastrophic",
"display": "Catastrophic-QHP",
"definition": "A plan with low monthly premiums and very high deductibles and are available only to those under 30 or with certain special exemptions."
}, {
"code": "lowdeductible",
"display": "Low Deductible",
"definition": "A plan that requires the insured to pay out of pocket a smaller proportion of incurred health care costs than a traditional insurance plan."
}, {
"code": "highdeductible",
"display": "High Deductible",
"definition": "A plan that requires the insured to pay out of pocket a larger proportion of incurred health care costs than a traditional insurance plan."
}, {
"code": "catastrophicplan",
"display": "Catastrophic Plan",
"definition": "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."
} ],
"caseSensitive": true,
"version": "1.0.0-ballot",
"contact": [ {
"name": "HL7 International - Patient Administration Work Group",
"telecom": [ {
"value": "http://hl7.org/Special/committees/pafm",
"system": "url"
}, {
"value": "pafm@lists.hl7.org",
"system": "email"
} ]
} ]
}