{
  "description": "Categories of cost-sharing used by plans",
  "_filename": "CodeSystem-InsurancePlanTypeCS.json",
  "package_name": "hl7.fhir.us.davinci-pdex-plan-net",
  "date": "2025-02-25T19:12:27+00:00",
  "publisher": "HL7 International / Financial Management",
  "jurisdiction": [ {
    "coding": [ {
      "code": "US",
      "system": "urn:iso:std:iso:3166"
    } ]
  } ],
  "content": "complete",
  "name": "InsurancePlanTypeCS",
  "type": null,
  "experimental": "false",
  "resourceType": "CodeSystem",
  "title": "Insurance Plan Type",
  "package_version": "1.2.0",
  "extension": [ {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode": "fm"
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode": "trial-use",
    "_valueCode": {
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical": "http://hl7.org/fhir/us/davinci-pdex-plan-net/ImplementationGuide/hl7.fhir.us.davinci-pdex-plan-net"
      } ]
    }
  } ],
  "status": "active",
  "id": "3a0a2e03-ebf9-4b89-99cd-8a2987bc723e",
  "kind": null,
  "count": 8,
  "url": "http://hl7.org/fhir/us/davinci-pdex-plan-net/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": "1.2.0",
  "contact": [ {
    "name": "HL7 International / Financial Management",
    "telecom": [ {
      "value": "http://www.hl7.org/Special/committees/fm",
      "system": "url"
    }, {
      "value": "fm@lists.HL7.org",
      "system": "email"
    } ]
  } ]
}