description: This Profile describes a health insurance offering comprised of a list of covered benefits (i.e. the product), costs associated with those benefits (i.e. the plan), and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc.
package_name: rs/ndhm.in
derivation: constraint
name: InsurancePlan
type: InsurancePlan
elements:
  coverageArea: {mustSupport: true, index: 13}
  name: {mustSupport: true, index: 8}
  coverage:
    mustSupport: true
    index: 16
    elements:
      type:
        binding: {strength: example, valueSet: 'https://nrces.in/ndhm/fhir/r4/ValueSet/ndhm-coverage-type'}
        index: 17
        elements:
          coding:
            index: 18
            elements:
              system: {index: 19}
              code: {index: 20}
              display: {index: 21}
            required: [code, display, system]
          text: {mustSupport: true, index: 22}
      benefit:
        mustSupport: true
        index: 23
        elements:
          type:
            binding: {strength: example, valueSet: 'https://nrces.in/ndhm/fhir/r4/ValueSet/ndhm-benefit-type'}
            index: 24
            elements:
              coding:
                index: 25
                elements:
                  system: {index: 26}
                  code: {index: 27}
                  display: {index: 28}
                required: [code, display, system]
              text: {mustSupport: true, index: 29}
  type:
    binding: {strength: example, valueSet: 'https://nrces.in/ndhm/fhir/r4/ValueSet/ndhm-insuranceplan-type'}
    mustSupport: true
    index: 2
    elements:
      coding:
        index: 3
        elements:
          system: {index: 4}
          code: {index: 5}
          display: {index: 6}
        required: [code, display, system]
      text: {mustSupport: true, index: 7}
  alias: {mustSupport: true, index: 9}
  status: {mustSupport: true, index: 1}
  identifier: {short: Business Identifier that should be as provided by IRDAI for Indian insurance., mustSupport: true, index: 0}
  administeredBy:
    type: Reference
    mustSupport: true
    refers: ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization']
    index: 12
  ownedBy:
    type: Reference
    mustSupport: true
    refers: ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization']
    index: 11
  network:
    type: Reference
    mustSupport: true
    refers: ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization']
    index: 15
  period: {mustSupport: true, index: 10}
  plan:
    mustSupport: true
    index: 30
    elements:
      type:
        binding: {strength: example, valueSet: 'https://nrces.in/ndhm/fhir/r4/ValueSet/ndhm-plan-type'}
        mustSupport: true
        index: 31
        elements:
          coding:
            index: 32
            elements:
              system: {index: 33}
              code: {index: 34}
              display: {index: 35}
            required: [code, display, system]
          text: {mustSupport: true, index: 36}
      coverageArea: {mustSupport: true, index: 37}
      network:
        type: Reference
        refers: ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization']
        index: 38
      generalCost: {mustSupport: true, index: 39}
      specificCost:
        mustSupport: true
        index: 40
        elements:
          category:
            binding: {strength: example, valueSet: 'https://nrces.in/ndhm/fhir/r4/ValueSet/ndhm-benefitcategory'}
            mustSupport: true
            index: 41
            elements:
              coding:
                index: 42
                elements:
                  system: {index: 43}
                  code: {index: 44}
                  display: {index: 45}
                required: [code, display, system]
              text: {mustSupport: true, index: 46}
          benefit:
            elements:
              type:
                binding: {strength: example, valueSet: 'https://nrces.in/ndhm/fhir/r4/ValueSet/ndhm-productorservice'}
                index: 47
                elements:
                  coding:
                    index: 48
                    elements:
                      system: {index: 49}
                      code: {index: 50}
                      display: {index: 51}
                    required: [code, display, system]
                  text: {mustSupport: true, index: 52}
    required: [type]
  contact: {mustSupport: true, index: 14}
package_version: 3.1.0
class: profile
kind: resource
url: https://nrces.in/ndhm/fhir/r4/StructureDefinition/InsurancePlan
base: http://hl7.org/fhir/StructureDefinition/InsurancePlan
version: 3.1.0
required: [administeredBy, coverage, identifier, name, ownedBy, period, plan, status, type]