Insurance Plan Type

{
  "description" : "Categories of cost-sharing used by plans",
  "date" : "2025-02-25T19:12:27+00:00",
  "publisher" : "HL7 International / Financial Management",
  "jurisdiction" : [ {
    "coding" : [ {
      "system" : "urn:iso:std:iso:3166",
      "code" : "US"
    } ]
  } ],
  "content" : "complete",
  "property" : null,
  "name" : "InsurancePlanTypeCS",
  "experimental" : false,
  "resourceType" : "CodeSystem",
  "title" : "Insurance Plan Type",
  "extension" : [ {
    "valueCode" : "fm",
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"
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    "valueCode" : "trial-use",
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    "_valueCode" : {
      "extension" : [ {
        "valueCanonical" : "http://hl7.org/fhir/us/davinci-pdex-plan-net/ImplementationGuide/hl7.fhir.us.davinci-pdex-plan-net",
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom"
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      "valueInteger" : 8
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    "url" : "http://health-samurai.io/extensions/excised-data"
  }, {
    "url" : "http://health-samurai.io/extensions/source",
    "valueCode" : "db"
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  "status" : "active",
  "id" : "InsurancePlanTypeCS",
  "count" : 8,
  "url" : "http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/InsurancePlanTypeCS",
  "caseSensitive" : true,
  "version" : "1.2.0",
  "contact" : [ {
    "name" : "HL7 International / Financial Management",
    "telecom" : [ {
      "system" : "url",
      "value" : "http://www.hl7.org/Special/committees/fm"
    }, {
      "system" : "email",
      "value" : "fm@lists.HL7.org"
    } ]
  } ],
  "text" : {
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem InsurancePlanTypeCS</b></p><a name=\"InsurancePlanTypeCS\"> </a><a name=\"hcInsurancePlanTypeCS\"> </a><a name=\"InsurancePlanTypeCS-en-US\"> </a><p>This case-sensitive code system <code>http://hl7.org/fhir/us/davinci-pdex-plan-net/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\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</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\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</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\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</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\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</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>",
    "status" : "generated"
  }
}