Insurance Product Type

active

ContentcompleteURL

http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/InsuranceProductTypeCS

Version

1.2.0

Concepts22Date2025-02-25T19:12:27+00:00PublisherHL7 International / Financial ManagementDescription

A distinct package of health insurance coverage benefits that are offered using a particular product network type.

Concepts

Select a concept to view details

Generated Narrative: CodeSystem InsuranceProductTypeCS

This case-sensitive code system http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/InsuranceProductTypeCS defines the following codes:

Code	Display	Definition
commppo	Commercial PPO	Health insurance provided through a Preferred Provider Organization (PPO).
commhdhp	Commercial HDHP	Health insurance provided through a High Deductible Health Plan (HDHP).
commpos	Commercial POS	Health insurance provided through a Point-of-Service (POS) Plan.
commhmo	Commercial HMO	Health insurance provided through a Health Maintenance Organization (HMO).
commepo	Commercial EPO	Health insurance provided through a Exclusive Provider Organization(EPO).
medi	Medicaid	Health insurance provided to eligible adults and children under the Federal Medicaid program
medihmo	Medicaid HMO	Health insurance provided to eligible adults and children under the Federal Medicaid program through a Health Maintenance Organization (HMO).
mediadv	Medicare Advantage	Health insurance provided by a private company that contracts with Medicare to provide all Medicare Part A and Part B benefits.
mediadvhmo	Medicare Advantage HMO	Health insurance offered by a private company that contracts with Medicare to provide all Medicare Part A and Part B benefits through a Health Maintenance Organization (HMO).
media	Medicare Part A	Health insurance provided under the Federal Medicare program covering inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
medib	Medicare Part B	Health insurance provided under the Federal Medicfare program covering certain doctors' services, outpatient care, medical supplies, and preventive services.
medid	Medicare Part D	Health insurance provided under the Federal Medicare program covering prescription drugs.
mediab	Medicare A/B	Health insurance provided under the Federal Medicare program covering inpatient hospital stays, care in a skilled nursing facility, hospice care, some home health care, certain doctors' services, outpatient care, medical supplies, and preventive services.
qhp	Qualified Health Plan	Health insurance provided through and certified by the Health Insurance Marketplace that provides essential health benefits (EHBs), follows established limits on cost sharing, and meets other requirements outlined within the application process.
ihs	Indian Health Service	Health care program provided to United States American Indians and Alaska Natives.
fep	Federal Employee Program	Health insurance provided to employees of the Federal government.
tri	TRICARE	Health care program provided to uniformed service members, retirees, and their families around the world.
va	Veterans Affairs Plan	Health care program provided to eligible veterans.
dent	Dental Plan	Health insurance provided to cover services related to the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the oral cavity.
denthmo	Dental HMO	Health insurance provided to cover services related to the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the oral cavity provided through a Health Maintenance Organization (HMO).
vis	Vision Plan	Health insurance provided to cover services related to the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the eyes.
vishmo	Vision HMO	Health insurance provided to cover services related to the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the eyes provided through a Health Maintenance Organization (HMO).

{
  "description" : "A distinct package of health insurance coverage benefits that are offered using a particular product network type.",
  "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" : "InsuranceProductTypeCS",
  "experimental" : false,
  "resourceType" : "CodeSystem",
  "title" : "Insurance Product Type",
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    "valueCode" : "db"
  } ],
  "status" : "active",
  "id" : "InsuranceProductTypeCS",
  "count" : 22,
  "url" : "http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/InsuranceProductTypeCS",
  "caseSensitive" : true,
  "version" : "1.2.0",
  "contact" : [ {
    "name" : "HL7 International / Financial Management",
    "telecom" : [ {
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    }, {
      "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 InsuranceProductTypeCS</b></p><a name=\"InsuranceProductTypeCS\"> </a><a name=\"hcInsuranceProductTypeCS\"> </a><a name=\"InsuranceProductTypeCS-en-US\"> </a><p>This case-sensitive code system <code>http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/InsuranceProductTypeCS</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\">commppo<a name=\"InsuranceProductTypeCS-commppo\"> </a></td><td>Commercial PPO</td><td>Health insurance provided through a Preferred Provider Organization (PPO).</td></tr><tr><td style=\"white-space:nowrap\">commhdhp<a name=\"InsuranceProductTypeCS-commhdhp\"> </a></td><td>Commercial HDHP</td><td>Health insurance provided through a High Deductible Health Plan (HDHP).</td></tr><tr><td style=\"white-space:nowrap\">commpos<a name=\"InsuranceProductTypeCS-commpos\"> </a></td><td>Commercial POS</td><td>Health insurance provided through a Point-of-Service (POS) Plan.</td></tr><tr><td style=\"white-space:nowrap\">commhmo<a name=\"InsuranceProductTypeCS-commhmo\"> </a></td><td>Commercial HMO</td><td>Health insurance provided through a Health Maintenance Organization (HMO).</td></tr><tr><td style=\"white-space:nowrap\">commepo<a name=\"InsuranceProductTypeCS-commepo\"> </a></td><td>Commercial EPO</td><td>Health insurance provided through a Exclusive Provider Organization(EPO).</td></tr><tr><td style=\"white-space:nowrap\">medi<a name=\"InsuranceProductTypeCS-medi\"> </a></td><td>Medicaid</td><td>Health insurance provided to eligible adults and children under the Federal Medicaid program</td></tr><tr><td style=\"white-space:nowrap\">medihmo<a name=\"InsuranceProductTypeCS-medihmo\"> </a></td><td>Medicaid HMO</td><td>Health insurance provided to eligible adults and children under the Federal Medicaid program through a Health Maintenance Organization (HMO).</td></tr><tr><td style=\"white-space:nowrap\">mediadv<a name=\"InsuranceProductTypeCS-mediadv\"> </a></td><td>Medicare Advantage</td><td>Health insurance provided by a private company that contracts with Medicare to provide all Medicare Part A and Part B benefits.</td></tr><tr><td style=\"white-space:nowrap\">mediadvhmo<a name=\"InsuranceProductTypeCS-mediadvhmo\"> </a></td><td>Medicare Advantage HMO</td><td>Health insurance offered by a private company that contracts with Medicare to provide all Medicare Part A and Part B benefits through a Health Maintenance Organization (HMO).</td></tr><tr><td style=\"white-space:nowrap\">media<a name=\"InsuranceProductTypeCS-media\"> </a></td><td>Medicare Part A</td><td>Health insurance provided under the Federal Medicare program covering inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.</td></tr><tr><td style=\"white-space:nowrap\">medib<a name=\"InsuranceProductTypeCS-medib\"> </a></td><td>Medicare Part B</td><td>Health insurance provided under the Federal Medicfare program covering certain doctors' services, outpatient care, medical supplies, and preventive services.</td></tr><tr><td style=\"white-space:nowrap\">medid<a name=\"InsuranceProductTypeCS-medid\"> </a></td><td>Medicare Part D</td><td>Health insurance provided under the Federal Medicare program covering prescription drugs.</td></tr><tr><td style=\"white-space:nowrap\">mediab<a name=\"InsuranceProductTypeCS-mediab\"> </a></td><td>Medicare A/B</td><td>Health insurance provided under the Federal Medicare program covering inpatient hospital stays, care in a skilled nursing facility, hospice care, some home health care, certain doctors' services, outpatient care, medical supplies, and preventive services.</td></tr><tr><td style=\"white-space:nowrap\">qhp<a name=\"InsuranceProductTypeCS-qhp\"> </a></td><td>Qualified Health Plan</td><td>Health insurance provided through and certified by the Health Insurance Marketplace that provides essential health benefits (EHBs), follows established limits on cost sharing, and meets other requirements outlined within the application process.</td></tr><tr><td style=\"white-space:nowrap\">ihs<a name=\"InsuranceProductTypeCS-ihs\"> </a></td><td>Indian Health Service</td><td>Health care program provided to United States American Indians and Alaska Natives.</td></tr><tr><td style=\"white-space:nowrap\">fep<a name=\"InsuranceProductTypeCS-fep\"> </a></td><td>Federal Employee Program</td><td>Health insurance provided to employees of the Federal government.</td></tr><tr><td style=\"white-space:nowrap\">tri<a name=\"InsuranceProductTypeCS-tri\"> </a></td><td>TRICARE</td><td>Health care program provided to uniformed service members, retirees, and their families around the world.</td></tr><tr><td style=\"white-space:nowrap\">va<a name=\"InsuranceProductTypeCS-va\"> </a></td><td>Veterans Affairs Plan</td><td>Health care program provided to eligible veterans.</td></tr><tr><td style=\"white-space:nowrap\">dent<a name=\"InsuranceProductTypeCS-dent\"> </a></td><td>Dental Plan</td><td>Health insurance provided to cover services related to the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the oral cavity.</td></tr><tr><td style=\"white-space:nowrap\">denthmo<a name=\"InsuranceProductTypeCS-denthmo\"> </a></td><td>Dental HMO</td><td>Health insurance provided to cover services related to the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the oral cavity provided through a Health Maintenance Organization (HMO).</td></tr><tr><td style=\"white-space:nowrap\">vis<a name=\"InsuranceProductTypeCS-vis\"> </a></td><td>Vision Plan</td><td>Health insurance provided to cover services related to the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the eyes.</td></tr><tr><td style=\"white-space:nowrap\">vishmo<a name=\"InsuranceProductTypeCS-vishmo\"> </a></td><td>Vision HMO</td><td>Health insurance provided to cover services related to the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the eyes provided through a Health Maintenance Organization (HMO).</td></tr></table></div>",
    "status" : "generated"
  }
}