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Coverage

Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment.

Properties

NameCardTypeDescription
id0..1stringLogical id of this artifact
meta0..1MetaMetadata about the resource
implicitRules0..1uriA set of rules under which this content was created
language0..1codeLanguage of the resource content
text0..1NarrativeText summary of the resource, for human interpretation
contained0..*ResourceContained, inline Resources
extension0..*ExtensionAdditional content defined by implementations
modifierExtension0..*ExtensionExtensions that cannot be ignored
identifier0..*IdentifierBusiness Identifier for the coverage
status1..1codeactive | cancelled | draft | entered-in-error
type0..1CodeableConceptCoverage category such as medical or accident
policyHolder0..1ReferenceOwner of the policy
subscriber0..1ReferenceSubscriber to the policy
subscriberId0..1stringID assigned to the subscriber
beneficiary1..1ReferencePlan beneficiary
dependent0..1stringDependent number
relationship0..1CodeableConceptBeneficiary relationship to the subscriber
period0..1PeriodCoverage start and end dates
payor1..*ReferenceIssuer of the policy
class0..*BackboneElementAdditional coverage classifications
order0..1positiveIntRelative order of the coverage
network0..1stringInsurer network
costToBeneficiary0..*BackboneElementPatient payments for services/products
subrogation0..1booleanReimbursement to insurer
contract0..*ReferenceContract details

Search Parameters

NameTypeDescriptionExpression
beneficiaryreferenceCovered partyCoverage.beneficiary
class-typetokenCoverage class (eg. plan, group)Coverage.class.type
class-valuestringValue of the class (eg. Plan number, group number)Coverage.class.value
dependentstringDependent numberCoverage.dependent
identifiertokenThe primary identifier of the insured and the coverageCoverage.identifier
patientreferenceRetrieve coverages for a patientCoverage.beneficiary
payorreferenceThe identity of the insurer or party paying for servicesCoverage.payor
policy-holderreferenceReference to the policyholderCoverage.policyHolder
statustokenThe status of the CoverageCoverage.status
subscriberreferenceReference to the subscriberCoverage.subscriber
typetokenThe kind of coverage (health plan, auto, Workers Compensation)Coverage.type