Healthcare Plan Details schema field group
Healthcare Plan Details is a standard schema field group for the Plan class. It provides a single object-type field healthcarePlanDetails
which captures properties related to a medical plan.
Property
Data type
Description
networkDetails
Array of objects
Lists the details of the insurer-defined network(s) of providers to which the beneficiary may seek treatment, and will be covered at the “in-network” rate. Each object includes the following properties:
networkID
: (String) The insurer-specific ID for the network.networkName
: (String) The insurer-specific name for the network.
affiliations
Array of strings
A list of business entities that are affiliated with the plan.
coverageType
String
The plan coverage type. Accepted values are:
medical
dental
vision
accident
isActive
Boolean
Indicates whether the plan is active.
lastVerificationDate
DateTime
The date on which the plan was last verified.
payerID
String
The unique identifier for the payer (in other words, the insurance provider for the plan).
planLevel
String
Indicates the plan level. Accepted values are:
primary
secondary
tertiary
quaternary
planType
String
Indicates the plan type. Accepted values are:
hmo
epo
pos
hdhp
targetOwnerType
String
The type of owner a plan is for. Examples include individual, group, organization, and so on.
For more details on the field group, refer to the public XDM repository.
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