| Name | Flags | Card. | Type | Description & Constraints![]() |
|---|---|---|---|---|
| DomainResource | Insurance or medical plan or a payment agreement | |||
| ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error CoverageStatus (Required) | |
| Σ | 1..1 | Identifier for the plan or agreement issuer | ||
| Identifier | ||||
| Reference(Organization | Patient | RelatedPerson) | ||||
| Σ | 0..1 | boolean | Is a Payment Agreement | |
| Σ | 0..1 | string | BIN Number | |
| Σ | 0..1 | Period | Coverage start and end dates | |
| Σ | 0..1 | Coding | Type of coverage ActCoverageTypeCode (Example) | |
| Σ | 1..1 | Plan holder | ||
| Identifier | ||||
| Reference(Patient | Organization) | ||||
| Σ | 1..1 | Plan Beneficiary | ||
| Identifier | ||||
| Reference(Patient) | ||||
| 1..1 | Coding | Beneficiary relationship to Planholder Policyholder Relationship Codes (Example) | ||
| Σ | 0..* | Identifier | The primary coverage ID | |
| Σ | 0..1 | string | An identifier for the group | |
| Σ | 0..1 | string | An identifier for the subsection of the group | |
| Σ | 0..1 | string | An identifier for the plan | |
| Σ | 0..1 | string | An identifier for the subsection of the plan | |
| Σ | 0..1 | string | An identifier for the class | |
| Σ | 0..1 | positiveInt | Dependent number | |
| Σ | 0..1 | positiveInt | The plan instance or sequence counter | |
| Σ | 0..1 | string | Insurer network | |
| 0..* | Reference(Contract) | Contract details | ||
Documentation for this format | ||||