NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage TUDomainResourceInsurance or medical plan or a payment agreement

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierBusiness identifier(s) for this coverage

... status ?!Σ1..1codeactive | cancelled | draft | entered-in-error
Binding: Financial Resource Status Codes (Required)
... kind Σ1..1codeinsurance | self-pay | other
Binding: Kind (Required)
... paymentBy 0..*BackboneElementSelf-pay parties and responsibility

.... party Σ1..1Reference(Patient | RelatedPerson | Organization)Parties performing self-payment
.... responsibility Σ0..1stringParty's responsibility
... type Σ0..1CodeableConceptCoverage category such as medical or accident
Binding: Coverage Type and Self-Pay Codes (Preferred)
... policyHolder Σ0..1Reference(Patient | RelatedPerson | Organization)Owner of the policy
... subscriber Σ0..1Reference(Patient | RelatedPerson)Subscriber to the policy
... subscriberId Σ0..*IdentifierID assigned to the subscriber

... beneficiary Σ1..1Reference(Patient)Plan beneficiary
... dependent Σ0..1stringDependent number
... relationship 0..1CodeableConceptBeneficiary relationship to the subscriber
Binding: SubscriberPolicyholder Relationship Codes (Extensible)
... period Σ0..1PeriodCoverage start and end dates
... insurer Σ0..1Reference(Organization)Issuer of the policy
... class 0..*BackboneElementAdditional coverage classifications

.... type Σ1..1CodeableConceptType of class such as 'group' or 'plan'
Binding: Coverage Class Codes (Extensible)
.... value Σ1..1IdentifierValue associated with the type
.... name Σ0..1stringHuman readable description of the type and value
... order Σ0..1positiveIntRelative order of the coverage
... network Σ0..1stringInsurer network
... costToBeneficiary 0..*BackboneElementPatient payments for services/products

.... type Σ0..1CodeableConceptCost category
Binding: Coverage Copay Type Codes (Extensible)
.... category 0..1CodeableConceptBenefit classification
Binding: Benefit Category Codes (Example)
.... network 0..1CodeableConceptIn or out of network
Binding: Network Type Codes (Example)
.... unit 0..1CodeableConceptIndividual or family
Binding: Unit Type Codes (Example)
.... term 0..1CodeableConceptAnnual or lifetime
Binding: Benefit Term Codes (Example)
.... value[x] Σ0..1The amount or percentage due from the beneficiary
..... valueQuantitySimpleQuantity
..... valueMoneyMoney
.... exception 0..*BackboneElementExceptions for patient payments

..... type Σ1..1CodeableConceptException category
Binding: Example Coverage Financial Exception Codes (Example)
..... period Σ0..1PeriodThe effective period of the exception
... subrogation 0..1booleanReimbursement to insurer
... contract 0..*Reference(Contract)Contract details

... insurancePlan 0..1Reference(InsurancePlan)Insurance plan details

doco Documentation for this format