DocumentationExperience PlatformExperience Data Model (XDM) Guide

Healthcare Plan Details schema field group

Last update: Fri Dec 15 2023 00:00:00 GMT+0000 (Coordinated Universal Time)

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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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