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ACAPlan2018SearchResult.md

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VericredClient::ACAPlan2018SearchResult

Properties

Name Type Description Notes
carrier_name String Name of the insurance carrier [optional]
display_name String Alternate name for the Plan [optional]
effective_date String Effective date of coverage. [optional]
expiration_date String Expiration date of coverage. [optional]
identifiers Array<PlanIdentifier> List of identifiers of this Plan [optional]
name String Marketing name of the plan [optional]
network_ids Array<Integer> List of Vericred-generated network_ids [optional]
plan_type String Category of the plan (e.g. EPO, HMO, PPO, POS, Indemnity, PACE, Medicare-Medicaid, HMO w/POS, Cost, FFS, MSA) [optional]
service_area_id String Foreign key for service area [optional]
source String Source of the plan benefit data [optional]
type String The type of the Plan [optional]
adult_dental BOOLEAN Does the plan provide dental coverage for adults? [optional]
age29_rider BOOLEAN True if the plan allows dependents up to age 29 [optional]
ambulance String Benefits string for ambulance coverage [optional]
benefits_summary_url String Link to the summary of benefits and coverage (SBC) document. [optional]
buy_link String Link to a location to purchase the plan. [optional]
child_dental BOOLEAN Does the plan provide dental coverage for children? [optional]
child_eyewear String Child eyewear benefits summary [optional]
child_eye_exam String Child eye exam benefits summary [optional]
customer_service_phone_number String Phone number to contact the insurance carrier [optional]
durable_medical_equipment String Benefits summary for durable medical equipment [optional]
diagnostic_test String Diagnostic tests benefit summary [optional]
dp_rider BOOLEAN True if plan does not cover domestic partners [optional]
drug_formulary_url String Link to the summary of drug benefits for the plan [optional]
emergency_room String Description of costs when visiting the ER [optional]
family_drug_deductible String Deductible for drugs when a family is on the plan. [optional]
family_drug_moop String Maximum out-of-pocket for drugs when a family is on the plan [optional]
family_medical_deductible String Deductible when a family is on the plan [optional]
family_medical_moop String Maximum out-of-pocket when a family is on the plan [optional]
fp_rider BOOLEAN True if plan does not cover family planning [optional]
generic_drugs String Cost for generic drugs [optional]
habilitation_services String Habilitation services benefits summary [optional]
hios_issuer_id String [optional]
home_health_care String Home health care benefits summary [optional]
hospice_service String Hospice service benefits summary [optional]
hsa_eligible BOOLEAN Is the plan HSA eligible? [optional]
id String Government-issued HIOS plan ID [optional]
imaging String Benefits summary for imaging coverage [optional]
individual_drug_deductible String Deductible for drugs when an individual is on the plan [optional]
individual_drug_moop String Maximum out-of-pocket for drugs when an individual is on the plan [optional]
individual_medical_deductible String Deductible when an individual is on the plan [optional]
individual_medical_moop String Maximum out-of-pocket when an individual is on the plan [optional]
inpatient_birth String Inpatient birth benefits summary [optional]
inpatient_facility String Cost under the plan for an inpatient facility [optional]
inpatient_mental_health String Inpatient mental helath benefits summary [optional]
inpatient_physician String Cost under the plan for an inpatient physician [optional]
inpatient_substance String Inpatient substance abuse benefits summary [optional]
in_network_ids Array<Integer> List of NPI numbers for Providers passed in who accept this Plan [optional]
level String Plan metal grouping (e.g. platinum, gold, silver, etc) [optional]
logo_url String Link to a copy of the insurance carrier's logo [optional]
non_preferred_brand_drugs String Cost under the plan for non-preferred brand drugs [optional]
on_market BOOLEAN Is the plan on-market? [optional]
off_market BOOLEAN Is the plan off-market? [optional]
out_of_network_coverage BOOLEAN Does this plan provide any out of network coverage? [optional]
out_of_network_ids Array<Integer> List of NPI numbers for Providers passed in who do not accept this Plan [optional]
outpatient_facility String Benefits summary for outpatient facility coverage [optional]
outpatient_mental_health String Benefits summary for outpatient mental health coverage [optional]
outpatient_physician String Benefits summary for outpatient physician coverage [optional]
outpatient_substance String Outpatient substance abuse benefits summary [optional]
plan_market String Market in which the plan is offered (on_marketplace, shop, etc) [optional]
preferred_brand_drugs String Cost under the plan for perferred brand drugs [optional]
prenatal_postnatal_care String Inpatient substance abuse benefits summary [optional]
preventative_care String Benefits summary for preventative care [optional]
premium_subsidized Float Cumulative premium amount after subsidy [optional]
premium Float Cumulative premium amount [optional]
premium_source String Source of the base pricing data [optional]
primary_care_physician String Cost under the plan to visit a Primary Care Physician [optional]
rehabilitation_services String Benefits summary for rehabilitation services [optional]
skilled_nursing String Benefits summary for skilled nursing services [optional]
specialist String Cost under the plan to visit a specialist [optional]
specialty_drugs String Cost under the plan for specialty drugs [optional]
urgent_care String Benefits summary for urgent care [optional]
actuarial_value Float Percentage of total average costs for covered benefits that a plan will cover. [optional]
chiropractic_services String Chiropractic services benefits summary [optional]
coinsurance Float Standard cost share for most benefits [optional]
embedded_deductible String Is the individual deductible for each covered person, embedded in the family deductible [optional]
gated BOOLEAN Does the plan's network require a physician referral? [optional]
imaging_center String Imaging center benefits summary [optional]
imaging_physician String Imaging physician benefits summary [optional]
lab_test String Lab test benefits summary [optional]
mail_order_rx Float Multiple of the standard Rx cost share for orders filled via mail order [optional]
nonpreferred_generic_drug_share String Non-preferred generic drugs benefits summary [optional]
nonpreferred_specialty_drug_share String Non-preferred specialty drugs benefits summary [optional]
outpatient_ambulatory_care_center String Outpatient ambulatory care center benefits summary [optional]
plan_calendar String Are deductibles and MOOPs reset on Dec-31 (&quot;calendar year&quot;), 365 days after enrollment date (&quot;plan year&quot;), or are both options available (&quot;both&quot;)? [optional]
prenatal_care String Prenatal care benefits summary [optional]
postnatal_care String Post-natal care benefits summary [optional]
skilled_nursing_facility_365 String Does the plan cover full-time, year-round, nursing facilities? [optional]
essential_health_benefits_percentage Float Percentage of essential plan benefits [optional]
match_percentage Integer Percentage of doctors who matched this Plan [optional]
perfect_match_percentage Integer Percentage of employees with 100% matchedch [optional]
employee_premium Float Cumulative premium amount for employees [optional]
dependent_premium Float Cumulative premium amount for dependents [optional]