--- type: "resource" title: "InsuranceProduct" resource: "InsuranceProduct" --- # InsuranceProduct ## Introduction ## Scope and Usage Insurance offerings will be fully described by the combination of both InsurancePlan (the costs) and InsuranceProduct (the benefits). A given payer’s products typically differ by network type and/or coverage benefits. An [InsurancePlan](insuranceplan) pairs the health insurance coverage benefits under an InsuranceProduct with the particular cost sharing structure offered to a consumer. A given InsuranceProduct may comprise multiple InsurancePlans. > **Note to Balloters:** > > This resource is likely to be removed from the specification and moved to being an [Additional Resource](resource#additional) after this ballot due to concerns around it's readiness, and the thin implementation experience. Ballot comments on this subject are welcome. ## Boundaries and Relationships Insurance Product describes a list of covered benefits and networks as well as details about who administers the product and applicable coverage areas. [InsurancePlan](insuranceplan) describes the costs to the subscriber or beneficiary associated with benefits, as well as additional information about the offering, such as who administers the plan, a coverage area, contact information, etc. The specific benefits covered by the plan are described in the InsuranceProduct referenced in InsurancePlan.product. A [Coverage](coverage) resource establishes the link between an InsurancePlan and a beneficiary and optionally a subscriber. ## Notes ## Notes: ## StructureDefinition ### Elements (Simplified) - **[InsuranceProduct](/insuranceproduct-definitions#InsuranceProduct)** [0..*]: - Details of a Health Insurance product provided by an organization - **[InsuranceProduct.identifier](/insuranceproduct-definitions#InsuranceProduct.identifier)** [0..*]: [Identifier](/Identifier) Business Identifier for Product - **[InsuranceProduct.status](/insuranceproduct-definitions#InsuranceProduct.status)** [0..1]: [code](/code) required:[publication-status](/valueset-publication-status) draft | active | retired | unknown - **[InsuranceProduct.type](/insuranceproduct-definitions#InsuranceProduct.type)** [0..*]: [CodeableConcept](/CodeableConcept) example:[insuranceproduct-type](/valueset-insuranceproduct-type) Kind of product - **[InsuranceProduct.name](/insuranceproduct-definitions#InsuranceProduct.name)** [0..1]: [string](/string) Official name - **[InsuranceProduct.alias](/insuranceproduct-definitions#InsuranceProduct.alias)** [0..*]: [string](/string) Alternate names - **[InsuranceProduct.period](/insuranceproduct-definitions#InsuranceProduct.period)** [0..1]: [Period](/Period) When the product is available - **[InsuranceProduct.ownedBy](/insuranceproduct-definitions#InsuranceProduct.ownedBy)** [0..1]: Reference([Organization](/Organization)) Product issuer - **[InsuranceProduct.administeredBy](/insuranceproduct-definitions#InsuranceProduct.administeredBy)** [0..1]: Reference([Organization](/Organization)) Product administrator - **[InsuranceProduct.coverageArea](/insuranceproduct-definitions#InsuranceProduct.coverageArea)** [0..*]: Reference([Location](/Location)) Where product applies - **[InsuranceProduct.contact](/insuranceproduct-definitions#InsuranceProduct.contact)** [0..*]: [ExtendedContactDetail](/ExtendedContactDetail) Official contact details relevant to the health insurance product - **[InsuranceProduct.endpoint](/insuranceproduct-definitions#InsuranceProduct.endpoint)** [0..*]: Reference([Endpoint](/Endpoint)) Technical endpoint - **[InsuranceProduct.network](/insuranceproduct-definitions#InsuranceProduct.network)** [0..*]: Reference([Organization](/Organization)) What networks are Included - **[InsuranceProduct.coverage](/insuranceproduct-definitions#InsuranceProduct.coverage)** [0..*]: [BackboneElement](/BackboneElement) Coverage details - **[InsuranceProduct.coverage.type](/insuranceproduct-definitions#InsuranceProduct.coverage.type)** [1..1]: [CodeableConcept](/CodeableConcept) Classification of Coverage - **[InsuranceProduct.coverage.network](/insuranceproduct-definitions#InsuranceProduct.coverage.network)** [0..*]: Reference([Organization](/Organization)) What networks provide coverage - **[InsuranceProduct.coverage.benefit](/insuranceproduct-definitions#InsuranceProduct.coverage.benefit)** [1..*]: [BackboneElement](/BackboneElement) List of benefits - **[InsuranceProduct.coverage.benefit.type](/insuranceproduct-definitions#InsuranceProduct.coverage.benefit.type)** [1..1]: [CodeableConcept](/CodeableConcept) Classification of benefit provided - **[InsuranceProduct.coverage.benefit.requirement](/insuranceproduct-definitions#InsuranceProduct.coverage.benefit.requirement)** [0..1]: [string](/string) Referral requirements - **[InsuranceProduct.coverage.benefit.limit](/insuranceproduct-definitions#InsuranceProduct.coverage.benefit.limit)** [0..*]: [BackboneElement](/BackboneElement) Limits on the provided benefits - **[InsuranceProduct.coverage.benefit.limit.value](/insuranceproduct-definitions#InsuranceProduct.coverage.benefit.limit.value)** [0..1]: [Quantity](/Quantity) Maximum value allowed - **[InsuranceProduct.coverage.benefit.limit.code](/insuranceproduct-definitions#InsuranceProduct.coverage.benefit.limit.code)** [0..1]: [CodeableConcept](/CodeableConcept) Benefit limit details - **[InsuranceProduct.related](/insuranceproduct-definitions#InsuranceProduct.related)** [0..*]: [BackboneElement](/BackboneElement) Associated insurance product - **[InsuranceProduct.related.product](/insuranceproduct-definitions#InsuranceProduct.related.product)** [0..1]: Reference([InsuranceProduct](/InsuranceProduct)) Related Product reference - **[InsuranceProduct.related.relationship](/insuranceproduct-definitions#InsuranceProduct.related.relationship)** [0..1]: [CodeableConcept](/CodeableConcept) Relationship of this product to the related product - **[InsuranceProduct.related.period](/insuranceproduct-definitions#InsuranceProduct.related.period)** [0..1]: [Period](/Period) Period that this Relationship is valid ## Mappings - [InsuranceProduct Mappings](/insuranceproduct-mappings) — 11 mapping entries ## Resource Packs ### list-InsuranceProduct-packs.xml ```xml ``` ## Search Parameters - [contact-address](/insuranceproduct-search#contact-address) — **string** — A server defined search that may match any of the string fields in the Address, including line, city, district, state, country, postalCode, and/or text — `InsuranceProduct.contact.address` - [contact-address-city](/insuranceproduct-search#contact-address-city) — **string** — A city specified in an address — `InsuranceProduct.contact.address.city` - [contact-address-country](/insuranceproduct-search#contact-address-country) — **string** — A country specified in an address — `InsuranceProduct.contact.address.country` - [contact-address-postalcode](/insuranceproduct-search#contact-address-postalcode) — **string** — A postal code specified in an address — `InsuranceProduct.contact.address.postalCode` - [contact-address-state](/insuranceproduct-search#contact-address-state) — **string** — A state specified in an address — `InsuranceProduct.contact.address.state` - [contact-address-use](/insuranceproduct-search#contact-address-use) — **token** — A use code specified in an address — `InsuranceProduct.contact.address.use` - [administered-by](/insuranceproduct-search#administered-by) — **reference** — Product administrator — `InsuranceProduct.administeredBy` - [endpoint](/insuranceproduct-search#endpoint) — **reference** — Technical endpoint — `InsuranceProduct.endpoint` - [identifier](/insuranceproduct-search#identifier) — **token** — Any identifier for the product (not the accreditation issuer's identifier) — `InsuranceProduct.identifier` - [name](/insuranceproduct-search#name) — **string** — A portion of the insurance product's name or alias — `InsuranceProduct.name | InsuranceProduct.alias` - [owned-by](/insuranceproduct-search#owned-by) — **reference** — The issuer of the insurance product — `InsuranceProduct.ownedBy` - [phonetic](/insuranceproduct-search#phonetic) — **string** — A portion of the product's name using some kind of phonetic matching algorithm — `InsuranceProduct.name` - [status](/insuranceproduct-search#status) — **token** — Is the Product record active — `InsuranceProduct.status` - [type](/insuranceproduct-search#type) — **token** — A code for the type of insurance product — `InsuranceProduct.type` - [endpoint](/insuranceproduct-search#endpoint) — **reference** — The endpoint(s) applicable to this product — `InsuranceProduct.endpoint` [Full Search Parameters](/insuranceproduct-search) ## Examples - [example](/insuranceproduct-example-example) — insuranceproduct-example — A general insurance product example - [insuranceproduct-example](/insuranceproduct-example-insuranceproduct-example) — insuranceproduct-example - [insuranceproduct-example-onc](/insuranceproduct-example-insuranceproduct-example-onc) — insuranceproduct-example-onc - [insuranceproduct-example1](/insuranceproduct-example-insuranceproduct-example1) — insuranceproduct-example1 - [insuranceproduct-examples-header](/insuranceproduct-example-insuranceproduct-examples-header) — insuranceproduct-examples-header [Full Examples](/insuranceproduct-examples) ## Mapping Exceptions ### insuranceproduct-fivews-mapping-exceptions.xml ### Unmapped Elements - **FiveWs.what** — Unknown - **FiveWs.recorded** — Unknown - **FiveWs.author** — Unknown - **FiveWs.actor** — Unknown - **FiveWs.cause** — Unknown - **FiveWs.version** — Unknown - **FiveWs.witness** — Unknown - **FiveWs.where** — Unknown - **FiveWs.context** — Unknown - **FiveWs.init** — Unknown - **FiveWs.why** — Unknown - **FiveWs.source** — Unknown - **FiveWs.who** — Unknown - **FiveWs.grade** — Unknown - **FiveWs.planned** — Unknown - **FiveWs.done** — Unknown - **FiveWs.subject** — Unknown