---
type: "example"
title: "InsurancePlan Example: insuranceplan-example-onc"
resource: "InsurancePlan"
example: "insuranceplan-example-onc"
---
# InsurancePlan Example: insuranceplan-example-onc

## Example XML



```xml
<?xml version="1.0" encoding="UTF-8"?>
<InsurancePlan xmlns="http://hl7.org/fhir">
    <id value="example-onc" />
        <type>
            <text value="Standard" />
        </type>
        <generalCost>
            <cost>
                <value value="2000" />
                <currency value="USD" />
            </cost>
        </generalCost>
        <specificCost>
            <category>
                <text value="Medical" />
            </category>
            <benefit>
                <type>
                    <text value="primary care office visit" />
                </type>
                <cost>
                    <type>
                        <text value="copay" />
                    </type>
                    <applicability>
                        <coding>
                            <system value="http://terminology.hl7.org/CodeSystem/applicability" />
                            <code value="in-network" />
                        </coding>
                        <text value="preferred" />
                    </applicability>
                    <value>
                        <value value="25" />
                        <unit value="USD" />
                    </value>
                </cost>
                <cost>
                    <type>
                        <text value="coinsurance" />
                    </type>
                    <applicability>
                        <coding>
                            <system value="http://terminology.hl7.org/CodeSystem/applicability" />
                            <code value="in-network" />
                        </coding>
                        <text value="participating" />
                    </applicability>
                    <value>
                        <value value="35" />
                        <unit value="%" />
                    </value>
                </cost>
                <cost>
                    <type>
                        <text value="coinsurance" />
                    </type>
                    <applicability>
                        <coding>
                            <system value="http://terminology.hl7.org/CodeSystem/applicability" />
                            <code value="out-of-network" />
                        </coding>
                        <text value="non-participating" />
                    </applicability>
                    <value>
                        <value value="35" />
                        <unit value="%" />
                    </value>
                </cost>
            </benefit>
            <benefit>
                <type>
                    <text value="specialty care office visit" />
                </type>
                <cost>
                    <type>
                        <text value="copay" />
                    </type>
                    <applicability>
                        <coding>
                            <system value="http://terminology.hl7.org/CodeSystem/applicability" />
                            <code value="in-network" />
                        </coding>
                        <text value="preferred" />
                    </applicability>
                    <value>
                        <value value="35" />
                        <unit value="USD" />
                    </value>
                </cost>
                <cost>
                    <type>
                        <text value="coinsurance" />
                    </type>
                    <applicability>
                        <coding>
                            <system value="http://terminology.hl7.org/CodeSystem/applicability" />
                            <code value="in-network" />
                        </coding>
                        <text value="participating" />
                    </applicability>
                    <value>
                        <value value="35" />
                        <unit value="%" />
                    </value>
                </cost>
                <cost>
                    <type>
                        <text value="coinsurance" />
                    </type>
                    <applicability>
                        <coding>
                            <system value="http://terminology.hl7.org/CodeSystem/applicability" />
                            <code value="out-of-network" />
                        </coding>
                        <text value="non-participating" />
                    </applicability>
                    <value>
                        <value value="35" />
                        <unit value="%" />
                    </value>
                </cost>
            </benefit>
        </specificCost>
</InsurancePlan>
```