I’m trying to use InsurancePlan resource but currently it has maturity level 0 and there are no examples on it so i’m posting this to get some clarifications.
- Why InsurancePlan.type has same suggested codes for InsurancePlan.Coverage.type ?
- Suppose that i want to define Coverage (Vision) with 2 benefits (Inpatient & Outpatient), for Outpatient i have 3 limits (max number of checkups = 2, max cost for eyeglasses = 300$, max number of eyeglasses = 1). Is this right usage of that structure ?
- Related to above structure, how can i define limit on Coverage level (2000$) - for whole Vision related treatments ?
Now going to plans level (InsurancePlan.plan), suppose i have 2 plans :
- Silver =>
limit : 100000$ (generalCost.value)
Specific cost : Coverage.category = Vision, 2 benefits (Inpatient , Outpatient), for Outpatient i have 2 costs (copay : 30$, individual-cap : 100$)
Based on above if i receive request from patient connected to this plan on Silver category for Vision treatment & Outpatient encounter i have all those details :
- Max number of checkups : 2
- Max cost for eyeglasses = 300$
- Max number of eye glasses = 1
- Copay 20$
- Individual-cap 100$
As you noticed above i collected his limits & coverage details from 2 levels InsurancePlan & specific sub-plan, is this usage correct ?
I noticed difference in suggested codes for Coverage.beneift.type & Plan.SpecificCost.Benefit.type but i supposed them the same, is that correct ?
How to give gold plan higher limit for eyeglasses (400$ for example) ?
Sorry for this number of questions, let me know if you need more clarifications.