> ## Documentation Index
> Fetch the complete documentation index at: https://docs.metriport.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Coverage

> Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment.

## Properties

| Name                | Required | Type                                                                                                                                                                                  | Description                                            |
| ------------------- | -------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------ |
| identifier          | No       | [Identifier](/medical-api/fhir/data-types/identifier)\[]                                                                                                                              | Business Identifier for the coverage                   |
| status              | Yes      | code                                                                                                                                                                                  | active / cancelled / draft / entered-in-error          |
| type                | No       | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept)                                                                                                                       | Coverage category such as medical or accident          |
| policyHolder        | No       | Reference\<[Patient](/medical-api/fhir/resources/patient) / [RelatedPerson](/medical-api/fhir/resources/relatedperson) / [Organization](/medical-api/fhir/resources/organization)>    | Owner of the policy                                    |
| subscriber          | No       | Reference\<[Patient](/medical-api/fhir/resources/patient) / [RelatedPerson](/medical-api/fhir/resources/relatedperson)>                                                               | Subscriber to the policy                               |
| subscriberId        | No       | string                                                                                                                                                                                | ID assigned to the subscriber                          |
| beneficiary         | Yes      | Reference\<[Patient](/medical-api/fhir/resources/patient)>                                                                                                                            | Plan beneficiary                                       |
| dependent           | No       | string                                                                                                                                                                                | Dependent number                                       |
| relationship        | No       | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept)                                                                                                                       | Beneficiary relationship to the subscriber             |
| period              | No       | [Period](/medical-api/fhir/data-types/period)                                                                                                                                         | Coverage start and end dates                           |
| payor               | Yes      | Reference\<[Organization](/medical-api/fhir/resources/organization) / [Patient](/medical-api/fhir/resources/patient) / [RelatedPerson](/medical-api/fhir/resources/relatedperson)>\[] | Issuer of the policy                                   |
| class               | No       | CoverageClass                                                                                                                                                                         | Additional coverage classifications                    |
| - id                | No       | string                                                                                                                                                                                | Unique id for inter-element referencing                |
| - extension         | No       | [Extension](/medical-api/fhir/data-types/extension)\[]                                                                                                                                | Additional content defined by implementations          |
| - modifierExtension | No       | [Extension](/medical-api/fhir/data-types/extension)\[]                                                                                                                                | Extensions that cannot be ignored even if unrecognized |
| - type              | Yes      | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept)                                                                                                                       | Type of class such as 'group' or 'plan'                |
| - value             | Yes      | string                                                                                                                                                                                | Value associated with the type                         |
| - name              | No       | string                                                                                                                                                                                | Human readable description of the type and value       |
| order               | No       | positiveInt                                                                                                                                                                           | Relative order of the coverage                         |
| network             | No       | string                                                                                                                                                                                | Insurer network                                        |
| costToBeneficiary   | No       | CoverageCostToBeneficiary                                                                                                                                                             | Patient payments for services/products                 |
| - id                | No       | string                                                                                                                                                                                | Unique id for inter-element referencing                |
| - extension         | No       | [Extension](/medical-api/fhir/data-types/extension)\[]                                                                                                                                | Additional content defined by implementations          |
| - modifierExtension | No       | [Extension](/medical-api/fhir/data-types/extension)\[]                                                                                                                                | Extensions that cannot be ignored even if unrecognized |
| - type              | No       | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept)                                                                                                                       | Cost category                                          |
| - value\[x]         | Yes      | [Quantity](/medical-api/fhir/data-types/quantity), [Money](/medical-api/fhir/data-types/money)                                                                                        | The amount or percentage due from the beneficiary      |
| - exception         | No       | CoverageCostToBeneficiaryException                                                                                                                                                    | Exceptions for patient payments                        |
| - id                | No       | string                                                                                                                                                                                | Unique id for inter-element referencing                |
| - extension         | No       | [Extension](/medical-api/fhir/data-types/extension)\[]                                                                                                                                | Additional content defined by implementations          |
| - modifierExtension | No       | [Extension](/medical-api/fhir/data-types/extension)\[]                                                                                                                                | Extensions that cannot be ignored even if unrecognized |
| - type              | Yes      | [CodeableConcept](/medical-api/fhir/data-types/codeableconcept)                                                                                                                       | Exception category                                     |
| - period            | No       | [Period](/medical-api/fhir/data-types/period)                                                                                                                                         | The effective period of the exception                  |
| subrogation         | No       | boolean                                                                                                                                                                               | Reimbursement to insurer                               |
| contract            | No       | Reference\<[Contract](/medical-api/fhir/resources/contract)>\[]                                                                                                                       | Contract details                                       |

## Search Parameters

| Name          | Type      | Description                                                    | Expression            |
| ------------- | --------- | -------------------------------------------------------------- | --------------------- |
| beneficiary   | reference | Covered party                                                  | Coverage.beneficiary  |
| class-type    | token     | Coverage class (eg. plan, group)                               | Coverage.class.type   |
| class-value   | string    | Value of the class (eg. Plan number, group number)             | Coverage.class.value  |
| dependent     | string    | Dependent number                                               | Coverage.dependent    |
| identifier    | token     | The primary identifier of the insured and the coverage         | Coverage.identifier   |
| patient       | reference | Retrieve coverages for a patient                               | Coverage.beneficiary  |
| payor         | reference | The identity of the insurer or party paying for services       | Coverage.payor        |
| policy-holder | reference | Reference to the policyholder                                  | Coverage.policyHolder |
| status        | token     | The status of the Coverage                                     | Coverage.status       |
| subscriber    | reference | Reference to the subscriber                                    | Coverage.subscriber   |
| type          | token     | The kind of coverage (health plan, auto, Workers Compensation) | Coverage.type         |

## Inherited Properties

| Name              | Required | Type                                                   | Description                                            |
| ----------------- | -------- | ------------------------------------------------------ | ------------------------------------------------------ |
| id                | No       | string                                                 | Logical id of this artifact                            |
| meta              | No       | [Meta](/medical-api/fhir/data-types/meta)              | Metadata about the resource                            |
| implicitRules     | No       | uri                                                    | A set of rules under which this content was created    |
| language          | No       | code                                                   | Language of the resource content                       |
| text              | No       | [Narrative](/medical-api/fhir/data-types/narrative)    | Text summary of the resource, for human interpretation |
| contained         | No       | Resource\[]                                            | Contained, inline Resources                            |
| extension         | No       | [Extension](/medical-api/fhir/data-types/extension)\[] | Additional content defined by implementations          |
| modifierExtension | No       | [Extension](/medical-api/fhir/data-types/extension)\[] | Extensions that cannot be ignored                      |

To view the FHIR specification for this resource, see [Coverage](https://www.hl7.org/fhir/StructureDefinition/Coverage).
