Return to our FHIR API Lists:      
FHIR - Patient Resources      
FHIR - Drug Formulary Resources      
FHIR - Provider Resources

Coverage

The Coverage API provides information about the member’s insurance plans.

HL7 FHIR interactions

Read Interaction:

GET [base]/Coverage/[id]

Search-Type Interaction:

GET [base]/Coverage?[parameter=value]

URLs

Sandbox

https://apipreprod.arkbluecross.com/blueware/V1/FHIR/Coverage

Production

https://api.arkbluecross.com/blueware/V1/FHIR/Coverage

Headers

ACCEPT: application/json
AUTHORIZATION: Bearer {ACCESS_TOKEN}

Sample Request

curl -X GET \https://apipreprod.arkbluecross.com/blueware/V1/FHIR/Coverage/450111b2-60ac-4f3d-82da-1d082e860289 \
-H 'Accept: application/json' \
-H 'Authorization: Bearer {your access token}' \

Sample Response

{
    "resourceType": "Coverage",
    "id": "450111b2-60ac-4f3d-82da-1d082e860289",
    "meta": {
        "versionId": "787bd8b5-a800-4a0e-8093-b053d4bd3dad",
        "lastUpdated": "2021-12-02T18:10:41.361+00:00",
        "profile": [
            "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage"
        ]
    },
    "identifier": [
        {
            "type": {
                "coding": [
                    {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "code": "MB"
                    }
                ]
            },
            "value": "AB971144801"
        },
        {
            "type": {
                "coding": [
                    {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "code": "PN"
                    }
                ],
                "text": "8117293"
            },
            "value": "8117293"
        }
    ],
    "status": "cancelled",
    "type": {
        "coding": [
            {
                "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                "code": "HMO",
                "display": "health maintenance organization policy"
            }
        ],
        "text": "A policy for a health plan that provides coverage for health care only through contracted or employed physicians and hospitals located in particular geographic or service areas. HMOs emphasize prevention and early detection of illness. Eligibility to enroll in an HMO is determined by where a covered party lives or works."
    },
    "policyHolder": {
        "type": "Patient",
        "identifier": {
            "type": {
                "coding": [
                    {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "code": "SN"
                    }
                ]
            },
            "system": "Patient/12bf6408-6bbc-4797-8ea3-259d397fba0a",
            "value": "AB971144801"
        }
    },
    "subscriber": {
        "reference": "/V1/FHIR/Patient/12bf6408-6bbc-4797-8ea3-259d397fba0a"
    },
    "subscriberId": "AB971144801",
    "beneficiary": {
        "reference": "/V1/FHIR/Patient/12bf6408-6bbc-4797-8ea3-259d397fba0a"
    },
    "relationship": {
        "coding": [
            {
                "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                "code": "self"
            }
        ],
        "text": "Self"
    },
    "period": {
        "start": "2021-01-01",
        "end": "2021-03-31"
    },
    "payor": [
        {
            "reference": "/V1/FHIR/Organization/ecbf17db-65a1-449f-915d-375e30ba557e"
        }
    ],
    "class": [
        {
            "type": {
                "coding": [
                    {
                        "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code": "plan",
                        "display": "Plan"
                    }
                ],
                "text": "A specific suite of benefits."
            },
            "value": "H6158_002",
            "name": "BlueMedicare Premier (HMO)"
        },
        {
            "type": {
                "coding": [
                    {
                        "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code": "group"
                    }
                ],
                "text": "Group"
            },
            "value": "26158",
            "name": "USABLE HMO INC"
        },
        {
            "type": {
                "coding": [
                    {
                        "system": "https://api.arkbluecross.com/blueware/V1/FHIR/ABCBSProductCodes",
                        "code": "product_cd"
                    }
                ],
                "text": "Product Code"
            },
            "value": "322200000",
            "name": "MEDIPAK ADV HMO"
        }
    ]
}