Marketplace Plan Example is an example object payload from Centers for Medicare and Medicaid Services, with 3 top-level fields. It illustrates the shape of data this provider's APIs accept or return.
{
"title": "Plan Example",
"description": "Example Plan object from CMS Marketplace API",
"example": {
"id": "string",
"name": "string",
"benefits": [
{
"name": {},
"covered": {},
"cost_sharings": {},
"explanation": {},
"exclusions": {},
"has_limits": {},
"limit_unit": {},
"limit_quantity": {}
}
],
"deductibles": [
{
"amount": {},
"csr": {},
"family_cost": {},
"network_tier": {},
"type": {},
"individual": {},
"family": {},
"display_string": {}
}
],
"disease_mgmt_programs": [
{}
],
"has_national_network": false,
"quality_rating": {
"available": false,
"year": 0,
"global_rating": 0,
"global_not_rated_reason": "string",
"clinical_quality_management_rating": 0,
"clinical_quality_management_not_rated_reason": "string",
"enrollee_experience_rating": 0,
"enrollee_experience_not_rated_reason": "string",
"plan_efficiency_rating": 0,
"plan_efficiency_not_rated_reason": "string"
},
"insurance_market": {},
"issuer": {
"eligible_dependents": [
{}
],
"id": "string",
"individual_url": "string",
"name": "string",
"shop_url": "string",
"state": "string",
"toll_free": "string",
"tty": "string"
},
"market": {},
"max_age_child": 0.0,
"metal_level": {},
"moops": [
{
"amount": {},
"csr": {},
"family_cost": {},
"network_tier": {},
"type": {},
"individual": {},
"family": {},
"display_string": {}
}
],
"premium": 0.0,
"premium_w_credit": 0.0,
"ehb_premium": 0.0,
"pediatric_ehb_premium": 0.0,
"aptc_eligible_premium": 0.0,
"guaranteed_rate": false,
"simple_choice": false,
"product_division": "HealthCare",
"specialist_referral_required": false,
"state": "string",
"type": "Indemnity",
"benefits_url": "string",
"brochure_url": "string",
"formulary_url": "string",
"network_url": "string",
"hsa_eligible": false,
"oopc": 0.0,
"suppression_state": "Available",
"tobacco_lookback": 0,
"certification": "Certified",
"network_adequacy": {
"scope": "string",
"networks": {}
},
"sbcs": {
"baby": null,
"diabetes": null,
"fracture": null
},
"rx_3mo_mail_order": false,
"is_ineligible": false,
"covers_nonhyde_abortion": false,
"service_area_id": "string"
}
}