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Amerihealth Caritas Health Plan Structure
Amerihealth Caritas Health Plan Structure
JSON Structure describing one AmeriHealth Caritas health plan brand (state Medicaid managed care, CHIP, D-SNP, LTSS, Marketplace, or behavioral-health line of business). Aggregated from the family-of-plans health plan finder.
Type: object
Properties: 10
Required: 5
Healthcare Health Insurance Managed Care Medicaid Medicare Dual Eligible CHIP LTSS Behavioral Health Pharmacy Benefits Interoperability FHIR CMS SMART on FHIR Patient Access Provider Directory
Amerihealth Caritas Health Plan Structure is a JSON Structure definition published by AmeriHealth Caritas, describing 10 properties, of which 5 are required. It conforms to the https://json-structure.org/schema/v0.json meta-schema.
Properties
brand
state
lineOfBusiness
url
fhirPlanCode
parent
stateAgency
fhirBaseUrl
capabilityStatementUrl
memberCount
Meta-schema: https://json-structure.org/schema/v0.json
JSON Structure
{
"$schema": "https://json-structure.org/schema/v0.json",
"$id": "https://raw.githubusercontent.com/api-evangelist/amerihealth-caritas/refs/heads/main/json-structure/amerihealth-caritas-health-plan-structure.json",
"title": "AmeriHealthCaritasHealthPlan",
"description": "JSON Structure describing one AmeriHealth Caritas health plan brand (state Medicaid managed care, CHIP, D-SNP, LTSS, Marketplace, or behavioral-health line of business). Aggregated from the family-of-plans health plan finder.",
"type": "object",
"required": ["brand", "state", "lineOfBusiness", "url", "fhirPlanCode"],
"properties": {
"brand": {
"type": "string",
"description": "Public brand name (e.g. AmeriHealth Caritas Louisiana, Keystone First, Blue Cross Complete of Michigan, First Choice by Select Health, PerformCare)."
},
"state": {
"type": "string",
"description": "U.S. state or D.C. served by the plan."
},
"lineOfBusiness": {
"type": "string",
"enum": [
"Medicaid Managed Care",
"CHIP",
"D-SNP",
"Dual Eligible",
"LTSS Managed Care",
"Marketplace",
"Behavioral Health"
]
},
"url": {
"type": "string",
"format": "uri",
"description": "Member-facing plan website."
},
"fhirPlanCode": {
"type": "string",
"description": "Four-digit plan code used to route per-plan FHIR endpoints at api-ext.amerihealthcaritas.com (e.g. 0100, 0500, 0900, 1200, 2100, 2400, 2600)."
},
"parent": {
"type": "string",
"description": "Operating parent (AmeriHealth Caritas, jointly owned by Independence Blue Cross and Blue Cross Blue Shield of Michigan)."
},
"stateAgency": {
"type": "string",
"description": "Contracting state Medicaid agency (e.g. PA DHS, LA LDH, NC DHHS, OH ODM, FL AHCA, MI MDHHS, DE DHSS, SC DHHS, NJ DHS, NH DHHS, DC DHCF)."
},
"fhirBaseUrl": {
"type": "string",
"format": "uri",
"description": "Per-plan FHIR base URL, of the form https://api-ext.amerihealthcaritas.com/{fhirPlanCode}/patient-api or .../provider-api"
},
"capabilityStatementUrl": {
"type": "string",
"format": "uri"
},
"memberCount": {
"type": "integer",
"description": "Approximate enrolled members (where publicly disclosed)."
}
}
}
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