Independence Blue Cross Plans Pricing
Independence Blue Cross exposes HL7 FHIR R4 APIs (Patient Access, Provider Directory, Drug Formulary) to satisfy the CMS Interoperability and Patient Access final rule (CMS-9115-F). API access is free to registered third-party applications: it is governed by SMART on FHIR / OAuth 2.0, member consent, and a CMS-aligned attestation rather than a commercial price tier. There is no list price, no metered rate card, and no paid subscription. Member health-plan products (commercial, Medicare Advantage, CHIP, dental, vision) are sold through employer brokers, the federal/PA Marketplace, CMS, and the Pennsylvania CHIP program and are out of scope for an API pricing surface.
Independence Blue Cross Plans Pricing is the machine-readable pricing-plan profile for Independence Blue Cross on the APIs.io network, conforming to the API Commons Plans specification.
It defines 5 plans, covering freemium and free tiers, with named plans including Developer Sandbox, CMS Patient Access (Production), Provider Directory (Public), Drug Formulary (Public), Transparency In Coverage Machine-Readable Files.
Tagged areas include FHIR, Healthcare, Health Insurance, Medicare Advantage, and CHIP.
Plans
Free sandbox access for testing against the IBX developer portal sandbox services. Sandbox member credentials are issued to registered developers after account activation.
- FHIR R4 sandbox endpoints (Patient Access, Provider Directory, Drug Formulary)
- Synthetic patient credentials issued to registered developers
- Live CapabilityStatements for all three APIs
- SMART App Launch / OAuth 2.0 / PKCE test flows
- No commercial cost
Production access for third-party member-facing apps under CMS-9115-F. Requires developer registration via https://devportal.ibx.com/cmssignin/, app attestation, and SMART on FHIR / OAuth 2.0 with member consent. In scope for Independence Medicare Advantage and Keystone HMO CHIP members. No fees are charged to the application or member.
- Member-consented FHIR R4 read access
- SMART App Launch 1.0.0 / OAuth 2.0 / PKCE
- CARIN BB / Da Vinci PDex / US Core 3.1.1 conformance
- No commercial price; access is regulatory-free
- Member consent revocation honored at any time
Public Da Vinci PDex Plan-Net Provider Directory FHIR API. No authentication required; intended for member-facing apps, brokers, care navigation tools, and price/transparency apps.
- Practitioner, PractitionerRole, Organization, OrganizationAffiliation
- Location, HealthcareService, InsurancePlan, Endpoint
- Da Vinci PDex Plan-Net IG conformance
- Public; no authentication
Public Da Vinci US Drug Formulary (USDF) FHIR API exposing the IBX covered drug list, tier information, and prior authorization indicators. No authentication required.
- MedicationKnowledge and List resources
- Da Vinci USDF IG conformance
- Public; no authentication
Monthly machine-readable JSON files of in-network rates, allowed amounts, and prescription drug pricing for three IBX-operated carrier brands (Keystone Health Plan East, QCC Insurance Company, Independence Assurance Co, Inc.). Public bulk download surface driven by the federal Transparency in Coverage rule.
- In-network negotiated rates per carrier brand
- Out-of-network allowed amounts per carrier brand
- Prescription drug pricing files
- Monthly refresh cadence
- Public; no authentication