Clever Care Health Plan website screenshot

Clever Care Health Plan

Clever Care Health Plan is a California Medicare Advantage (HMO and HMO C-SNP) insurer that blends Eastern and Western medicine for seniors. For developers it publishes an HL7 FHIR R4 (4.0.1) API implementing the CMS Interoperability and Patient Access final rule (CMS-9115-F): a secured Patient Access API (Patient, Coverage, and CARIN Blue Button ExplanationOfBenefit) protected with SMART-on-FHIR OAuth 2.0 / OpenID Connect, plus public, rate-limited Provider Directory and Drug Formulary APIs. The FHIR server runs on WSO2 Open Healthcare with a developer portal for app registration and API subscription.

Clever Care Health Plan publishes 3 API contracts indexed on the APIs.io network: Drug Formulary API, Patient Access API, and Provider Directory API. Tagged areas include Company, Healthcare, Health Insurance, Medicare Advantage, and FHIR.

Clever Care Health Plan’s developer surface includes getting-started guide, documentation, API reference, signup flow, authentication, and 19 more developer resources.

🌐 Visit website📡 Profile data on GitHub
45.0/100 developing ▬ flat Agent 26/100 agent aware Front door AI 1/6 silent saas Full breakdown ↓
scored 2026-10-31 · rubric v0.25.0 · Show this score on your site →
AccessSelf serve
1 published contract 3 Agent Skills
CompanyHealthcareHealth InsuranceMedicare AdvantageFHIRInteroperabilityPatient AccessProvider DirectoryDrug FormularyCMS-9115-F

What this lets a business do 1

Business capabilities this provider's published APIs can perform, derived from its own contracts. Browse all capabilities →

Health Information Management
BC-2900
Patient Access
GET /ExplanationOfBenefit

Kin Score

Kin Score Kin Score How this is scored →
scored 2026-10-31 · rubric v0.25.0
Composite quality — 45.0/100 · developing
Contract Quality 9.5 / 21
Developer Ergonomics 8.8 / 17
Access Clarity 7.2 / 17
Operational Transparency 0.0 / 11
Contract Governance 1.9 / 10
Discoverability 5.6 / 9
Regulatory Posture 8.1 / 15
Agent readiness — 26/100 · agent aware
Machine-Readable Contract 18 / 18
Agentic Access Contract 10 / 10
Documented Reversibility 0 / 6
MCP Server 0 / 12
Machine-Readable Auth 10 / 10
Idempotency 0 / 9
Stable Error Semantics 8 / 8
Request/Response Examples 0 / 7
Rate-Limit Signaling 0 / 7
Typed Event Surface 0 / 6
Agent Skills 5 / 5
Well-Known Catalog 0 / 4
Consent & Bot Identity 0 / 3
A2A Agent Card 0 / 8
Dry-Run / Simulate Mode 0 / 4
Delegated User Identity 6 / 6
Protected Resource Metadata 0 / 5
Registration Without a Human 0 / 6
Agentic Commerce Well-Known Document 0 / 5
Pagination 5 / 5
Distinct Operations 3 / 3
Regulatory Posture applies to this provider. Its tags matched the Health regime, so Regulatory Posture carries 15 points of the composite. If this regime is wrong for your business, say so on your provider repo — the applicability map is public and we will correct it.
Create-or-Update Ergonomics could not be measured. We hold no machine-readable contract for this provider to read, so there is nothing to measure a write surface against. Excluded rather than scored zero: never-measured and measured-empty are different facts. Publishing an OpenAPI is what makes this facet — and several others — scorable at all.
The six quality facets above are damped to 85 points between them, because the conditional facet above carries the other 15. That is why each facet's contribution is shown against a damped maximum: raising a quality facet moves the composite by 85% of its nominal weight, not 100%. The full arithmetic is at apis.io/rating/.
Show this score on your site. Kin Score badge preview for Clever Care Health Plan It updates itself when the score changes. Paste this where you link to your API docs: 
<a href="https://apis.io/providers/clevercarehealthplan/"><img src="https://apis.io/badge/clevercarehealthplan/card.svg" alt="Clever Care Health Plan on APIs.io — Kin Score by API Evangelist"></a>
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Agent readiness — checks not met, largest first (exact, from this profile):
  • MCP Server +12 pts — deployment.mode + probe verdict on the mcp/ manifest, not the pointer; an unprobed slug falls back to authorship
  • Idempotency +9 pts — OpenAPI mutating operations declare an idempotency key — a header, a request-body property, or a named de-duplication token whose own description says so (verified); else common[].type matches /idempoten/i (documented)
  • A2A Agent Card +8 pts — a2a/-a2a.yml manifest, graded on conformance.grade against A2A 1.0.0
  • Rate-Limit Signaling +7 pts — OpenAPI responses document X-RateLimit-* / RateLimit headers (verified), else a rate_limits artifact or RateLimits link (documented)
  • Request/Response Examples +7 pts — share of operations carrying request/response examples; else an Examples / Code Samples link
  • Registration Without a Human +6 pts — a `registration_endpoint` in the served RFC 8414 / OIDC discovery document
7 more unmet checks in the Agent Readiness table above.
Kin Score — facets with the most composite points still available (weight × headroom):
Each check links to what satisfies it. Publish the artifact, or tell us where it already lives, and the score moves on the next scoring run.
Improve this rating by publishing the missing artifacts — every area above can be raised, and the full rubric is at apis.io/rating/. Every facet and dimension name above is a link: it opens that measurement's own page — what it means, the exact checks that feed it, how the whole catalog distributes on it, and the providers at the top of it. This rating is computed from the provider profile at artifacts.apis.io/clevercarehealthplan/apis.yml: open an issue on github.com/api-evangelist/clevercarehealthplan to ask a question or point us at an artifact you publish. Submit an artifact on GitHub — free → Manage your own listing — the Influence plan, $499/mo →

Standards implemented 1

Standards this provider implements or carries. De facto ones are profiled and measured by the API Commons; formal ones come from the standards directory and are linked by the provider's own tags. The evidence column says how each claim was established — not that it was made.

HL7 FHIR
tagged — the provider's own APIs.json carries the standard as a tag; implementation not verified

APIs 3

Individual APIs this provider publishes, each with its own machine-readable definition.

Clever Care Health Plan Drug Formulary API

Public (rate limited) drug formulary resources

Clever Care Health Plan Patient Access API

Secured (OpenID Connect / OAuth 2.0) member data resources

Clever Care Health Plan Provider Directory API

Public (rate limited) provider directory resources

Open Collections 3

Open, tool-agnostic API collections (OpenAPI-derived and Bruno).

Clever Care Health Plan FHIR R4 Drug Formulary API

OPEN COLLECTION

Clever Care Health Plan FHIR R4 Drug Formulary Patient Access API

OPEN COLLECTION

Clever Care Health Plan FHIR R4 Drug Formulary Provider Directory API

OPEN COLLECTION

Agent Skills 3

Packaged agent skills for driving this provider's APIs from an AI assistant.

Clever Care drug formulary lookup

AGENT SKILL

Clever Care patient access (claims and coverage)

AGENT SKILL

Clever Care provider directory search

AGENT SKILL

OpenAPI Overlays 1

Overlays applied on top of this provider's contracts. Each card says who wrote it: a document the provider publishes, or one API Evangelist derived or generated.

Clevercarehealthplan Fhir Overlay

2 actions · update · clevercarehealthplan-fhir-openapi.yml

DERIVED

Security Posture 2

Authentication, domain security, vulnerability disclosure, and trust-center signals.

Clevercarehealthplan Authentication

oauth2 · 1 scheme

SECURITY

Clevercarehealthplan Domain Security

TLSv1.3 · HSTS · DMARC

SECURITY

Scopes 1

OAuth scopes governing access to this provider's APIs.

Clevercarehealthplan Scopes

4 scopes · authorizationCode/clientCredentials

4 scopes

SCOPES

Agentic Access 1

Recommended x-agentic-access execution contracts for AI agents.

Clevercarehealthplan Agentic Access

27 operations

27 operations · 0 acting

AGENTIC

Resources

Get Started 3

Portal, sign-up, and the first successful call

DeveloperPortal
DeveloperPortal
 GettingStarted
GettingStarted
 SignUp
SignUp

Documentation 2

Reference material describing how the API behaves

Documentation
Documentation
 APIReference
APIReference

Agent Surfaces 5

MCP servers, agent skills, and machine-readable catalogs

AgenticAccess
AgenticAccess
 X-MCPServerCandidate
X-MCPServerCandidate
 AgentSkill
AgentSkill
 WellKnown
WellKnown
 LLMsTxt
LLMsTxt

Design & Contract 5

Pagination, idempotency, versioning, errors, and events

Conformance
Conformance
 ErrorCatalog
ErrorCatalog
 Conventions
Conventions
 Lifecycle
Lifecycle
 DataModel
DataModel

Access & Security 4

Authentication, authorization, and security posture

Authentication
Authentication
 OAuthScopes
OAuthScopes
 Compliance
Compliance
 DomainSecurity
DomainSecurity

Commercial 2

Pricing, plans, and the legal terms of use

PrivacyPolicy
PrivacyPolicy
 TermsOfService
TermsOfService

Company 1

The organization behind the API

Website
Website

Other 2

Properties that don't map to a standard resource type

CapabilityMap
CapabilityMap
 Overlay
Overlay

Source (apis.yml)

apis.yml Raw ↑ 
aid: clevercarehealthplan
deliveryModel:
  model: saas
  open_source: false
  commercial: true
  callable_host: true
  label: Hosted service · you call their endpoint
  confidence: high
  source:
  - openapi
  - pricing
  generated: '2026-08-28'
  method: derived
accessModel:
  pricing: unknown
  onboarding: self-serve
  trial: false
  try_now: false
  public: false
  label: Self-serve signup
  confidence: medium
  source:
  - authentication
  generated: '2026-07-22'
  method: derived
image: https://kinlane-images.s3.amazonaws.com/shared/apis-json/icons/clevercarehealthplan.png
name: Clever Care Health Plan
description: 'Clever Care Health Plan is a California Medicare Advantage (HMO and HMO C-SNP) insurer that blends Eastern and
  Western medicine for seniors. For developers it publishes an HL7 FHIR R4 (4.0.1) API implementing the CMS Interoperability
  and Patient Access final rule (CMS-9115-F): a secured Patient Access API (Patient, Coverage, and CARIN Blue Button ExplanationOfBenefit)
  protected with SMART-on-FHIR OAuth 2.0 / OpenID Connect, plus public, rate-limited Provider Directory and Drug Formulary
  APIs. The FHIR server runs on WSO2 Open Healthcare with a developer portal for app registration and API subscription.'
url: https://raw.githubusercontent.com/api-evangelist/clevercarehealthplan/refs/heads/main/apis.yml
x-type: company
x-source: vc-portfolio
x-backed-by:
- norwest-venture-partners
x-tier: enriched
x-tier-reason: fhir-api-found
specificationVersion: '0.23'
created: '2026-07-17'
modified: '2026-07-18'
tags:
- Company
- Healthcare
- Health Insurance
- Medicare Advantage
- FHIR
- Interoperability
- Patient Access
- Provider Directory
- Drug Formulary
- CMS-9115-F
maintainers:
- FN: Kin Lane
  email: kin@apievangelist.com
- FN: APIs.json
  email: info@apis.io
apis:
- aid: clevercarehealthplan:clevercarehealthplan-drug-formulary-api
  name: Clever Care Health Plan Drug Formulary API
  description: Public (rate limited) drug formulary resources
  humanURL: https://clevercarehealthplan.com/fhir-api-developer-resources/
  baseURL: https://fhir.clevercarehealthplan.com/r4
  tags:
  - Drug Formulary
  properties:
  - type: OpenAPI
    url: openapi/clevercarehealthplan-drug-formulary-api-openapi.yml
  - type: Documentation
    url: https://fhir-portal.clevercarehealthplan.com/api-docs/
  - type: APIReference
    url: https://fhir-portal.clevercarehealthplan.com/api-docs/
- aid: clevercarehealthplan:clevercarehealthplan-patient-access-api
  name: Clever Care Health Plan Patient Access API
  description: Secured (OpenID Connect / OAuth 2.0) member data resources
  humanURL: https://clevercarehealthplan.com/fhir-api-developer-resources/
  baseURL: https://fhir.clevercarehealthplan.com/r4
  tags:
  - Patient Access
  properties:
  - type: OpenAPI
    url: openapi/clevercarehealthplan-patient-access-api-openapi.yml
  - type: Documentation
    url: https://fhir-portal.clevercarehealthplan.com/api-docs/
  - type: APIReference
    url: https://fhir-portal.clevercarehealthplan.com/api-docs/
- aid: clevercarehealthplan:clevercarehealthplan-provider-directory-api
  name: Clever Care Health Plan Provider Directory API
  description: Public (rate limited) provider directory resources
  humanURL: https://clevercarehealthplan.com/fhir-api-developer-resources/
  baseURL: https://fhir.clevercarehealthplan.com/r4
  tags:
  - Provider Directory
  properties:
  - type: OpenAPI
    url: openapi/clevercarehealthplan-provider-directory-api-openapi.yml
  - type: Documentation
    url: https://fhir-portal.clevercarehealthplan.com/api-docs/
  - type: APIReference
    url: https://fhir-portal.clevercarehealthplan.com/api-docs/
common:
- type: CapabilityMap
  url: capabilities/clevercarehealthplan-capability-edges.yml
  name: Clever Care Health Plan Business Capability Map
- type: Overlay
  url: overlays/clevercarehealthplan-fhir-overlay.yaml
- type: DeveloperPortal
  url: https://fhir-portal.clevercarehealthplan.com/devportal
- type: GettingStarted
  url: https://clevercarehealthplan.com/fhir-api-developer-resources/
- type: Documentation
  url: https://fhir-portal.clevercarehealthplan.com/api-docs/
- type: APIReference
  url: https://fhir-portal.clevercarehealthplan.com/api-docs/
- type: SignUp
  url: https://fhir-portal.clevercarehealthplan.com/devportal
- type: Authentication
  url: authentication/clevercarehealthplan-authentication.yml
- type: OAuthScopes
  url: scopes/clevercarehealthplan-scopes.yml
- type: AgenticAccess
  url: agentic-access/clevercarehealthplan-agentic-access.yml
- type: X-MCPServerCandidate
  url: mcp/clevercarehealthplan-mcp.yml
  note: 'Renamed from MCPServer 2026-09-03 (roadmap#247): the manifest self-describes as status: candidate — a tool list derived
    from the published API contracts, not an existing server. The scorer already read the manifest and reported mcp_server
    correctly; the MCPServer type was crediting the artifact-type surfaces with a server that does not exist.'
- type: AgentSkill
  url: skills/_index.yml
- type: WellKnown
  url: well-known/clevercarehealthplan-well-known.yml
- type: LLMsTxt
  url: llms/clevercarehealthplan-llms.txt
- type: Conformance
  url: conformance/clevercarehealthplan-conformance.yml
- type: Compliance
  url: https://clevercarehealthplan.com/medicare-compliance/
- type: ErrorCatalog
  url: errors/clevercarehealthplan-problem-types.yml
- type: Conventions
  url: conventions/clevercarehealthplan-conventions.yml
- type: Lifecycle
  url: lifecycle/clevercarehealthplan-lifecycle.yml
- type: DataModel
  url: data-model/clevercarehealthplan-data-model.yml
- type: DomainSecurity
  url: security/clevercarehealthplan-domain-security.yml
- type: PrivacyPolicy
  url: https://clevercarehealthplan.com/privacy-practices/
- type: TermsOfService
  url: https://clevercarehealthplan.com/terms-of-use/
- type: Website
  url: https://clevercarehealthplan.com
x-enrichment:
  date: '2026-07-19'
  status: backfilled
  pass: local-v1
  note: backfilled from .gitignore signal + verified work evidence

Clever Care Health Plan API — frequently asked questions

Does Clever Care Health Plan have an API?

Yes. APIs.io lists 3 APIs from Clever Care Health Plan, including Clever Care Health Plan Drug Formulary API, Clever Care Health Plan Patient Access API and Clever Care Health Plan Provider Directory API.

Is there an OpenAPI specification for the Clever Care Health Plan API?

Yes. APIs.io indexes 3 OpenAPI specifications for Clever Care Health Plan, each linked for download from this page.

How do I authenticate with the Clever Care Health Plan API?

Clever Care Health Plan documents its authentication (oauth2 · 1 scheme). The details are profiled on APIs.io as Clevercarehealthplan Authentication.

Is the Clever Care Health Plan API ready for AI agents?

Clever Care Health Plan has a Kin Score of 45.0 out of 100 (developing) and an Agent Readiness score of 25.5 (agent-aware), scored by API Evangelist on 2026-10-31.

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