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 APIs 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 📡 Source on GitHub

40.4/100 developing ▬ flat Agent 30/100 agent ready saas Full breakdown ↓
scored 2026-08-30 · rubric v0.17.2

AccessSelf serve

1 APIs 1 MCP Servers

Company Healthcare Health Insurance Medicare Advantage FHIR Interoperability Patient Access Provider Directory Drug Formulary

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 How this is scored →
scored 2026-08-30 · rubric v0.17.2

Composite quality — 40.4/100 · developing

Contract Quality 10.5 / 21

Developer Ergonomics 6.8 / 17

Access Clarity 2.2 / 17

Operational Transparency 0.0 / 11

Contract Governance 1.9 / 10

Discoverability 6.5 / 9

Regulatory Posture 10.5 / 15

Agent readiness — 30/100 · agent ready

Machine-Readable Contract 18 / 18

Agentic Access Contract 10 / 10

Documented Reversibility 6 / 6

MCP Server 0 / 12

Machine-Readable Auth 10 / 10

Idempotency 9 / 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 4 / 4

Delegated User Identity 6 / 6

Protected Resource Metadata 0 / 5

Registration Without a Human 0 / 6

Agentic Commerce Surface 0 / 5

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.

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/.

Improve this rating by publishing the missing artifacts — every area above can be raised, and the full rubric is at apis.io/rating/. This rating is computed from github.com/api-evangelist/clevercarehealthplan: open an issue to ask a question, or submit a pull request to add artifacts. Want it done for you? Prioritized profiling — $2,500 →

APIs 3

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

MCP Servers 1

Model Context Protocol servers that expose these APIs to AI agents.

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

MCPServer

AgentSkill

WellKnown

LLMsTxt

Design & Contract 5

Pagination, idempotency, versioning, errors, and events

Conformance

ErrorCatalog

Conventions

Lifecycle

DataModel

Access & Security 4

Authentication, authorization, and security posture

Authentication

OAuthScopes

Compliance

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)

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
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: MCPServer
  url: mcp/clevercarehealthplan-mcp.yml
- 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

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Tools for providers

9 MCP tools reach this

find_providersBrowse and filter every provider in the catalog.
get_provider_artifactsEvery artifact this provider publishes, grouped by type.
get_provider_operationsEvery operation across all of their OpenAPIs — one call instead of parsing every spec.
get_provider_toolsEvery MCP tool they ship, with the operation each wraps.
get_provider_evidenceHow each part of their score was established. Free — the basis for a claim should not sit behind it.
get_provider_ratingPRO — composite, band, trend and facet scores.
apis_io_searchSTART HERE — APIs, providers and tags for one query, each with its total.
resolveTurn a domain, URL or GitHub org into the provider it belongs to.
find_cohortsEvery scored population of providers in the catalog.

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How their score was established

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Clever Care Health Plan

What this lets a business do 1

Kin Score

APIs 3

Clever Care Health Plan Drug Formulary API

Clever Care Health Plan Patient Access API

Clever Care Health Plan Provider Directory API

Open Collections 4

API Collection

Clever Care Health Plan FHIR R4 Drug Formulary API

Clever Care Health Plan FHIR R4 Drug Formulary Patient Access API

Clever Care Health Plan FHIR R4 Drug Formulary Provider Directory API