UnitedHealth Group FHIR Coverage

FHIR R4 Coverage resource representing UnitedHealth Group insurance coverage including plan, group, and benefit period

HealthcareHealth InsuranceFHIRClaimsInteroperabilityFortune 100

Properties

Name	Type	Description
resourceType	string	FHIR resource type
id	string	Resource ID
status	string	Coverage status
type	object	Coverage type coding
subscriber	object	Subscriber reference
subscriberId	string	Subscriber/member ID
beneficiary	object	Beneficiary patient reference
relationship	object	Relationship to subscriber
period	object	Coverage period
payor	array	Payer references
class	array	Plan classification

View JSON Schema on GitHub

JSON Schema

{
  "$schema": "https://json-schema.org/draft/2020-12/schema",
  "$id": "https://raw.githubusercontent.com/api-evangelist/unitedhealth/refs/heads/main/json-schema/optum-fhir-coverage-schema.json",
  "title": "UnitedHealth Group FHIR Coverage",
  "description": "FHIR R4 Coverage resource representing UnitedHealth Group insurance coverage including plan, group, and benefit period",
  "type": "object",
  "properties": {
    "resourceType": {
      "type": "string",
      "enum": [
        "Coverage"
      ],
      "description": "FHIR resource type"
    },
    "id": {
      "type": "string",
      "description": "Resource ID"
    },
    "status": {
      "type": "string",
      "enum": [
        "active",
        "cancelled",
        "draft",
        "entered-in-error"
      ],
      "description": "Coverage status"
    },
    "type": {
      "type": "object",
      "description": "Coverage type coding"
    },
    "subscriber": {
      "type": "object",
      "description": "Subscriber reference"
    },
    "subscriberId": {
      "type": "string",
      "description": "Subscriber/member ID"
    },
    "beneficiary": {
      "type": "object",
      "description": "Beneficiary patient reference"
    },
    "relationship": {
      "type": "object",
      "description": "Relationship to subscriber"
    },
    "period": {
      "type": "object",
      "description": "Coverage period",
      "properties": {
        "start": {
          "type": "string",
          "format": "date"
        },
        "end": {
          "type": "string",
          "format": "date"
        }
      }
    },
    "payor": {
      "type": "array",
      "description": "Payer references",
      "items": {
        "type": "object"
      }
    },
    "class": {
      "type": "array",
      "description": "Plan classification",
      "items": {
        "type": "object",
        "properties": {
          "type": {
            "type": "object"
          },
          "value": {
            "type": "string"
          },
          "name": {
            "type": "string"
          }
        }
      }
    }
  }
}

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