UnitedHealthcare Eligibility Response

{
  "$schema": "https://json-schema.org/draft/2020-12/schema",
  "$id": "https://raw.githubusercontent.com/api-evangelist/unitedhealthcare/refs/heads/main/json-schema/provider-eligibility-response-schema.json",
  "title": "UnitedHealthcare Eligibility Response",
  "description": "Real-time eligibility verification response with coverage details",
  "type": "object",
  "properties": {
    "memberId": {
      "type": "string",
      "description": "UnitedHealthcare member ID"
    },
    "memberName": {
      "type": "string",
      "description": "Member full name"
    },
    "coverageStatus": {
      "type": "string",
      "enum": [
        "ACTIVE",
        "INACTIVE",
        "TERMED"
      ],
      "description": "Coverage status"
    },
    "planName": {
      "type": "string",
      "description": "Insurance plan name"
    },
    "groupNumber": {
      "type": "string",
      "description": "Group number"
    },
    "effectiveDate": {
      "type": "string",
      "format": "date",
      "description": "Coverage effective date"
    },
    "terminationDate": {
      "type": "string",
      "format": "date",
      "description": "Coverage termination date"
    },
    "deductible": {
      "type": "number",
      "description": "Annual deductible amount"
    },
    "deductibleMet": {
      "type": "number",
      "description": "YTD deductible met"
    },
    "outOfPocketMax": {
      "type": "number",
      "description": "Annual out-of-pocket maximum"
    },
    "outOfPocketMet": {
      "type": "number",
      "description": "YTD out-of-pocket met"
    },
    "copay": {
      "type": "number",
      "description": "Copay amount"
    },
    "coinsurance": {
      "type": "number",
      "description": "Coinsurance percentage"
    },
    "networkStatus": {
      "type": "string",
      "enum": [
        "IN_NETWORK",
        "OUT_OF_NETWORK",
        "UNKNOWN"
      ],
      "description": "Network status"
    }
  }
}