Valueset coverage-type

pay

http://terminology.hl7.org/CodeSystem/coverage-selfpay

Pay

An individual or organization is paying directly for goods and services.

EHCPOL

http://terminology.hl7.org/CodeSystem/v3-ActCode

extended healthcare

Private insurance policy that provides coverage in addition to other policies (e.g. in addition to a Public Healthcare insurance policy).

HSAPOL

http://terminology.hl7.org/CodeSystem/v3-ActCode

health spending account

Insurance policy that provides for an allotment of funds replenished on a periodic (e.g. annual) basis. The use of the funds under this policy is at the discretion of the covered party.

AUTOPOL

http://terminology.hl7.org/CodeSystem/v3-ActCode

automobile

Insurance policy for injuries sustained in an automobile accident. Will also typically covered non-named parties to the policy

COL

http://terminology.hl7.org/CodeSystem/v3-ActCode

collision coverage policy

Definition: An automobile insurance policy under which the insurance company will cover the cost of damages to an automobile owned by the named insured that are caused by accident or intentionally by another party.

UNINSMOT

http://terminology.hl7.org/CodeSystem/v3-ActCode

uninsured motorist policy

Definition: An automobile insurance policy under which the insurance company will indemnify a loss for which another motorist is liable if that motorist is unable to pay because he or she is uninsured. Coverage under the policy applies to bodily injury damages only. Injuries to the covered party caused by a hit-and-run driver are also covered.

PUBLICPOL

http://terminology.hl7.org/CodeSystem/v3-ActCode

public healthcare

Insurance policy funded by a public health system such as a provincial or national health plan. Examples include BC MSP (British Columbia Medical Services Plan) OHIP (Ontario Health Insurance Plan)

DENTPRG

http://terminology.hl7.org/CodeSystem/v3-ActCode

dental program

Definition: A public or government health program that administers and funds coverage for dental care to assist program eligible who meet financial and health status criteria.

DISEASEPRG

http://terminology.hl7.org/CodeSystem/v3-ActCode

public health program

Definition: A public or government health program that administers and funds coverage for health and social services to assist program eligible who meet financial and health status criteria related to a particular disease. Example: Reproductive health

CANPRG

http://terminology.hl7.org/CodeSystem/v3-ActCode

women's cancer detection program

Definition: A program that provides low-income

ENDRENAL

http://terminology.hl7.org/CodeSystem/v3-ActCode

end renal program

Definition: A public or government program that administers publicly funded coverage of kidney dialysis and kidney transplant services. Example: In the U.S.

HIVAIDS

http://terminology.hl7.org/CodeSystem/v3-ActCode

HIV-AIDS program

Definition: Government administered and funded HIV-AIDS program for beneficiaries meeting financial and health status criteria. Administration

MANDPOL

http://terminology.hl7.org/CodeSystem/v3-ActCode

mandatory health program

mandatory health program

MENTPRG

http://terminology.hl7.org/CodeSystem/v3-ActCode

mental health program

Definition: Government administered and funded mental health program for beneficiaries meeting financial and mental health status criteria. Administration

SAFNET

http://terminology.hl7.org/CodeSystem/v3-ActCode

safety net clinic program

Definition: Government administered and funded program to support provision of care to underserved populations through safety net clinics. Example: In the U.S.

SUBPRG

http://terminology.hl7.org/CodeSystem/v3-ActCode

substance use program

Definition: Government administered and funded substance use program for beneficiaries meeting financial

SUBSIDIZ

http://terminology.hl7.org/CodeSystem/v3-ActCode

subsidized health program

Definition: A government health program that provides coverage for health services to persons meeting eligibility criteria such as income

SUBSIDMC

http://terminology.hl7.org/CodeSystem/v3-ActCode

subsidized managed care program

Definition: A government health program that provides coverage through managed care contracts for health services to persons meeting eligibility criteria such as income

SUBSUPP

http://terminology.hl7.org/CodeSystem/v3-ActCode

subsidized supplemental health program

Definition: A government health program that provides coverage for health services to persons meeting eligibility criteria for a supplemental health policy or program such as income

WCBPOL

http://terminology.hl7.org/CodeSystem/v3-ActCode

worker's compensation

Insurance policy for injuries sustained in the work place or in the course of employment.

DENTAL

http://terminology.hl7.org/CodeSystem/v3-ActCode

dental care policy

Definition: A health insurance policy that that covers benefits for dental services.

DISEASE

http://terminology.hl7.org/CodeSystem/v3-ActCode

disease specific policy

Definition: A health insurance policy that covers benefits for healthcare services provided for named conditions under the policy

DRUGPOL

http://terminology.hl7.org/CodeSystem/v3-ActCode

drug policy

Definition: A health insurance policy that covers benefits for prescription drugs

HIP

http://terminology.hl7.org/CodeSystem/v3-ActCode

health insurance plan policy

Definition: A health insurance policy that covers healthcare benefits by protecting covered parties from medical expenses arising from health conditions

LTC

http://terminology.hl7.org/CodeSystem/v3-ActCode

long term care policy

Definition: An insurance policy that covers benefits for long-term care services people need when they no longer can care for themselves. This may be due to an accident

MCPOL

http://terminology.hl7.org/CodeSystem/v3-ActCode

managed care policy

Definition: Government mandated program providing coverage

POS

http://terminology.hl7.org/CodeSystem/v3-ActCode

point of service policy

Definition: A policy for a health plan that has features of both an HMO and a FFS plan. Like an HMO

HMO

http://terminology.hl7.org/CodeSystem/v3-ActCode

health maintenance organization policy

Definition: A policy for a health plan that provides coverage for health care only through contracted or employed physicians and hospitals located in particular geographic or service areas. HMOs emphasize prevention and early detection of illness. Eligibility to enroll in an HMO is determined by where a covered party lives or works.

PPO

http://terminology.hl7.org/CodeSystem/v3-ActCode

preferred provider organization policy

Definition: A network-based

MENTPOL

http://terminology.hl7.org/CodeSystem/v3-ActCode

mental health policy

Definition: A health insurance policy that covers benefits for mental health services and prescriptions.

SUBPOL

http://terminology.hl7.org/CodeSystem/v3-ActCode

substance use policy

Definition: A health insurance policy that covers benefits for substance use services.

VISPOL

http://terminology.hl7.org/CodeSystem/v3-ActCode

vision care policy

Definition: Set of codes for a policy that provides coverage for health care expenses arising from vision services. A health insurance policy that covers benefits for vision care services

DIS

http://terminology.hl7.org/CodeSystem/v3-ActCode

disability insurance policy

Definition: An insurance policy that provides a regular payment to compensate for income lost due to the covered party's inability to work because of illness or injury.

EWB

http://terminology.hl7.org/CodeSystem/v3-ActCode

employee welfare benefit plan policy

Definition: An insurance policy under a benefit plan run by an employer or employee organization for the purpose of providing benefits other than pension-related to employees and their families. Typically provides health-related benefits

FLEXP

http://terminology.hl7.org/CodeSystem/v3-ActCode

flexible benefit plan policy

Definition: An insurance policy that covers qualified benefits under a Flexible Benefit plan such as group medical insurance

LIFE

http://terminology.hl7.org/CodeSystem/v3-ActCode

life insurance policy

Definition: A policy under which the insurer agrees to pay a sum of money upon the occurrence of the covered partys death. In return

ANNU

http://terminology.hl7.org/CodeSystem/v3-ActCode

annuity policy

Definition: A policy that

TLIFE

http://terminology.hl7.org/CodeSystem/v3-ActCode

term life insurance policy

Definition: Life insurance under which the benefit is payable only if the insured dies during a specified period. If an insured dies during that period

ULIFE

http://terminology.hl7.org/CodeSystem/v3-ActCode

universal life insurance policy

Definition: Life insurance under which the benefit is payable upon the insuredaTMs death or diagnosis of a terminal illness. If an insured dies during that period

PNC

http://terminology.hl7.org/CodeSystem/v3-ActCode

property and casualty insurance policy

Definition: A type of insurance that covers damage to or loss of the policyholderaTMs property by providing payments for damages to property damage or the injury or death of living subjects. The terms "casualty" and "liability" insurance are often used interchangeably. Both cover the policyholder's legal liability for damages caused to other persons and/or their property.

REI

http://terminology.hl7.org/CodeSystem/v3-ActCode

reinsurance policy

Definition: An agreement between two or more insurance companies by which the risk of loss is proportioned. Thus the risk of loss is spread and a disproportionately large loss under a single policy does not fall on one insurance company. Acceptance by an insurer

SURPL

http://terminology.hl7.org/CodeSystem/v3-ActCode

surplus line insurance policy

Definition: A risk or part of a risk for which there is no normal insurance market available. Insurance written by unauthorized insurance companies. Surplus lines insurance is insurance placed with unauthorized insurance companies through licensed surplus lines agents or brokers.

UMBRL

http://terminology.hl7.org/CodeSystem/v3-ActCode

umbrella liability insurance policy

Definition: A form of insurance protection that provides additional liability coverage after the limits of your underlying policy are reached. An umbrella liability policy also protects you (the insured) in many situations not covered by the usual liability policies.

CHAR

http://terminology.hl7.org/CodeSystem/v3-ActCode

charity program

Definition: A program that covers the cost of services provided directly to a beneficiary who typically has no other source of coverage without charge.

CRIME

http://terminology.hl7.org/CodeSystem/v3-ActCode

crime victim program

Definition: A program that covers the cost of services provided to crime victims for injuries or losses related to the occurrence of a crime.

EAP

http://terminology.hl7.org/CodeSystem/v3-ActCode

employee assistance program

Definition: An employee assistance program is run by an employer or employee organization for the purpose of providing benefits and covering all or part of the cost for employees to receive counseling

GOVEMP

http://terminology.hl7.org/CodeSystem/v3-ActCode

government employee health program

Definition: A set of codes used to indicate a government program that is an organized structure for administering and funding coverage of a benefit package for covered parties meeting eligibility criteria

HIRISK

http://terminology.hl7.org/CodeSystem/v3-ActCode

high risk pool program

Definition: A government program that provides health coverage to individuals who are considered medically uninsurable or high risk

IND

http://terminology.hl7.org/CodeSystem/v3-ActCode

indigenous peoples health program

Definition: Services provided directly and through contracted and operated indigenous peoples health programs. Example: Indian Health Service in the U.S.

MILITARY

http://terminology.hl7.org/CodeSystem/v3-ActCode

military health program

Definition: A government program that provides coverage for health services to military personnel

RETIRE

http://terminology.hl7.org/CodeSystem/v3-ActCode

retiree health program

Definition: A government mandated program with specific eligibility requirements based on premium contributions made during employment

SOCIAL

http://terminology.hl7.org/CodeSystem/v3-ActCode

social service program

Definition: A social service program funded by a public or governmental entity. Example: Programs providing habilitation

VET

http://terminology.hl7.org/CodeSystem/v3-ActCode

veteran health program

Definition: Services provided directly and through contracted and operated veteran health programs.