Output representation of the insurance plan eligibility check.
JSON Example
{
"memberId": "0BMxx000000000001",
"contextId": "42ce00ea6a44dcc0d308ba1ea7c4c9bb455bd14bb0405ff03dca1b5371c42cda",
"isSuccess": true,
"planEligibilityDetails": {
"plans": [
{
"planId": "8ckxx000000000001",
"planName": "Group Medical Plan",
"productCategory": "Medical",
"isOptional": false,
"attributes": [
{
"entries": [
{
"key": "AGE_BAND",
"value": "18-25"
}
]
}
],
"coverages": [
{
"planId": "8ckxx000000000002",
"planName": "Dental Coverage",
"productCategory": "Dental",
"isOptional": true,
"attributes": [],
"uiTreatments": [
{
"uiTreatmentType": "disable",
"uiTreatmentTarget": "attribute_picklist_value",
"details": {
"planId": "8ckxx000000000002",
"attributeCode": "COVERAGE_TIER",
"attributeValue": "Family"
}
},
{
"details": {
"attributeId": "0tjxx000000000DAAQ",
"attributeCode": "inCoverageCoinsurance",
"attributeValue": "0",
"stiId": "ref_4316263b_b30e_45fd_ad18_d2830d96f597",
"attributePicklistValue": "CoinsuranceZero",
"attributePicklistValueId": "0v6xx000000000SAAQ"
},
"uiTreatmentTarget": "attribute_picklist_value",
"uiTreatmentType": "hide"
},
{
"details": {
"attributeId": "0tjxx000000000DAAQ",
"attributeCode": "inCoverageCoinsurance",
"attributeValue": "10",
"stiId": "ref_4316263b_b30e_45fd_ad18_d2830d96f597",
"attributePicklistValue": "CoinsuranceTen",
"attributePicklistValueId": "0v6xx000000000TAAQ"
},
"uiTreatmentTarget": "attribute_picklist_value",
"uiTreatmentType": "hide"
}
]
}
],
"uiTreatments": [
{
"details": {
"attributeId": "0tjxx000000000cAAA",
"attributeCode": "onmedFees",
"stiId": "ref_875915aa_61c4_4916_ae58_9fa7e0dec529",
"attributeName": "Out-Network ICU Fees"
},
"uiTreatmentTarget": "attribute",
"uiTreatmentType": "hide"
}
]
}
],
"messages": [
{
"message": "Plan eligibility evaluated successfully.",
"messageType": "INFO"
}
]
}
}
| Property Name | Type | Description | Filter Group and Version | Available Version |
|---|---|---|---|---|
| contextId | String | ID of the context that's used for the eligibility check. | Small, 66.0 | 66.0 |
| errors | Insurance Error[] | List of errors that occurred during the eligibility check. | Small, 66.0 | 66.0 |
| isSuccess | Boolean | Indicates whether the API operation is successful (true) or not (false). | Small, 66.0 | 66.0 |
| memberId | String | ID of the group census member. | Small, 66.0 | 66.0 |
| planEligibilityDetails | Eligible Plan Details | Details of the eligible plans. | Small, 66.0 | 66.0 |