Test Sandbox APIs
Using Data
API Reference
Capability Statement

Coverage

The Coverage API provides information about the member’s Humana insurance plans in accordance with the R4 FHIR specification.

URL


Headers

ACCEPT application/json
AUTHORIZATION Bearer {ACCESS_TOKEN}

Sample Request

curl -X GET \
https://sandbox-fhir.humana.com/api/Coverage \
-H 'Accept: application/json' \
-H 'Authorization: Bearer {your access token}' \
curl -X GET \
https://fhir.humana.com/api/Coverage \
-H 'Accept: application/json' \
-H 'Authorization: Bearer {your access token}' \

Sample Response


{
    "resourceType": "Bundle",
    "type": "searchset",
    "timestamp": "2025-01-15T04:26:09.921+00:00",
    "meta": {
        "lastUpdated": "2025-01-15T04:26:09.921+00:00",
        "versionId": "d2773722-3f3c-4b72-9710-58e433fd3de8"
    },
    "entry": [
        {
            "fullUrl": "https://sandbox-fhir.humana.com/api/Coverage/7538b5f63216b3289a883ea25edfd5ddf80f1a9226a10c9bc7acf0e6a57fc238",
            "search": {
                "mode": "match"
            },
            "resource": {
                "resourceType": "Coverage",
                "id": "7538b5f63216b3289a883ea25edfd5ddf80f1a9226a10c9bc7acf0e6a57fc238",
                "identifier": [
                    {
                        "type": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code": "SN",
                                    "display": "Subscriber Number"
                                }
                            ]
                        },
                        "system": "https://fhir.humana.com/documentation/glossary/memberIdBase",
                        "value": "H71681904"
                    },
                    {
                        "system": "https://fhir.humana.com/documentation/glossary/memberIDDependentCode",
                        "value": "00"
                    },
                    {
                        "type": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code": "MA",
                                    "display": "Patient Medicaid number"
                                }
                            ]
                        },
                        "value": "87281847",
                        "assigner": {
                            "display": "MO"
                        }
                    }
                ],
                "status": "active",
                "type": {
                    "coding": [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                            "code": "VISPOL",
                            "display": "vision care policy"
                        }
                    ]
                },
                "subscriberId": "H71681904",
                "beneficiary": {
                    "reference": "Patient/5a357166754b59777137634248494434654c336d68773d3d"
                },
                "dependent": "00",
                "relationship": {
                    "coding": [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                            "code": "self",
                            "display": "self"
                        }
                    ]
                },
                "period": {
                    "start": "2011-07-01"
                },
                "payor": [
                    {
                        "reference": "Organization/67c29814ee1eb20b1be2c2c692cfdd2cfb84e919a867998eccd1762b7b785780",
                        "identifier": {
                            "system": "https://fhir.humana.com/documentation/glossary/platform-code",
                            "value": "LV"
                        },
                        "display": "Humana"
                    }
                ],
                "class": [
                    {
                        "type": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                                    "code": "group",
                                    "display": "group"
                                }
                            ]
                        },
                        "value": "327454"
                    }
                ],
                "meta": {
                    "versionId": "b4d78f44-ac58-4236-9078-7485ff0713b6",
                    "lastUpdated": "2025-01-15T03:59:48.004+00:00"
                }
            }
        },
        {
            "fullUrl": "https://sandbox-fhir.humana.com/api/Coverage/48a076c2ab048808ae7c8aed0432ea6facfa3a6f097359eab11d255b9a7f589b",
            "search": {
                "mode": "match"
            },
            "resource": {
                "resourceType": "Coverage",
                "id": "48a076c2ab048808ae7c8aed0432ea6facfa3a6f097359eab11d255b9a7f589b",
                "identifier": [
                    {
                        "type": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code": "SN",
                                    "display": "Subscriber Number"
                                }
                            ]
                        },
                        "system": "https://fhir.humana.com/documentation/glossary/memberIdBase",
                        "value": "915634980"
                    },
                    {
                        "system": "https://fhir.humana.com/documentation/glossary/memberIDDependentCode",
                        "value": "01"
                    },
                    {
                        "type": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code": "MA",
                                    "display": "Patient Medicaid number"
                                }
                            ]
                        },
                        "value": "87281847",
                        "assigner": {
                            "display": "MO"
                        }
                    }
                ],
                "status": "active",
                "type": {
                    "coding": [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                            "code": "DENTAL",
                            "display": "dental care policy"
                        }
                    ]
                },
                "subscriberId": "915634980",
                "beneficiary": {
                    "reference": "Patient/5a357166754b59777137634248494434654c336d68773d3d"
                },
                "dependent": "01",
                "relationship": {
                    "coding": [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                            "code": "self",
                            "display": "self"
                        }
                    ]
                },
                "period": {
                    "start": "2024-01-01"
                },
                "payor": [
                    {
                        "reference": "Organization/67c29814ee1eb20b1be2c2c692cfdd2cfb84e919a867998eccd1762b7b785780",
                        "identifier": {
                            "system": "https://fhir.humana.com/documentation/glossary/platform-code",
                            "value": "EM"
                        },
                        "display": "Humana"
                    }
                ],
                "class": [
                    {
                        "type": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                                    "code": "group",
                                    "display": "group"
                                }
                            ]
                        },
                        "value": "675717"
                    }
                ],
                "network": "HumanaDental Medicare",
                "meta": {
                    "versionId": "b277af1c-1b6f-4579-b4fb-1f73df4d70d9",
                    "lastUpdated": "2025-01-15T03:59:48.096+00:00"
                }
            }
        },
        {
            "fullUrl": "https://sandbox-fhir.humana.com/api/Coverage/c7eb910ce365c80092a21afe2e1ecb3d87d67abb20baf97d49a8d50fd0f952f4",
            "search": {
                "mode": "match"
            },
            "resource": {
                "resourceType": "Coverage",
                "id": "c7eb910ce365c80092a21afe2e1ecb3d87d67abb20baf97d49a8d50fd0f952f4",
                "identifier": [
                    {
                        "type": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code": "SN",
                                    "display": "Subscriber Number"
                                }
                            ]
                        },
                        "system": "https://fhir.humana.com/documentation/glossary/memberIdBase",
                        "value": "915634980"
                    },
                    {
                        "system": "https://fhir.humana.com/documentation/glossary/memberIDDependentCode",
                        "value": "01"
                    },
                    {
                        "type": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code": "MA",
                                    "display": "Patient Medicaid number"
                                }
                            ]
                        },
                        "value": "87281847",
                        "assigner": {
                            "display": "MO"
                        }
                    }
                ],
                "status": "active",
                "type": {
                    "coding": [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                            "code": "DENTAL",
                            "display": "dental care policy"
                        }
                    ]
                },
                "subscriberId": "915634980",
                "beneficiary": {
                    "reference": "Patient/5a357166754b59777137634248494434654c336d68773d3d"
                },
                "dependent": "01",
                "relationship": {
                    "coding": [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                            "code": "self",
                            "display": "self"
                        }
                    ]
                },
                "period": {
                    "start": "2022-01-01"
                },
                "payor": [
                    {
                        "reference": "Organization/67c29814ee1eb20b1be2c2c692cfdd2cfb84e919a867998eccd1762b7b785780",
                        "identifier": {
                            "system": "https://fhir.humana.com/documentation/glossary/platform-code",
                            "value": "EM"
                        },
                        "display": "Humana"
                    }
                ],
                "class": [
                    {
                        "type": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                                    "code": "group",
                                    "display": "group"
                                }
                            ]
                        },
                        "value": "675717"
                    }
                ],
                "meta": {
                    "versionId": "aa75d0be-3976-45a1-bd7d-ea16db5f079a",
                    "lastUpdated": "2025-01-15T03:59:49.155+00:00"
                }
            }
        },
        {
            "fullUrl": "https://sandbox-fhir.humana.com/api/Coverage/96acb260ec0cbee906647143019168bb161dca2b9a386e2bbd5b722568c59b7f",
            "search": {
                "mode": "match"
            },
            "resource": {
                "resourceType": "Coverage",
                "id": "96acb260ec0cbee906647143019168bb161dca2b9a386e2bbd5b722568c59b7f",
                "identifier": [
                    {
                        "type": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code": "SN",
                                    "display": "Subscriber Number"
                                }
                            ]
                        },
                        "system": "https://fhir.humana.com/documentation/glossary/memberIdBase",
                        "value": "915634980"
                    },
                    {
                        "system": "https://fhir.humana.com/documentation/glossary/memberIDDependentCode",
                        "value": "01"
                    },
                    {
                        "type": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code": "MA",
                                    "display": "Patient Medicaid number"
                                }
                            ]
                        },
                        "value": "87281847",
                        "assigner": {
                            "display": "MO"
                        }
                    }
                ],
                "status": "active",
                "type": {
                    "coding": [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                            "code": "DENTAL",
                            "display": "dental care policy"
                        }
                    ]
                },
                "subscriberId": "915634980",
                "beneficiary": {
                    "reference": "Patient/5a357166754b59777137634248494434654c336d68773d3d"
                },
                "dependent": "01",
                "relationship": {
                    "coding": [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                            "code": "self",
                            "display": "self"
                        }
                    ]
                },
                "period": {
                    "start": "2023-01-01"
                },
                "payor": [
                    {
                        "reference": "Organization/67c29814ee1eb20b1be2c2c692cfdd2cfb84e919a867998eccd1762b7b785780",
                        "identifier": {
                            "system": "https://fhir.humana.com/documentation/glossary/platform-code",
                            "value": "EM"
                        },
                        "display": "Humana"
                    }
                ],
                "class": [
                    {
                        "type": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                                    "code": "group",
                                    "display": "group"
                                }
                            ]
                        },
                        "value": "675717"
                    }
                ],
                "network": "HumanaDental Medicare",
                "meta": {
                    "versionId": "b8128674-dadd-4093-9e44-a771216cc2f6",
                    "lastUpdated": "2025-01-15T03:59:49.188+00:00"
                }
            }
        },
        {
            "fullUrl": "https://sandbox-fhir.humana.com/api/Coverage/d662fa3afd441e3bc410df200edcdb577ca7ed8a4948fc81d535b4498927fdf4",
            "search": {
                "mode": "match"
            },
            "resource": {
                "resourceType": "Coverage",
                "id": "d662fa3afd441e3bc410df200edcdb577ca7ed8a4948fc81d535b4498927fdf4",
                "identifier": [
                    {
                        "type": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code": "SN",
                                    "display": "Subscriber Number"
                                }
                            ]
                        },
                        "system": "https://fhir.humana.com/documentation/glossary/memberIdBase",
                        "value": "H71681904"
                    },
                    {
                        "system": "https://fhir.humana.com/documentation/glossary/memberIDDependentCode",
                        "value": "00"
                    },
                    {
                        "type": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code": "MA",
                                    "display": "Patient Medicaid number"
                                }
                            ]
                        },
                        "value": "87281847",
                        "assigner": {
                            "display": "MO"
                        }
                    }
                ],
                "status": "cancelled",
                "type": {
                    "coding": [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                            "code": "HIP",
                            "display": "health insurance plan policy"
                        }
                    ]
                },
                "subscriberId": "H71681904",
                "beneficiary": {
                    "reference": "Patient/5a357166754b59777137634248494434654c336d68773d3d"
                },
                "dependent": "00",
                "relationship": {
                    "coding": [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                            "code": "self",
                            "display": "self"
                        }
                    ]
                },
                "period": {
                    "start": "2024-01-01",
                    "end": "2024-12-31"
                },
                "payor": [
                    {
                        "reference": "Organization/67c29814ee1eb20b1be2c2c692cfdd2cfb84e919a867998eccd1762b7b785780",
                        "identifier": {
                            "system": "https://fhir.humana.com/documentation/glossary/platform-code",
                            "value": "LV"
                        },
                        "display": "Humana"
                    }
                ],
                "class": [
                    {
                        "type": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                                    "code": "plan",
                                    "display": "plan"
                                }
                            ]
                        },
                        "value": "Medicare"
                    },
                    {
                        "type": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                                    "code": "group",
                                    "display": "group"
                                }
                            ]
                        },
                        "value": "329099"
                    }
                ],
                "network": "Gold+/Emp HMO - All Othr WA",
                "meta": {
                    "versionId": "4f1a3996-c8bc-483d-a76d-5936e4128815",
                    "lastUpdated": "2025-01-15T03:59:49.212+00:00"
                }
            }
        },
        {
            "fullUrl": "https://sandbox-fhir.humana.com/api/Coverage/b2cb820d23936974b353230f6b0fc1c3acccb593fb2172199efc288e240f2412",
            "search": {
                "mode": "match"
            },
            "resource": {
                "resourceType": "Coverage",
                "id": "b2cb820d23936974b353230f6b0fc1c3acccb593fb2172199efc288e240f2412",
                "identifier": [
                    {
                        "type": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code": "SN",
                                    "display": "Subscriber Number"
                                }
                            ]
                        },
                        "system": "https://fhir.humana.com/documentation/glossary/memberIdBase",
                        "value": "H71681904"
                    },
                    {
                        "system": "https://fhir.humana.com/documentation/glossary/memberIDDependentCode",
                        "value": "00"
                    },
                    {
                        "type": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code": "MA",
                                    "display": "Patient Medicaid number"
                                }
                            ]
                        },
                        "value": "87281847",
                        "assigner": {
                            "display": "MO"
                        }
                    }
                ],
                "status": "cancelled",
                "type": {
                    "coding": [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                            "code": "HIP",
                            "display": "health insurance plan policy"
                        }
                    ]
                },
                "subscriberId": "H71681904",
                "beneficiary": {
                    "reference": "Patient/5a357166754b59777137634248494434654c336d68773d3d"
                },
                "dependent": "00",
                "relationship": {
                    "coding": [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                            "code": "self",
                            "display": "self"
                        }
                    ]
                },
                "period": {
                    "start": "2022-01-01",
                    "end": "2022-12-31"
                },
                "payor": [
                    {
                        "reference": "Organization/67c29814ee1eb20b1be2c2c692cfdd2cfb84e919a867998eccd1762b7b785780",
                        "identifier": {
                            "system": "https://fhir.humana.com/documentation/glossary/platform-code",
                            "value": "LV"
                        },
                        "display": "Humana"
                    }
                ],
                "class": [
                    {
                        "type": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                                    "code": "plan",
                                    "display": "plan"
                                }
                            ]
                        },
                        "value": "Medicare"
                    },
                    {
                        "type": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                                    "code": "group",
                                    "display": "group"
                                }
                            ]
                        },
                        "value": "310556"
                    }
                ],
                "network": "Gold+/Emp HMO - All Othr WA",
                "meta": {
                    "versionId": "d59f51d1-278d-4a76-bd66-de4a3c504dcd",
                    "lastUpdated": "2025-01-15T03:59:49.236+00:00"
                }
            }
        },
        {
            "fullUrl": "https://sandbox-fhir.humana.com/api/Coverage/60547dafdb865d2c8b559d8f44aa941a211373676a679bfde613d3293f814150",
            "search": {
                "mode": "match"
            },
            "resource": {
                "resourceType": "Coverage",
                "id": "60547dafdb865d2c8b559d8f44aa941a211373676a679bfde613d3293f814150",
                "identifier": [
                    {
                        "type": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code": "SN",
                                    "display": "Subscriber Number"
                                }
                            ]
                        },
                        "system": "https://fhir.humana.com/documentation/glossary/memberIdBase",
                        "value": "H71681904"
                    },
                    {
                        "system": "https://fhir.humana.com/documentation/glossary/memberIDDependentCode",
                        "value": "00"
                    },
                    {
                        "type": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code": "MA",
                                    "display": "Patient Medicaid number"
                                }
                            ]
                        },
                        "value": "87281847",
                        "assigner": {
                            "display": "MO"
                        }
                    }
                ],
                "status": "cancelled",
                "type": {
                    "coding": [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                            "code": "HIP",
                            "display": "health insurance plan policy"
                        }
                    ]
                },
                "subscriberId": "H71681904",
                "beneficiary": {
                    "reference": "Patient/5a357166754b59777137634248494434654c336d68773d3d"
                },
                "dependent": "00",
                "relationship": {
                    "coding": [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                            "code": "self",
                            "display": "self"
                        }
                    ]
                },
                "period": {
                    "start": "2023-01-01",
                    "end": "2023-12-31"
                },
                "payor": [
                    {
                        "reference": "Organization/67c29814ee1eb20b1be2c2c692cfdd2cfb84e919a867998eccd1762b7b785780",
                        "identifier": {
                            "system": "https://fhir.humana.com/documentation/glossary/platform-code",
                            "value": "LV"
                        },
                        "display": "Humana"
                    }
                ],
                "class": [
                    {
                        "type": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                                    "code": "plan",
                                    "display": "plan"
                                }
                            ]
                        },
                        "value": "Medicare"
                    },
                    {
                        "type": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                                    "code": "group",
                                    "display": "group"
                                }
                            ]
                        },
                        "value": "327454"
                    }
                ],
                "network": "Gold+/Emp HMO - All Othr WA",
                "meta": {
                    "versionId": "459481ce-9546-4091-aa95-9fe8af62349a",
                    "lastUpdated": "2025-01-15T03:59:49.261+00:00"
                }
            }
        },
        {
            "fullUrl": "https://sandbox-fhir.humana.com/api/Coverage/6908b86dc403b6f1a119b5b8e6498151968906e3424f464d20f286658284558f",
            "search": {
                "mode": "match"
            },
            "resource": {
                "resourceType": "Coverage",
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    "link": [
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            "url": "https://sandbox-fhir.humana.com/api/Coverage?patient=5a357166754b59777137634248494434654c336d68773d3d&_total=accurate&_count=10&_skip=0"
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}