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://fhir.humana.com/sandbox/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",
  "id": "63a98cc2a4ea498f83d5959d3e88b872",
  "meta": {
    "lastUpdated": "2021-09-13T12:49:56.8559278+00:00"
  },
  "type": "searchset",
  "link": [
    {
      "relation": "next",
      "url": "https://fhir.humana.com/sandbox/api/Coverage?_count=3&patient=5a357166754b59777137634248494434654c336d68773d3d&ct=W3sidG9rZW4iOiIrUklEOn5RNlpxQU9jemxRdkQzQVlBQUFBQUFBPT0jUlQ6MSNUUkM6MyNJU1Y6MiNJRU86NjU1NTEjUUNGOjQjRlBDOkFnRWJjaHNFQU1FY0dBQWdBZ0QvbnlNQ0FOR0JjZ2dBd3hnbGtVUWlDUUE9IiwicmFuZ2UiOnsibWluIjoiIiwibWF4IjoiRkYifX1d"
    },
    {
      "relation": "self",
      "url": "https://fhir.humana.com/sandbox/api/Coverage?_count=3&patient=5a357166754b59777137634248494434654c336d68773d3d"
    }
  ],
  "entry": [
    {
      "fullUrl": "https://fhir.humana.com/sandbox/api/Coverage/27b280793b954bfe09465912e06b3e8391e4cd60c43f76917f33375b6be659d6",
      "resource": {
        "resourceType": "Coverage",
        "id": "27b280793b954bfe09465912e06b3e8391e4cd60c43f76917f33375b6be659d6",
        "meta": {
          "versionId": "719",
          "lastUpdated": "2021-09-13T08:30:12.916+00:00",
          "source": "https://fhir.humana.com/documentation/glossary/HumanaDataSource",
          "tag": [
            {
              "system": "https://www.hl7.org/fhir/patient.html",
              "code": "Patient/5a357166754b59777137634248494434654c336d68773d3d"
            },
            {
              "system": "https://fhir.humana.com/documentation/glossary/lastRefreshedOn",
              "code": "2021-09-13T08:30:12.096Z"
            }
          ]
        },
        "text": {
          "status": "generated",
          "div": "

DENTAL

"
        },
        "identifier": [
          {
            "type": {
              "text": "MemberIDDependentCode"
            },
            "system": "https://fhir.humana.com/documentation/glossary/memberIDDependentCode",
            "value": "00",
            "assigner": {
              "display": "Humana"
            }
          },
          {
            "type": {
              "text": "MemberIdBase"
            },
            "system": "https://fhir.humana.com/documentation/glossary/memberIdBase",
            "value": "563288214",
            "assigner": {
              "display": "Humana"
            }
          },
          {
            "type": {
              "text": "DivisionId"
            },
            "value": "94220175",
            "assigner": {
              "display": "Humana"
            }
          },
          {
            "type": {
              "text": "GroupId"
            },
            "value": "965632",
            "assigner": {
              "display": "Humana"
            }
          },
          {
            "use": "official",
            "type": {
              "text": "NetworkId"
            },
            "value": "7919697",
            "assigner": {
              "display": "Humana"
            }
          },
          {
            "use": "usual",
            "type": {
              "text": "NetworkId"
            },
            "value": "HUMANA PPO GOLD MEMBER PLAN",
            "assigner": {
              "display": "Humana"
            }
          }
        ],
        "status": "active",
        "type": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
              "code": "DENTAL",
              "display": "dental care policy"
            }
          ],
          "text": "dental care policy"
        },
        "subscriberId": "563288214-00",
        "beneficiary": {
          "reference": "Patient/5a357166754b59777137634248494434654c336d68773d3d"
        },
        "dependent": "00",
        "relationship": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
              "code": "self",
              "display": "Self"
            }
          ],
          "text": "Self"
        },
        "period": {
          "start": "2021-01-01",
          "end": "2021-12-31"
        },
        "payor": [
          {
            "display": "Humana"
          }
        ],
        "class": [
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code": "group"
                }
              ]
            },
            "value": "965632"
          },
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code": "plan"
                }
              ]
            },
            "value": "HU300004",
            "name": "DENTAL"
          }
        ]
      },
      "search": {
        "mode": "match"
      }
    },
    {
      "fullUrl": "https://fhir.humana.com/sandbox/api/Coverage/ba6dc213a4e30fdead23fbe135e2f2a8f32a0bb4f025ec286d988a525d5ee6fc",
      "resource": {
        "resourceType": "Coverage",
        "id": "ba6dc213a4e30fdead23fbe135e2f2a8f32a0bb4f025ec286d988a525d5ee6fc",
        "meta": {
          "versionId": "459",
          "lastUpdated": "2021-09-13T08:30:12.944+00:00",
          "source": "https://fhir.humana.com/documentation/glossary/HumanaDataSource",
          "tag": [
            {
              "system": "https://www.hl7.org/fhir/patient.html",
              "code": "Patient/5a357166754b59777137634248494434654c336d68773d3d"
            },
            {
              "system": "https://fhir.humana.com/documentation/glossary/lastRefreshedOn",
              "code": "2021-09-13T08:30:12.096Z"
            }
          ]
        },
        "text": {
          "status": "generated",
          "div": "

DENTAL

"
        },
        "identifier": [
          {
            "type": {
              "text": "MemberIDDependentCode"
            },
            "system": "https://fhir.humana.com/documentation/glossary/memberIDDependentCode",
            "value": "00",
            "assigner": {
              "display": "Humana"
            }
          },
          {
            "type": {
              "text": "MemberIdBase"
            },
            "system": "https://fhir.humana.com/documentation/glossary/memberIdBase",
            "value": "425155877",
            "assigner": {
              "display": "Humana"
            }
          },
          {
            "type": {
              "text": "DivisionId"
            },
            "value": "94220175",
            "assigner": {
              "display": "Humana"
            }
          },
          {
            "type": {
              "text": "GroupId"
            },
            "value": "965632",
            "assigner": {
              "display": "Humana"
            }
          },
          {
            "use": "official",
            "type": {
              "text": "NetworkId"
            },
            "value": "4710787",
            "assigner": {
              "display": "Humana"
            }
          },
          {
            "use": "usual",
            "type": {
              "text": "NetworkId"
            },
            "value": "HUMANA PPO SILVER MEMBER PLAN",
            "assigner": {
              "display": "Humana"
            }
          }
        ],
        "status": "cancelled",
        "type": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
              "code": "DENTAL",
              "display": "dental care policy"
            }
          ],
          "text": "dental care policy"
        },
        "subscriberId": "425155877-00",
        "beneficiary": {
          "reference": "Patient/5a357166754b59777137634248494434654c336d68773d3d"
        },
        "dependent": "00",
        "relationship": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
              "code": "self",
              "display": "Self"
            }
          ],
          "text": "Self"
        },
        "period": {
          "start": "2020-01-01",
          "end": "2020-12-31"
        },
        "payor": [
          {
            "display": "Humana"
          }
        ],
        "class": [
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code": "group"
                }
              ]
            },
            "value": "965632"
          },
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code": "plan"
                }
              ]
            },
            "value": "HU300004",
            "name": "DENTAL"
          }
        ]
      },
      "search": {
        "mode": "match"
      }
    },
    {
      "fullUrl": "https://fhir.humana.com/sandbox/api/Coverage/291e81da7b757621d3dee5481a630e052bb31547413e7d2ca85fa9e29c46d992",
      "resource": {
        "resourceType": "Coverage",
        "id": "291e81da7b757621d3dee5481a630e052bb31547413e7d2ca85fa9e29c46d992",
        "meta": {
          "versionId": "459",
          "lastUpdated": "2021-09-13T08:30:12.971+00:00",
          "source": "https://fhir.humana.com/documentation/glossary/HumanaDataSource",
          "tag": [
            {
              "system": "https://www.hl7.org/fhir/patient.html",
              "code": "Patient/5a357166754b59777137634248494434654c336d68773d3d"
            },
            {
              "system": "https://fhir.humana.com/documentation/glossary/lastRefreshedOn",
              "code": "2021-09-13T08:30:12.096Z"
            }
          ]
        },
        "text": {
          "status": "generated",
          "div": "

DENTAL

"
        },
        "identifier": [
          {
            "type": {
              "text": "MemberIDDependentCode"
            },
            "system": "https://fhir.humana.com/documentation/glossary/memberIDDependentCode",
            "value": "00",
            "assigner": {
              "display": "Humana"
            }
          },
          {
            "type": {
              "text": "MemberIdBase"
            },
            "system": "https://fhir.humana.com/documentation/glossary/memberIdBase",
            "value": "961172028",
            "assigner": {
              "display": "Humana"
            }
          },
          {
            "type": {
              "text": "DivisionId"
            },
            "value": "94220175",
            "assigner": {
              "display": "Humana"
            }
          },
          {
            "type": {
              "text": "GroupId"
            },
            "value": "965632",
            "assigner": {
              "display": "Humana"
            }
          },
          {
            "use": "official",
            "type": {
              "text": "NetworkId"
            },
            "value": "7919697",
            "assigner": {
              "display": "Humana"
            }
          },
          {
            "use": "usual",
            "type": {
              "text": "NetworkId"
            },
            "value": "HUMANA PPO GOLD MEMBER PLAN",
            "assigner": {
              "display": "Humana"
            }
          }
        ],
        "status": "cancelled",
        "type": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
              "code": "DENTAL",
              "display": "dental care policy"
            }
          ],
          "text": "dental care policy"
        },
        "subscriberId": "961172028-00",
        "beneficiary": {
          "reference": "Patient/5a357166754b59777137634248494434654c336d68773d3d"
        },
        "dependent": "00",
        "relationship": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
              "code": "self",
              "display": "Self"
            }
          ],
          "text": "Self"
        },
        "period": {
          "start": "2019-01-01",
          "end": "2019-12-31"
        },
        "payor": [
          {
            "display": "Humana"
          }
        ],
        "class": [
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code": "group"
                }
              ]
            },
            "value": "965632"
          },
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code": "plan"
                }
              ]
            },
            "value": "HU300004",
            "name": "DENTAL"
          }
        ]
      },
      "search": {
        "mode": "match"
      }
    }
  ]
}