Get Eligibility

Beta

GET

/coverages/v1//:id/eligibility/:check_id

Gets the eligibility of a patient for a specific coverage if successful.

Path parameters

idUUIDRequired

The unique identifier for a Coverage in the database

check_idstringRequired

Response

This endpoint returns an object.

metadataobject

checkobjectOptional

GET

1 curl https://pre-api.joincandidhealth.com/coverages/v1//d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32/eligibility/:check_id \
2      -H "Authorization: Bearer <token>"

200Retrieved

1 {
2   "metadata": {
3     "check_id": "string",
4     "service_code": "1",
5     "status": "CREATED",
6     "initiated_by": "string",
7     "initiated_at": "2023-01-01T00:00:00Z"
8   },
9   "check": {
10     "raw_json": {},
11     "eligibility_status": "ACTIVE",
12     "errors": {},
13     "plan_metadata": {
14       "insurance_type": "string",
15       "insurance_type_code": "string",
16       "plan_name": "string",
17       "member_id": "string",
18       "group_number": "string",
19       "start_date": "2023-01-01",
20       "end_date": "2023-01-01",
21       "plan_dates": [
22         {
23           "start_date": "2023-01-01",
24           "field_name": "string",
25           "end_date": "2023-01-01"
26         }
27       ]
28     },
29     "benefits": {
30       "plan_coverage": {
31         "in_network": {
32           "deductible": {
33             "family": 1,
34             "individual": 1
35           },
36           "deductible_remaining": {
37             "family": 1,
38             "individual": 1
39           },
40           "oop_max": {
41             "family": 1,
42             "individual": 1
43           },
44           "oop_max_remaining": {
45             "family": 1,
46             "individual": 1
47           },
48           "additional_notes": "string"
49         },
50         "in_network_flat": [
51           {
52             "type": "DEDUCTIBLE",
53             "coverageLevel": "INDIVIDUAL",
54             "unit": "PERCENT",
55             "value": 1,
56             "additional_notes": "string"
57           }
58         ],
59         "out_of_network": {
60           "deductible": {
61             "family": 1,
62             "individual": 1
63           },
64           "deductible_remaining": {
65             "family": 1,
66             "individual": 1
67           },
68           "oop_max": {
69             "family": 1,
70             "individual": 1
71           },
72           "oop_max_remaining": {
73             "family": 1,
74             "individual": 1
75           },
76           "additional_notes": "string"
77         },
78         "out_of_network_flat": [
79           {
80             "type": "DEDUCTIBLE",
81             "coverageLevel": "INDIVIDUAL",
82             "unit": "PERCENT",
83             "value": 1,
84             "additional_notes": "string"
85           }
86         ]
87       },
88       "service_specific_coverage": [
89         {
90           "service_code": "1",
91           "in_network": {
92             "copay": {
93               "family": 1,
94               "individual": 1
95             },
96             "coinsurance": {
97               "family": 1,
98               "individual": 1
99             },
100             "visits": {
101               "family": 1,
102               "individual": 1
103             },
104             "visits_remaining": {
105               "family": 1,
106               "individual": 1
107             },
108             "additional_notes": "string"
109           },
110           "in_network_flat": [
111             {
112               "type": "DEDUCTIBLE",
113               "coverageLevel": "INDIVIDUAL",
114               "unit": "PERCENT",
115               "value": 1,
116               "additional_notes": "string"
117             }
118           ],
119           "out_of_network": {
120             "copay": {
121               "family": 1,
122               "individual": 1
123             },
124             "coinsurance": {
125               "family": 1,
126               "individual": 1
127             },
128             "visits": {
129               "family": 1,
130               "individual": 1
131             },
132             "visits_remaining": {
133               "family": 1,
134               "individual": 1
135             },
136             "additional_notes": "string"
137           },
138           "out_of_network_flat": [
139             {
140               "type": "DEDUCTIBLE",
141               "coverageLevel": "INDIVIDUAL",
142               "unit": "PERCENT",
143               "value": 1,
144               "additional_notes": "string"
145             }
146           ]
147         }
148       ],
149       "notes": "string"
150     }
151   }
152 }

Built with

1	curl https://pre-api.joincandidhealth.com/coverages/v1//d5e9c84f-c2b2-4bf4-b4b0-7ffd7a9ffc32/eligibility/:check_id \
2	-H "Authorization: Bearer <token>"

1	{
2	"metadata": {
3	"check_id": "string",
4	"service_code": "1",
5	"status": "CREATED",
6	"initiated_by": "string",
7	"initiated_at": "2023-01-01T00:00:00Z"
8	},
9	"check": {
10	"raw_json": {},
11	"eligibility_status": "ACTIVE",
12	"errors": {},
13	"plan_metadata": {
14	"insurance_type": "string",
15	"insurance_type_code": "string",
16	"plan_name": "string",
17	"member_id": "string",
18	"group_number": "string",
19	"start_date": "2023-01-01",
20	"end_date": "2023-01-01",
21	"plan_dates": [
22	{
23	"start_date": "2023-01-01",
24	"field_name": "string",
25	"end_date": "2023-01-01"
26	}
27	]
28	},
29	"benefits": {
30	"plan_coverage": {
31	"in_network": {
32	"deductible": {
33	"family": 1,
34	"individual": 1
35	},
36	"deductible_remaining": {
37	"family": 1,
38	"individual": 1
39	},
40	"oop_max": {
41	"family": 1,
42	"individual": 1
43	},
44	"oop_max_remaining": {
45	"family": 1,
46	"individual": 1
47	},
48	"additional_notes": "string"
49	},
50	"in_network_flat": [
51	{
52	"type": "DEDUCTIBLE",
53	"coverageLevel": "INDIVIDUAL",
54	"unit": "PERCENT",
55	"value": 1,
56	"additional_notes": "string"
57	}
58	],
59	"out_of_network": {
60	"deductible": {
61	"family": 1,
62	"individual": 1
63	},
64	"deductible_remaining": {
65	"family": 1,
66	"individual": 1
67	},
68	"oop_max": {
69	"family": 1,
70	"individual": 1
71	},
72	"oop_max_remaining": {
73	"family": 1,
74	"individual": 1
75	},
76	"additional_notes": "string"
77	},
78	"out_of_network_flat": [
79	{
80	"type": "DEDUCTIBLE",
81	"coverageLevel": "INDIVIDUAL",
82	"unit": "PERCENT",
83	"value": 1,
84	"additional_notes": "string"
85	}
86	]
87	},
88	"service_specific_coverage": [
89	{
90	"service_code": "1",
91	"in_network": {
92	"copay": {
93	"family": 1,
94	"individual": 1
95	},
96	"coinsurance": {
97	"family": 1,
98	"individual": 1
99	},
100	"visits": {
101	"family": 1,
102	"individual": 1
103	},
104	"visits_remaining": {
105	"family": 1,
106	"individual": 1
107	},
108	"additional_notes": "string"
109	},
110	"in_network_flat": [
111	{
112	"type": "DEDUCTIBLE",
113	"coverageLevel": "INDIVIDUAL",
114	"unit": "PERCENT",
115	"value": 1,
116	"additional_notes": "string"
117	}
118	],
119	"out_of_network": {
120	"copay": {
121	"family": 1,
122	"individual": 1
123	},
124	"coinsurance": {
125	"family": 1,
126	"individual": 1
127	},
128	"visits": {
129	"family": 1,
130	"individual": 1
131	},
132	"visits_remaining": {
133	"family": 1,
134	"individual": 1
135	},
136	"additional_notes": "string"
137	},
138	"out_of_network_flat": [
139	{
140	"type": "DEDUCTIBLE",
141	"coverageLevel": "INDIVIDUAL",
142	"unit": "PERCENT",
143	"value": 1,
144	"additional_notes": "string"
145	}
146	]
147	}
148	],
149	"notes": "string"
150	}
151	}
152	}