<status value="active" /> <experimental value="false" /> <description value="Indicates the period of time over which the member's private coverage is not contributing to drug costs - typically because the patient has reached their maximum for the benefit period. Coverage will reset when the private plan starts a new coverage period." /> <fhirVersion value="5.0.0" /> <mapping> <identity value="BPCS" /> <name value="Internal BPCS API" /> </mapping> <kind value="complex-type" /> <abstract value="false" /> <context> <type value="element" /> <expression value="Coverage.period" /> </context> <type value="Extension" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" /> <derivation value="constraint" /> <snapshot> <element id="Extension"> <path value="Extension" /> <short value="Coverage not paying period" /> <definition value="Indicates the period of time over which the member's private coverage is not contributing to drug costs - typically because the patient has reached their maximum for the benefit period. Coverage will reset when the private plan starts a new coverage period." /> <min value="0" /> <max value="1" /> <base> <path value="Extension" /> <min value="0" /> <max value="*" /> </base> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Extension.id"> <path value="Extension.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <condition value="ele-1" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Extension.extension"> <path value="Extension.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Extension.url"> <path value="Extension.url" /> <representation value="xmlAttr" /> <short value="identifies the meaning of the extension" /> <definition value="Source of the definition for the extension code - a logical name or a URL." /> <comment value="The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension." /> <min value="1" /> <max value="1" /> <base> <path value="Extension.url" /> <min value="1" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="uri" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <fixedUri value="https://bpcs.exchange/fhir/StructureDefinition/ext-Coverage-NotPayingPeriod" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Extension.value[x]"> <path value="Extension.value[x]" /> <short value="Value of extension" /> <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list)." /> <min value="0" /> <max value="1" /> <base> <path value="Extension.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Period" /> </type> <condition value="ext-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Extension.value[x].id"> <path value="Extension.value[x].id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <condition value="ele-1" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Extension.value[x].extension"> <path value="Extension.value[x].extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Extension.value[x].start"> <path value="Extension.value[x].start" /> <short value="maximumReachedDate" /> <definition value="The most recent date within the overall coverage period for the private insurance when its maximum covered amount is reached. I.e. after this date, this private insurance will no longer reimburse for eligible costs." /> <comment value="If the low element is missing, the meaning is that the low boundary is not known." /> <min value="1" /> <max value="1" /> <base> <path value="Period.start" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <condition value="per-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="DR.1" /> </mapping> <mapping> <identity value="rim" /> <map value="./low" /> </mapping> <mapping> <identity value="BPCS" /> <map value="RecipientInsuranceDTO/FamilyMemberHistoryDTO.maximumReachedDate1 or maximumReachedDate2, FamilyMemberInsuranceDTO.maximumReachedDate, InsuranceDTO.maximumReachedDate" /> </mapping> </element> <element id="Extension.value[x].end"> <path value="Extension.value[x].end" /> <short value="reinstatementDate" /> <definition value="The first date when the private insurance max reached is reset and coverage will be resumed. For example, if the coverage limits to $2000 within a year and the maximum had been exceeded, when the renewal date is reached, the counter starts again at zero and the private insurance will again make payments for receipts after that date." /> <comment value="The end value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03." /> <min value="0" /> <max value="1" /> <base> <path value="Period.end" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <meaningWhenMissing value="If the end of the period is missing, it means that the period is ongoing" /> <condition value="per-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="DR.2" /> </mapping> <mapping> <identity value="rim" /> <map value="./high" /> </mapping> <mapping> <identity value="BPCS" /> <map value="RecipientInsuranceDTO/FamilyMemberHistoryDTO.reinstatementDate1 or reinstatementDate2, FamilyMemberInsuranceDTO.reinstatementDate, InsuranceDTO.reinstatementDate" /> </mapping> </element> </snapshot> <differential> <element id="Extension"> <path value="Extension" /> <short value="Coverage not paying period" /> <definition value="Indicates the period of time over which the member's private coverage is not contributing to drug costs - typically because the patient has reached their maximum for the benefit period. Coverage will reset when the private plan starts a new coverage period." /> <max value="1" /> </element> <element id="Extension.url"> <path value="Extension.url" /> <fixedUri value="https://bpcs.exchange/fhir/StructureDefinition/ext-Coverage-NotPayingPeriod" /> </element> <element id="Extension.value[x]"> <path value="Extension.value[x]" /> <type> <code value="Period" /> </type> <mustSupport value="true" /> </element> <element id="Extension.value[x].start"> <path value="Extension.value[x].start" /> <short value="maximumReachedDate" /> <definition value="The most recent date within the overall coverage period for the private insurance when its maximum covered amount is reached. I.e. after this date, this private insurance will no longer reimburse for eligible costs." /> <min value="1" /> <mustSupport value="true" /> <mapping> <identity value="BPCS" /> <map value="RecipientInsuranceDTO/FamilyMemberHistoryDTO.maximumReachedDate1 or maximumReachedDate2, FamilyMemberInsuranceDTO.maximumReachedDate, InsuranceDTO.maximumReachedDate" /> </mapping> </element> <element id="Extension.value[x].end"> <path value="Extension.value[x].end" /> <short value="reinstatementDate" /> <definition value="The first date when the private insurance max reached is reset and coverage will be resumed. For example, if the coverage limits to $2000 within a year and the maximum had been exceeded, when the renewal date is reached, the counter starts again at zero and the private insurance will again make payments for receipts after that date." /> <mustSupport value="true" /> <mapping> <identity value="BPCS" /> <map value="RecipientInsuranceDTO/FamilyMemberHistoryDTO.reinstatementDate1 or reinstatementDate2, FamilyMemberInsuranceDTO.reinstatementDate, InsuranceDTO.reinstatementDate" /> </mapping> </element> </differential> </StructureDefinition>