979 - Insurance Descriptor Codes

X12 External Code Source 979 5/17/2018 LAST UPDATED

These codes describe, identify, or clarify the insurance being reported in an eligibility and benefits response.

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DDisability Insurance
Provides periodic payments to replace income when an insured person is unable to work as a result of illness, injury or disease.
Start: 05/17/2018
MMedicare Advantage Point of Service (POS) Plan that excludes Part D coverage
Start: 05/17/2018
17 Dental Insurance
Start: 05/17/2018
18Vision Insurance
Start: 05/17/2018
19Prescription Drug Insurance
Start: 05/17/2018
AP Automobile Insurance
Start: 05/17/2018
C1 Commercial Insurance
Start: 05/17/2018
EP Exclusive Provider Organization (EPO) Plan
Gives subscriber a choice of providers from an approved/contracted payer list; there are fixed dollar co-payments for most covered services in return for using plan providers.
Start: 05/17/2018
HB Health Insurance Exchange (HIX) Bronze
Start: 05/17/2018
HD High Deductible Health Plan (HDHP)
Start: 05/17/2018
HG Health Insurance Exchange (HIX) Gold
Start: 05/17/2018
HM Health Maintenance Organization (HMO) Plan
Start: 05/17/2018
HP Health Insurance Exchange (HIX) Platinum
Start: 05/17/2018
HS Health Insurance Exchange (HIX) Silver
An individual eligible for Medicare for whom Medicaid pays only Medicare premiums.
Start: 05/17/2018
IN Indemnity Plan
Gives a subscriber the choice to select any provider. Payment is fixed percentage of the cost for covered care after satisfying an annual deductible.
Start: 05/17/2018
LC Long Term Care Insurance
Coverage designed to help pay for some or all long term care costs, reducing the risk that a policy-holder would need to deplete all of his or her assets to pay for long term care.
Start: 05/17/2018
LI Life Insurance
Start: 05/17/2018
MA Medicare Part A
Start: 05/17/2018
MB Medicare Part B
Start: 05/17/2018
MD Medicare Part D
Start: 05/17/2018
ME Medicare Advantage Preferred Provider Organization (PPO) Plan that excludes Part D Coverage
Start: 05/17/2018
MJ Medicare Advantage Health Maintenance Organization (HMO) Plan that includes Part D Coverage
Start: 05/17/2018
MK Medicare Advantage Health Maintenance Organization (HMO) Risk Plan that includes Part D Coverage
Start: 05/17/2018
ML Medicare Advantage Indemnity Plan that includes Part D Coverage
Start: 05/17/2018
MM Medicare Advantage Preferred Provider Organization (PPO) Plan that includes Part D Coverage
Start: 05/17/2018
MN Medicare Advantage Indemnity Plan that excludes Part D coverage
Start: 05/17/2018
MO Medicare Advantage Point of Service (POS) Plan that includes Part D Coverage
Start: 05/17/2018
MR Medicare Advantage Health Maintenance Organization (HMO) Risk Plan that excludes Part D coverage
Start: 05/17/2018
MT Medicare Advantage Health Maintenance Organization (HMO) Plan that excludes Part D coverage
Start: 05/17/2018
OA Open Access Point of Service Plan (POS) Plan
Start: 05/17/2018
PE Property Insurance - Personal
Start: 05/17/2018
PR Preferred Provider Organization (PPO) Plan
Start: 05/17/2018
PS Point of Service (POS) Plan
Start: 05/17/2018
RP Property Insurance - Real
Start: 05/17/2018
SP Supplemental Insurance
An insurance policy intended to cover non-covered charges of another insurance policy.
Start: 05/17/2018
WC Workers Compensation Insurance
Coverage provides medical treatment, rehabilitation, lost wages and related expenses arising from a job related injury or disease.
Start: 05/17/2018
WU Wrap-Up Insurance
A Workers Compensation Policy written for a specific job site, which will include or cover more than one insured.
Start: 05/17/2018