How AI is applied across API Evangelist and APIs.io. Read my AI disclosure →
API Evangelist API Evangelist
Discovery
Learnings
Guidance
Toolbox
Alignment
API Evangelist LLC

CMS — Centers for Medicare & Medicaid Services Insurance Plans API

Data on both health and dental insurance plans.

CMS — Centers for Medicare & Medicaid Services Insurance Plans API is one of 56 APIs that CMS — Centers for Medicare & Medicaid Services publishes on the APIs.io network, described by a machine-readable OpenAPI specification.

Tagged areas include Insurance Plans. The published artifact set on APIs.io includes an OpenAPI specification, API documentation, authentication docs, a GitHub repository, a changelog, and an API reference.

This API exposes 6 operations across 6 paths, and defines 35 schemas. It is described by OpenAPI 3.2.0, at version 1.

Requests are made against a single base URL, https://marketplace.api.healthcare.gov/api/v1.

6 operations 6 paths 35 schemas 3 GET3 POST

Metadata

The identity and technical contract details declared by the specification.

Specification
OpenAPI 3.2.0
API Version
1
Base URL
https://api.bluebutton.cms.gov/v2/fhir
Authentication
API Key
Resource Areas
1

Authentication & Security 1

CMS — Centers for Medicare & Medicaid Services Insurance Plans API declares 1 security scheme for authenticating requests. An API key is passed in the query as apikey (API_Key). By default, every request must be authenticated.

  • API_Key — Your API key should be included as a query parameter with the request. You can [fill out this form](https://cms.gov1.qualtrics.com/jfe/form/SV4N2GHCJfNuX7n8x)…

Paths & Operations 6

Across 6 paths, the API surfaces 6 operations — 3 GET, 3 POST. Each is listed below with its method, path, parameters, and response codes.

Insurance Plans 6

Data on both health and dental insurance plans.

GET
/crosswalk
Crosswalk a previous year plan
getCrosswalk 6 params → 200
POST
/plans
Get multiple plans
postPlans 2 params body → 200
POST
/plans/search
Search for insurance plans
postPlansSearch 2 params body → 200
POST
/plans/search/stats
Retrieve stats on groups of insurance plans
postPlansSearchStats 2 params body → 200
GET
/plans/{plan_id}
Get a plan
getPlansByPlanId 3 params → 200
GET
/plans/{plan_id}/quality-ratings
Get plans by plan id quality ratings
getPlansByPlanIdQualityRatings 3 params → 200

Schemas 35

The contract defines 35 schemas that model the data the API accepts and returns. The most detailed are Plan (39 properties), PlanSearchFilter (22 properties), Person (14 properties), PlanSearchRequest (12 properties). Each schema is shown below with its type and property counts.

SuppressionStatus
string
Plan
object
39 properties
GenderEnum
string
Range
object
2 properties
PlanSearchFilter
object
plan search filter
22 properties
CurrentEnrollment
object
Current/existing enrollment information used to determine tobacco status for CiC enrollments. This will ensure rate calculation is done correctly.
3 properties 3 required
Person
object
14 properties 2 required
Place
object
3 properties 3 required
CertificationStatus
string
FamilyCostEnum
string
family cost enumeration for MOOPs and deductibles
RateArea
object
2 properties
CostSharing
object
7 properties
MetalLevelEnum
string
ProductDivisionEnum
string
CSRRequestEnum
string
Cost-sharing reduction (CSR) override for requests
DiseaseMgmtProgramsEnum
string
Household
object
If a household is not included, will default to Individual household
5 properties
DesignTypeEnum
string
InsuranceMarketEnum
string
CostSharingReductionEnum
string
Cost-sharing reduction (CSR)
PlanSearchRequest
object
12 properties 2 required
PlanIDList
array
SBCScenario
object
4 properties
MetalDesignType
object
2 properties
Benefit
object
8 properties
PlanID
string
NetworkTierEnum
string
UtilizationEnum
string
Relationship
string
Should match one of the [listed valid relationships](introduction/more-information-about-households).
QualityRating
object
10 properties
Issuer
object
8 properties
Deductible
object
8 properties
MarketEnum
string
PlanTypeEnum
string
MOOP
object
maximum out-of-pocket
8 properties

Specification

The full machine-readable OpenAPI contract behind this narrative.

Source

cms-gov-insurance-plans-api-openapi.yml Raw ↑

Other APIs CMS — Centers for Medicare & Medicaid Services publishes across the network.

CMS — Centers for Medicare & Medicaid Services Articles API
CMS — Centers for Medicare & Medicaid Services Auth API
CMS — Centers for Medicare & Medicaid Services Benchmarks API
CMS — Centers for Medicare & Medicaid Services Bulk Export API
CMS — Centers for Medicare & Medicaid Services Catalog API
CMS — Centers for Medicare & Medicaid Services Coverage API
CMS — Centers for Medicare & Medicaid Services Data API
CMS — Centers for Medicare & Medicaid Services Drugs API
CMS — Centers for Medicare & Medicaid Services Eligibility API
CMS — Centers for Medicare & Medicaid Services ExplanationOfBenefit API
CMS — Centers for Medicare & Medicaid Services Geography API
CMS — Centers for Medicare & Medicaid Services Group API
Where this information came from

This is an independent, third-party profile of CMS — Centers for Medicare & Medicaid Services Insurance Plans API, published by API Evangelist. We do not operate, host, resell, or support these APIs, and we are not affiliated with or endorsed by the company unless stated above. Everything here is built from publicly available information — the company's own site, developer portal, documentation, public repositories, and the specifications it publishes for public use. Nothing is obtained by breaching a system, defeating an access control, or using credentials.

The Kin Score and Agent Readiness rating are independently calculated assessments of a company's public API artifacts, scored against a published rubric. They are not certifications, endorsements, security assessments, or audits.

Corrections, re-scores, and removal are free — no partnership or purchase required, and you do not need to justify the request. A removed company is recorded as unrated, never scored zero for having asked. Acknowledgement within one business day; removal within two.

info@apievangelist.com · Read the full data-sourcing policy →
On a security or compliance team? Put security in the subject line and you will get a person, not a form — we will tell you exactly which public URLs this profile was built from.