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CMS — Centers for Medicare & Medicaid Services Plans API

The Plans API from CMS — Centers for Medicare & Medicaid Services — 2 operation(s) for plans.

CMS — Centers for Medicare & Medicaid Services 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.

This API exposes 3 JSON Schema definitions.

Tagged areas include Plans. The published artifact set on APIs.io includes an OpenAPI specification, API documentation, a JSON-LD context, and 3 JSON Schemas.

This API exposes 3 operations across 3 paths, and defines 30 schemas. It is described by OpenAPI 3.2.0, at version 1.0.

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

3 operations 3 paths 30 schemas 1 GET2 POST

Metadata

The identity and technical contract details declared by the specification.

Specification
OpenAPI 3.2.0
API Version
1.0
Base URL
https://api.bluebutton.cms.gov/v2/fhir
Authentication
API Key, API Key
Resource Areas
1

Authentication & Security 2

CMS — Centers for Medicare & Medicaid Services Plans API declares 2 security schemes for authenticating requests. An API key is passed in the query as apikey (ApiKey). An API key is passed in the query as apikey (API_Key).

  • 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 3

Across 3 paths, the API surfaces 3 operations — 1 GET, 2 POST. Each is listed below with its method, path, parameters, and response codes.

Plans 3
POST
/plans/search
Search Marketplace Plans
searchPlans body → 200
GET
/plans/{planId}
Get Plan Details
getPlan 2 params → 200
POST
/plans/{plan_id}
Get plan details with premiums for a household
postPlansByPlanId 2 params body → 200

Schemas 30

The contract defines 30 schemas that model the data the API accepts and returns. The most detailed are Plan_2 (39 properties), Person (14 properties), QualityRating (10 properties), Plan (9 properties). Each schema is shown below with its type and property counts.

Plan
object
9 properties
SuppressionStatus
string
Plan_2
object
39 properties
GenderEnum
string
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
SBCScenario
object
4 properties
InsuranceMarketEnum
string
CostSharingReductionEnum
string
Cost-sharing reduction (CSR)
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-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 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.

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