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Centers for Medicare and Medicaid Services Households & Eligibility API

Household specific calculations, including eligibility information, out of pocket costs, poverty levels, and cost benchmarks.

This API exposes 6 operations across 6 paths, and defines 15 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 15 schemas 1 GET5 POST

Metadata

The identity and technical contract details declared by the specification.

Specification
OpenAPI 3.2.0
API Version
1
Base URL
https://marketplace.api.healthcare.gov/api/v1
Authentication
API Key
Resource Areas
1

Authentication & Security 1

Centers for Medicare and Medicaid Services Households & Eligibility 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 — 1 GET, 5 POST. Each is listed below with its method, path, parameters, and response codes.

Households & Eligibility 6

Household specific calculations, including eligibility information, out of pocket costs, poverty levels, and cost benchmarks.

POST
/households/eligibility/estimates
Create households eligibility estimates
postHouseholdsEligibilityEstimates 2 params body → 200
POST
/households/ichra
Get affordability and premium of the lowest cost silver plan
postHouseholdsIchra 2 params body → 200
POST
/households/lcbp
Get lowest cost bronze plan for a household
postHouseholdsLcbp 2 params body → 200
POST
/households/slcsp
Get second lowest cost silver plan
postHouseholdsSlcsp 2 params body → 200
POST
/households/lcsp
Get lowest cost silver plan
postHouseholdsLcsp 2 params body → 200
GET
/households/pcfpl
Get households pcfpl
getHouseholdsPcfpl 5 params → 200

Schemas 15

The contract defines 15 schemas that model the data the API accepts and returns. The most detailed are Person (14 properties), Household (5 properties), Eligibility (4 properties), LowestCostPlanResponse (4 properties). Each schema is shown below with its type and property counts.

LowestCostPlanHousehold
object
2 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
Eligibility
object
4 properties
CSREligibilityEnum
string
Cost-sharing reduction (CSR)
GenderEnum
string
ICHRAResponse
object
2 properties
Person
object
14 properties 2 required
Place
object
3 properties 3 required
Household
object
If a household is not included, will default to Individual household
5 properties
LowestCostPlanPerson
object
2 properties
UtilizationEnum
string
Relationship
string
Should match one of the [listed valid relationships](introduction/more-information-about-households).
LowestCostPlanResponse
object
4 properties
PlanID
string
MetalLevelEnum
string

Specification

The full machine-readable OpenAPI contract behind this narrative.

Source

cms-households-eligibility-api-openapi.yml Raw ↑
Where this information came from

This is an independent, third-party profile of Centers for Medicare and Medicaid Services Households & Eligibility 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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