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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.

Centers for Medicare and Medicaid Services Households & Eligibility API is one of 16 APIs that Centers for Medicare and Medicaid Services publishes on the APIs.io network, described by a machine-readable OpenAPI specification.

Tagged areas include Households & Eligibility. The published artifact set on APIs.io includes an OpenAPI specification, API documentation, authentication docs, and a GitHub repository.

This API exposes 6 operations across 6 paths, and defines 15 schemas. It is described by OpenAPI 2.0, at version 1.

Requests are made against the 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 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
Note Use this JSON example in the POST Body in the request pane to view results: { "household": { "income": 52000, "people": [ { "dob": "1992-01-01", "aptceligible": true, "gender": "Female", "usesto…
3 params → 200
POST
/households/ichra
Get affordability and premium of the lowest cost silver plan
3 params → 200
POST
/households/lcbp
Get lowest cost bronze plan for a household
3 params → 200
POST
/households/slcsp
Get second lowest cost silver plan
3 params → 200
POST
/households/lcsp
Get lowest cost silver plan
3 params → 200
GET
/households/pcfpl
Household income as a percentage of the federal poverty level
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.

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

Specification

The full machine-readable OpenAPI contract behind this narrative.

Source

cms-households-eligibility-api-openapi.yml Raw ↑

Other APIs Centers for Medicare and Medicaid Services publishes across the network.

CMS Beneficiary Claims Data API (BCDA)
CMS AB2D API (Claims Data to Part D Sponsors)
CMS Data at the Point of Care (DPC) API
CMS Finder API
CMS Quality Payment Program (QPP) Submissions API
Centers for Medicare and Medicaid Services API Reference API
Centers for Medicare and Medicaid Services Bulk Data API
Centers for Medicare and Medicaid Services Code Search API
Centers for Medicare and Medicaid Services Cost Search API
Centers for Medicare and Medicaid Services Enrollments API
Centers for Medicare and Medicaid Services Geography API
Centers for Medicare and Medicaid Services Insurance Issuers API