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Centers for Medicare and Medicaid Services Insurance Plans API

Data on both health and dental insurance plans.

Centers for Medicare and Medicaid Services Insurance Plans API is one of 41 APIs that Centers for Medicare and 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, and a GitHub repository.

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://marketplace.api.healthcare.gov/api/v1
Authentication
API Key
Resource Areas
1

Authentication & Security 1

Centers for Medicare and 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
6 params → 200
POST
/plans
Get multiple plans
2 params body → 200
POST
/plans/search
Search for insurance plans
2 params body → 200
POST
/plans/search/stats
Retrieve stats on groups of insurance plans
2 params body → 200
GET
/plans/{plan_id}
Get a plan
3 params → 200
GET
/plans/{plan_id}/quality-ratings
Quality ratings for a plan. If a rating value is missing or is 0, then the rating is considered 'Not Rated' and the corresponding reason value will indicate the reason for the non-rating.
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.

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

Specification

The full machine-readable OpenAPI contract behind this narrative.

Source

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

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

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 Households & Eligibility API
Centers for Medicare and Medicaid Services Insurance Issuers API
Centers for Medicare and Medicaid Services Plans API
Where this information came from

This is an independent, third-party profile of Centers for Medicare and 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.

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