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Centers for Medicare and Medicaid Services Plans API

The Plans API from Centers for Medicare and Medicaid Services — 1 operation(s) for plans.

Centers for Medicare and Medicaid Services 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 Plans. The published artifact set on APIs.io includes an OpenAPI specification, API documentation, authentication docs, and a GitHub repository.

This API exposes 1 operation across 1 path, and defines 29 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.

1 operations 1 paths 29 schemas 1 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 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 1

Across 1 path, the API surfaces 1 operation — 1 POST. Each is listed below with its method, path, parameters, and response codes.

Plans 1
POST
/plans/{plan_id}
Get plan details with premiums for a household
2 params body → 200

Schemas 29

The contract defines 29 schemas that model the data the API accepts and returns. The most detailed are Plan (39 properties), Person (14 properties), QualityRating (10 properties), Issuer (8 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
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
MarketEnum
string
Household
object
If a household is not included, will default to Individual household
5 properties
CertificationStatus
string
PlanTypeEnum
string
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)
Plan
object
39 properties
Person
object
14 properties 2 required
Issuer
object
8 properties
SBCScenario
object
4 properties
Place
object
3 properties 3 required
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-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 Insurance Plans API
Where this information came from

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