> ## Documentation Index
> Fetch the complete documentation index at: https://docs.clinikehr.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Get an insurer plan

> **Permission:** `insurance.plans:read`

Get one plan with its benefits.

Returns the plan and up to 500 benefit lines.



## OpenAPI

````yaml /openapi/ehr-api.v1.yaml get /v1/clinics/{clinic_id}/insurance/plans/{plan_id}
openapi: 3.1.0
info:
  title: ClinikEHR API
  version: 1.0.0
  description: >-
    Server-to-server REST API for a clinic's own data, reached with a key the
    clinic (or a developer workspace) creates in the developer portal.


    Authenticate every request with `Authorization: Bearer <key>`. Test keys
    reach only your workspace's own synthetic sandbox; live keys reach the
    clinic that created them. Lists wrap their rows as `{ data, has_more,
    next_cursor }`; single resources are returned directly. Errors are
    `application/problem+json` (RFC 9457) with a stable `code`.


    Write requests accept an `Idempotency-Key` header so a retry never repeats a
    change. See the guides for authentication, permissions, pagination, rate
    limits and retries.
servers:
  - url: https://api.clinikehr.com
security:
  - ApiKey: []
paths:
  /v1/clinics/{clinic_id}/insurance/plans/{plan_id}:
    get:
      tags:
        - HMO insurance
      summary: Get an insurer plan
      description: |-
        **Permission:** `insurance.plans:read`

        Get one plan with its benefits.

        Returns the plan and up to 500 benefit lines.
      operationId: getInsurancePlan
      parameters:
        - name: clinic_id
          in: path
          required: true
          schema:
            type: string
            format: uuid
        - name: plan_id
          in: path
          required: true
          schema:
            type: string
            format: uuid
      responses:
        '200':
          description: OK.
          content:
            application/json:
              schema:
                type: object
                required:
                  - data
                properties:
                  data:
                    $ref: '#/components/schemas/InsurancePlan'
        '400':
          $ref: '#/components/responses/BadRequest'
        '401':
          $ref: '#/components/responses/Unauthorized'
        '403':
          $ref: '#/components/responses/Forbidden'
        '404':
          $ref: '#/components/responses/NotFound'
        '409':
          $ref: '#/components/responses/Conflict'
        '429':
          $ref: '#/components/responses/TooManyRequests'
      security:
        - ApiKey: []
components:
  schemas:
    InsurancePlan:
      type: object
      description: >-
        A plan of an insurer the clinic linked to your organization. The list
        omits `benefits`; the single-plan read carries them (up to 500).
      required:
        - id
        - insurance_company_id
        - name
      properties:
        id:
          type: string
          format: uuid
        insurance_company_id:
          type: string
          format: uuid
        name:
          type: string
        code:
          type:
            - string
            - 'null'
        id_from_hmo:
          type:
            - string
            - 'null'
          description: The insurer's own identifier for the plan.
        plan_type:
          type:
            - string
            - 'null'
        coverage_type:
          type:
            - string
            - 'null'
        description:
          type:
            - string
            - 'null'
        amount_limit:
          type:
            - number
            - 'null'
        co_payment_value:
          type:
            - number
            - 'null'
        cover_dependants:
          type:
            - boolean
            - 'null'
        dependant_limit:
          type:
            - number
            - 'null'
        pre_authorization_required:
          type:
            - boolean
            - 'null'
        network_type:
          type:
            - string
            - 'null'
        waiting_period_days:
          type:
            - number
            - 'null'
        active:
          type:
            - boolean
            - 'null'
        updated_at:
          type:
            - string
            - 'null'
          format: date-time
        benefits:
          type: array
          description: Present on the single-plan read only.
          items:
            $ref: '#/components/schemas/InsurancePlanBenefit'
    InsurancePlanBenefit:
      type: object
      description: >-
        One benefit line of a plan - what is covered, at what percentage, with
        what limit.
      properties:
        id:
          type: string
          format: uuid
        name:
          type:
            - string
            - 'null'
        coverage_type:
          type:
            - string
            - 'null'
        claim_category:
          type:
            - string
            - 'null'
        covered:
          type:
            - boolean
            - 'null'
        coverage_percentage:
          type:
            - number
            - 'null'
        co_payment_value:
          type:
            - number
            - 'null'
        limit_type:
          type:
            - string
            - 'null'
        limit_value:
          type:
            - number
            - 'null'
        max_amount:
          type:
            - number
            - 'null'
        waiting_period:
          type:
            - number
            - 'null'
        enrollee_type:
          type:
            - string
            - 'null'
        gender:
          type:
            - string
            - 'null'
        active:
          type:
            - boolean
            - 'null'
    Problem:
      type: object
      description: RFC 9457 application/problem+json.
      required:
        - type
        - title
        - status
        - code
        - request_id
      properties:
        type:
          type: string
          format: uri
        title:
          type: string
        status:
          type: integer
        detail:
          type: string
        code:
          type: string
        request_id:
          type: string
        errors:
          type: array
          items:
            type: object
            required:
              - pointer
              - message
            properties:
              pointer:
                type: string
              message:
                type: string
  responses:
    BadRequest:
      description: >-
        The request failed validation (unknown query parameter, limit out of
        range, malformed body, or a write-off sent without its reason —
        `reason_required`).
      content:
        application/problem+json:
          schema:
            $ref: '#/components/schemas/Problem'
    Unauthorized:
      description: >-
        Missing, malformed, unknown, revoked or expired key, or the wrong
        secret.
      content:
        application/problem+json:
          schema:
            $ref: '#/components/schemas/Problem'
    Forbidden:
      description: >-
        The key or connection lacks the required scope, the plan does not
        include this resource, the request came from an address this key's IP
        allow-list does not permit, a TEST-environment workspace key asked for a
        clinic_id other than its own workspace's sandbox (`sandbox_only`), or a
        LIVE workspace key asked for a real clinic while its workspace's
        verification has lapsed (`not_verified`) — the response never names
        which addresses ARE allowed, nor which clinic actually is the sandbox.
      content:
        application/problem+json:
          schema:
            $ref: '#/components/schemas/Problem'
    NotFound:
      description: The record is absent, or out of the key's scope — one message for both.
      content:
        application/problem+json:
          schema:
            $ref: '#/components/schemas/Problem'
    Conflict:
      description: >-
        The request is well-formed but conflicts with the CURRENT STATE of the
        record — a double-booked slot (`slot_taken`), a clinician's calendar
        blocked at that time (`out_of_office`), nobody eligible free
        (`no_provider_available`), an item that still has stock
        (`item_has_stock`), an item that has been used and so cannot be deleted
        (`item_has_history`), a ledger movement that cannot be covered
        (`insufficient_stock`, `expired_stock_not_transferable`), a note already
        signed or clinician-touched (`note_not_editable`), an Idempotency-Key
        already used for a different request or still in flight
        (`idempotency_key_conflict`, `idempotency_key_reused`), or an
        external-stock batch rejected as structurally invalid or a suspicious
        shrink versus the clinic's last accepted batch (`batch_rejected`), or an
        outside record that conflicts with what was already submitted or
        decided: the same `client_reference` sent again with different content
        (`client_reference_conflict`), or a submission a clinician has already
        decided (`submission_not_pending`), or an insurance write that conflicts
        with the clinic's setup or the coverage's state: the patient already has
        a coverage for that payer (`coverage_exists`, the existing coverage's id
        is in `detail` when the caller can see that patient), a payer the clinic
        has not enabled in Settings → Insurance (`payer_not_enabled`), or
        `coverage_active: true` sent through the API
        (`activation_requires_staff` — only clinic staff activate a coverage),
        or a change to an outside care provider the clinic added rather than an
        app (`care_provider_clinic_managed` — only the clinic can change or
        remove it).
      content:
        application/problem+json:
          schema:
            $ref: '#/components/schemas/Problem'
    TooManyRequests:
      description: Rate limited. See the Retry-After header.
      content:
        application/problem+json:
          schema:
            $ref: '#/components/schemas/Problem'
  securitySchemes:
    ApiKey:
      type: http
      scheme: bearer
      bearerFormat: ehr_live_<keyId>_<secret> or ehr_test_<keyId>_<secret>

````

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