coverage-rights

{'type': 'object', '$schema': 'http://json-schema.org/draft-07/schema#', 'required': ['program', 'denial_reason'], 'properties': {'state': {'type': 'string', 'maxLength': 2, 'minLength': 2, 'description': "Two-letter state code, e.g. 'ca'"}, 'program': {'enum': ['medicare-advantage', 'original-medicare', 'medicare-part-d', 'erisa-employer-plans', 'aca-marketplace', 'medicaid', 'fehb', 'tricare', 'other-unknown'], 'type': 'string', 'description': 'Plan type'}, 'appeal_stage': {'enum': ['initial-denial', 'internal-appeal-filed', 'first-internal-denial', 'final-internal-denial', 'external-review-filed', 'unknown'], 'type': 'string'}, 'drug_channel': {'enum': ['not-a-drug', 'medical-benefit', 'pharmacy-benefit', 'unknown'], 'type': 'string', 'description': 'For a drug denial, whether the medical or pharmacy benefit applies'}, 'insurer_slug': {'type': 'string', 'description': 'Insurer slug for insurer-specific stats'}, 'denial_reason': {'enum': ['medical-necessity', 'experimental-investigational', 'prior-authorization', 'out-of-network', 'not-covered-benefit', 'coding-billing-error', 'prescription-drug'], 'type': 'string', 'description': "Denial reason category. Use 'prescription-drug' for medication denials â\x80\x94 formulary exclusion, step therapy, quantity limits, or drug prior authorization â\x80\x94 which return the formulary-exception grounds and their short decision deadlines."}, 'employer_type': {'enum': ['private', 'government', 'church', 'union', 'unknown'], 'type': 'string', 'description': 'Required to resolve job-based coverage'}, 'current_status': {'enum': ['awaiting-service', 'receiving-service', 'service-ended', 'post-service-claim', 'unknown'], 'type': 'string'}, 'funding_status': {'enum': ['fully-insured', 'self-funded', 'unknown'], 'type': 'string', 'description': 'Required to resolve job-based state versus federal governance'}, 'regulatory_marker': {'enum': ['state-regulated', 'federal-or-self-funded', 'unknown'], 'type': 'string'}, 'regulatory_state_basis': {'enum': ['denial-letter', 'insurance-card', 'plan-document', 'residence-only', 'unknown'], 'type': 'string'}}, 'additionalProperties': False}

{'type': 'object', '$schema': 'http://json-schema.org/draft-07/schema#', 'required': ['slug'], 'properties': {'slug': {'type': 'string', 'description': "Condition slug, e.g. 'obesity', 'autism', 'hepatitis-c'"}}, 'additionalProperties': False}

{'type': 'object', '$schema': 'http://json-schema.org/draft-07/schema#', 'required': ['drug'], 'properties': {'drug': {'type': 'string', 'maxLength': 80, 'minLength': 2, 'description': "Brand or generic drug name, e.g. 'Zepbound', 'ustekinumab'"}}, 'additionalProperties': False}

{'type': 'object', '$schema': 'http://json-schema.org/draft-07/schema#', 'required': ['slug'], 'properties': {'slug': {'type': 'string', 'description': "Insurer slug from list_insurers, e.g. 'unitedhealthcare'"}}, 'additionalProperties': False}

{'type': 'object', '$schema': 'http://json-schema.org/draft-07/schema#', 'required': ['state'], 'properties': {'state': {'type': 'string', 'maxLength': 2, 'minLength': 2, 'description': "Two-letter state code, e.g. 'ca', 'ny', 'fl'"}}, 'additionalProperties': False}

{'type': 'object', '$schema': 'http://json-schema.org/draft-07/schema#', 'required': ['slug'], 'properties': {'slug': {'type': 'string', 'description': "Treatment slug, e.g. 'zepbound', 'pharmacy', 'speech-therapy'. Use search_outcomes to find slugs."}}, 'additionalProperties': False}

{'type': 'object', '$schema': 'http://json-schema.org/draft-07/schema#', 'properties': {}}

{'type': 'object', '$schema': 'http://json-schema.org/draft-07/schema#', 'properties': {}}

{'type': 'object', '$schema': 'http://json-schema.org/draft-07/schema#', 'required': ['query'], 'properties': {'limit': {'type': 'integer', 'maximum': 50, 'minimum': 1, 'description': 'Max results per type (default 10)'}, 'query': {'type': 'string', 'minLength': 2, 'description': "Search text, e.g. 'wegovy', 'back pain', 'imaging'"}}, 'additionalProperties': False}