Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage	C	0..*	Coverage	Insurance or medical plan or a payment agreement Constraints: vn-coverage-subscriberid-consistency
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:bhytCardType	S	0..1	CodeableConcept	Loại đối tượng BHYT (DN, HC, HN, TE...) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-bhyt-card-type Binding: Loại đối tượng thẻ BHYT — Vietnam BHYT Card Type ValueSet (required)
extension:primaryCareFacility	S	0..1	Reference(Cơ sở y tế VN Core — VN Core Organization Profile)	Nơi ĐKKCB ban đầu (MA_DKBD) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-primary-care-facility
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	0..*	Identifier	Business Identifier for the coverage Slice: Unordered, Open by value:system
identifier:BHYT	SΣ	0..1	Identifier	Business Identifier for the coverage
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://fhir.hl7.org.vn/core/sid/bhyt
value	ΣC	1..1	string	Số thẻ BHYT Constraints: vn-bhyt-format Example General: 123456
status	?!SΣ	1..1	code	Trạng thái thẻ (active, cancelled) Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	SΣ	1..1	CodeableConcept	Loại coverage theo ngữ nghĩa chuẩn FHIR Binding: CoverageTypeAndSelf-PayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.
Slices for coding	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:coverageCategory	SΣ	1..1	Coding	Code defined by a terminology system
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/insurance-coverage-type
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: medical
text	Σ	0..1	string	Tên hiển thị tiếng Việt của loại coverage
subscriber	SΣ	0..1	Reference(Bệnh nhân VN Core — VN Core Patient Profile | Người liên quan/người giám hộ VN Core — VN Core RelatedPerson Profile)	Người đứng tên/đối tượng subscriber theo Coverage
subscriberId	ΣC	0..1	string	Số thẻ BHYT (deprecated — dùng identifier[BHYT]) Constraints: vn-bhyt-format
beneficiary	SΣ	1..1	Reference(Bệnh nhân VN Core — VN Core Patient Profile)	Người thụ hưởng BHYT
relationship	S	0..1	CodeableConcept	Quan hệ giữa beneficiary và subscriber Binding: SubscriberPolicyholder Relationship Codes (required)
period	SΣ	0..1	Period	Thời hạn thẻ BHYT
start	SΣC	0..1	dateTime	Ngày bắt đầu hiệu lực
end	SΣC	0..1	dateTime	Ngày hết hiệu lực
payor	SΣ	1..*	Reference(Organization | Patient | RelatedPerson)	Cơ quan chi trả (BHXH Việt Nam)
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.identifier:BHYT.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Coverage.status	Base	required	Financial Resource Status Codes	📍4.0.1	FHIR Std.
Coverage.type	Base	preferred	Coverage Type and Self-Pay Codes	📍4.0.1	FHIR Std.
Coverage.relationship	Base	required	SubscriberPolicyholder Relationship Codes	📦1.0.1	THO v7.1

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Coverage	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Coverage	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Coverage	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
vn-bhyt-format	warning	Coverage.identifier:BHYT.value, Coverage.subscriberId	Số thẻ BHYT phải theo 1 trong 3 format: (1) 12 chữ số = CCCD (hỗ trợ từ 15/8/2025 per NĐ 188/2025), (2) 10 chữ số = mã BHXH (từ 01/4/2021), (3) 15 ký tự = 2 chữ + 13 số format cũ (trước 2021). Cả 3 format đều được chấp nhận song song	$this.empty() or $this.matches('^[0-9]{12}$') or $this.matches('^[0-9]{10}$') or $this.matches('^[A-Z]{2}[0-9]{13}$')
vn-coverage-subscriberid-consistency	error	Coverage	Nếu đồng thời dùng subscriberId và identifier[BHYT] thì hai giá trị phải trùng nhau	subscriberId.empty() or identifier.where(system='http://fhir.hl7.org.vn/core/sid/bhyt').empty() or subscriberId = identifier.where(system='http://fhir.hl7.org.vn/core/sid/bhyt').first().value

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage	C	0..*	Coverage	Insurance or medical plan or a payment agreement Constraints: vn-coverage-subscriberid-consistency
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:bhytCardType	S	0..1	CodeableConcept	Loại đối tượng BHYT (DN, HC, HN, TE...) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-bhyt-card-type Binding: Loại đối tượng thẻ BHYT — Vietnam BHYT Card Type ValueSet (required)
extension:primaryCareFacility	S	0..1	Reference(Cơ sở y tế VN Core — VN Core Organization Profile)	Nơi ĐKKCB ban đầu (MA_DKBD) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-primary-care-facility
Slices for identifier	S	0..*	Identifier	Business Identifier for the coverage Slice: Unordered, Open by value:system
identifier:BHYT	S	0..1	Identifier	Business Identifier for the coverage
system		1..1	uri	The namespace for the identifier value Fixed Value: http://fhir.hl7.org.vn/core/sid/bhyt
value	C	1..1	string	Số thẻ BHYT Constraints: vn-bhyt-format
status	S	1..1	code	Trạng thái thẻ (active, cancelled)
type	S	1..1	CodeableConcept	Loại coverage theo ngữ nghĩa chuẩn FHIR
Slices for coding	S	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:coverageCategory	S	1..1	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/insurance-coverage-type
code		1..1	code	Symbol in syntax defined by the system Fixed Value: medical
text		0..1	string	Tên hiển thị tiếng Việt của loại coverage
subscriber	S	0..1	Reference(Bệnh nhân VN Core — VN Core Patient Profile | Người liên quan/người giám hộ VN Core — VN Core RelatedPerson Profile)	Người đứng tên/đối tượng subscriber theo Coverage
subscriberId	C	0..1	string	Số thẻ BHYT (deprecated — dùng identifier[BHYT]) Constraints: vn-bhyt-format
beneficiary	S	1..1	Reference(Bệnh nhân VN Core — VN Core Patient Profile)	Người thụ hưởng BHYT
relationship	S	0..1	CodeableConcept	Quan hệ giữa beneficiary và subscriber Binding: SubscriberPolicyholder Relationship Codes (required)
period	S	0..1	Period	Thời hạn thẻ BHYT
start	S	0..1	dateTime	Ngày bắt đầu hiệu lực
end	S	0..1	dateTime	Ngày hết hiệu lực
payor	S	1..*	Reference(Organization | Patient | RelatedPerson)	Cơ quan chi trả (BHXH Việt Nam)
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Coverage.relationship	Base	required	SubscriberPolicyholder Relationship Codes	📦1.0.1	THO v7.1

Constraints

Id	Grade	Path(s)	Description	Expression
vn-bhyt-format	warning	Coverage.identifier:BHYT.value, Coverage.subscriberId	Số thẻ BHYT phải theo 1 trong 3 format: (1) 12 chữ số = CCCD (hỗ trợ từ 15/8/2025 per NĐ 188/2025), (2) 10 chữ số = mã BHXH (từ 01/4/2021), (3) 15 ký tự = 2 chữ + 13 số format cũ (trước 2021). Cả 3 format đều được chấp nhận song song	$this.empty() or $this.matches('^[0-9]{12}$') or $this.matches('^[0-9]{10}$') or $this.matches('^[A-Z]{2}[0-9]{13}$')
vn-coverage-subscriberid-consistency	error	Coverage	Nếu đồng thời dùng subscriberId và identifier[BHYT] thì hai giá trị phải trùng nhau	subscriberId.empty() or identifier.where(system='http://fhir.hl7.org.vn/core/sid/bhyt').empty() or subscriberId = identifier.where(system='http://fhir.hl7.org.vn/core/sid/bhyt').first().value

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage	C	0..*	Coverage	Insurance or medical plan or a payment agreement Constraints: vn-coverage-subscriberid-consistency
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:bhytCardType	S	0..1	CodeableConcept	Loại đối tượng BHYT (DN, HC, HN, TE...) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-bhyt-card-type Binding: Loại đối tượng thẻ BHYT — Vietnam BHYT Card Type ValueSet (required)
extension:primaryCareFacility	S	0..1	Reference(Cơ sở y tế VN Core — VN Core Organization Profile)	Nơi ĐKKCB ban đầu (MA_DKBD) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-primary-care-facility
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	0..*	Identifier	Business Identifier for the coverage Slice: Unordered, Open by value:system
identifier:BHYT	SΣ	0..1	Identifier	Business Identifier for the coverage
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://fhir.hl7.org.vn/core/sid/bhyt
value	ΣC	1..1	string	Số thẻ BHYT Constraints: vn-bhyt-format Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	Trạng thái thẻ (active, cancelled) Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	SΣ	1..1	CodeableConcept	Loại coverage theo ngữ nghĩa chuẩn FHIR Binding: CoverageTypeAndSelf-PayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:coverageCategory	SΣ	1..1	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/insurance-coverage-type
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: medical
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Tên hiển thị tiếng Việt của loại coverage
policyHolder	Σ	0..1	Reference(Patient | RelatedPerson | Organization)	Owner of the policy
subscriber	SΣ	0..1	Reference(Bệnh nhân VN Core — VN Core Patient Profile | Người liên quan/người giám hộ VN Core — VN Core RelatedPerson Profile)	Người đứng tên/đối tượng subscriber theo Coverage
subscriberId	ΣC	0..1	string	Số thẻ BHYT (deprecated — dùng identifier[BHYT]) Constraints: vn-bhyt-format
beneficiary	SΣ	1..1	Reference(Bệnh nhân VN Core — VN Core Patient Profile)	Người thụ hưởng BHYT
dependent	Σ	0..1	string	Dependent number
relationship	S	0..1	CodeableConcept	Quan hệ giữa beneficiary và subscriber Binding: SubscriberPolicyholder Relationship Codes (required)
period	SΣ	0..1	Period	Thời hạn thẻ BHYT
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	0..1	dateTime	Ngày bắt đầu hiệu lực
end	SΣC	0..1	dateTime	Ngày hết hiệu lực
payor	SΣ	1..*	Reference(Organization | Patient | RelatedPerson)	Cơ quan chi trả (BHXH Việt Nam)
class		0..*	BackboneElement	Additional coverage classifications
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
value	Σ	1..1	string	Value associated with the type
name	Σ	0..1	string	Human readable description of the type and value
order	Σ	0..1	positiveInt	Relative order of the coverage
network	Σ	0..1	string	Insurer network
costToBeneficiary		0..*	BackboneElement	Patient payments for services/products
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	0..1	CodeableConcept	Cost category Binding: CoverageCopayTypeCodes (extensible): The types of services to which patient copayments are specified.
value[x]	Σ	1..1		The amount or percentage due from the beneficiary
valueQuantity			Quantity(SimpleQuantity)
valueMoney			Money
exception		0..*	BackboneElement	Exceptions for patient payments
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Exception category Binding: ExampleCoverageFinancialExceptionCodes (example): The types of exceptions from the part or full value of financial obligations such as copays.
period	Σ	0..1	Period	The effective period of the exception
subrogation		0..1	boolean	Reimbursement to insurer
contract		0..*	Reference(Contract)	Contract details
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Coverage.identifier:BHYT.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Coverage.identifier:BHYT.​type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
Coverage.status	Base	required	Financial Resource Status Codes	📍4.0.1	FHIR Std.
Coverage.type	Base	preferred	Coverage Type and Self-Pay Codes	📍4.0.1	FHIR Std.
Coverage.relationship	Base	required	SubscriberPolicyholder Relationship Codes	📦1.0.1	THO v7.1
Coverage.class.type	Base	extensible	Coverage Class Codes	📍4.0.1	FHIR Std.
Coverage.costToBeneficiary.​type	Base	extensible	Coverage Copay Type Codes	📍4.0.1	FHIR Std.
Coverage.costToBeneficiary.​exception.type	Base	example	Example Coverage Financial Exception Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Coverage	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Coverage	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Coverage	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
vn-bhyt-format	warning	Coverage.identifier:BHYT.value, Coverage.subscriberId	Số thẻ BHYT phải theo 1 trong 3 format: (1) 12 chữ số = CCCD (hỗ trợ từ 15/8/2025 per NĐ 188/2025), (2) 10 chữ số = mã BHXH (từ 01/4/2021), (3) 15 ký tự = 2 chữ + 13 số format cũ (trước 2021). Cả 3 format đều được chấp nhận song song	$this.empty() or $this.matches('^[0-9]{12}$') or $this.matches('^[0-9]{10}$') or $this.matches('^[A-Z]{2}[0-9]{13}$')
vn-coverage-subscriberid-consistency	error	Coverage	Nếu đồng thời dùng subscriberId và identifier[BHYT] thì hai giá trị phải trùng nhau	subscriberId.empty() or identifier.where(system='http://fhir.hl7.org.vn/core/sid/bhyt').empty() or subscriberId = identifier.where(system='http://fhir.hl7.org.vn/core/sid/bhyt').first().value

Summary

Mandatory: 5 elements(2 nested mandatory elements)
Must-Support: 15 elements
Fixed: 3 elements

Structures

This structure refers to these other structures:

• Bệnh nhân VN Core — VN Core Patient Profile (http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-patient)
• Người liên quan/người giám hộ VN Core — VN Core RelatedPerson Profile (http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-relatedperson)

Extensions

This structure refers to these extensions:

• http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-bhyt-card-type
• http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-primary-care-facility

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the values of Coverage.identifier
• The element 1 is sliced based on the values of Coverage.type.coding

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage	C	0..*	Coverage	Insurance or medical plan or a payment agreement Constraints: vn-coverage-subscriberid-consistency
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:bhytCardType	S	0..1	CodeableConcept	Loại đối tượng BHYT (DN, HC, HN, TE...) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-bhyt-card-type Binding: Loại đối tượng thẻ BHYT — Vietnam BHYT Card Type ValueSet (required)
extension:primaryCareFacility	S	0..1	Reference(Cơ sở y tế VN Core — VN Core Organization Profile)	Nơi ĐKKCB ban đầu (MA_DKBD) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-primary-care-facility
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	0..*	Identifier	Business Identifier for the coverage Slice: Unordered, Open by value:system
identifier:BHYT	SΣ	0..1	Identifier	Business Identifier for the coverage
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://fhir.hl7.org.vn/core/sid/bhyt
value	ΣC	1..1	string	Số thẻ BHYT Constraints: vn-bhyt-format Example General: 123456
status	?!SΣ	1..1	code	Trạng thái thẻ (active, cancelled) Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	SΣ	1..1	CodeableConcept	Loại coverage theo ngữ nghĩa chuẩn FHIR Binding: CoverageTypeAndSelf-PayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.
Slices for coding	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:coverageCategory	SΣ	1..1	Coding	Code defined by a terminology system
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/insurance-coverage-type
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: medical
text	Σ	0..1	string	Tên hiển thị tiếng Việt của loại coverage
subscriber	SΣ	0..1	Reference(Bệnh nhân VN Core — VN Core Patient Profile | Người liên quan/người giám hộ VN Core — VN Core RelatedPerson Profile)	Người đứng tên/đối tượng subscriber theo Coverage
subscriberId	ΣC	0..1	string	Số thẻ BHYT (deprecated — dùng identifier[BHYT]) Constraints: vn-bhyt-format
beneficiary	SΣ	1..1	Reference(Bệnh nhân VN Core — VN Core Patient Profile)	Người thụ hưởng BHYT
relationship	S	0..1	CodeableConcept	Quan hệ giữa beneficiary và subscriber Binding: SubscriberPolicyholder Relationship Codes (required)
period	SΣ	0..1	Period	Thời hạn thẻ BHYT
start	SΣC	0..1	dateTime	Ngày bắt đầu hiệu lực
end	SΣC	0..1	dateTime	Ngày hết hiệu lực
payor	SΣ	1..*	Reference(Organization | Patient | RelatedPerson)	Cơ quan chi trả (BHXH Việt Nam)
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.identifier:BHYT.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Coverage.status	Base	required	Financial Resource Status Codes	📍4.0.1	FHIR Std.
Coverage.type	Base	preferred	Coverage Type and Self-Pay Codes	📍4.0.1	FHIR Std.
Coverage.relationship	Base	required	SubscriberPolicyholder Relationship Codes	📦1.0.1	THO v7.1

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Coverage	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Coverage	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Coverage	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
vn-bhyt-format	warning	Coverage.identifier:BHYT.value, Coverage.subscriberId	Số thẻ BHYT phải theo 1 trong 3 format: (1) 12 chữ số = CCCD (hỗ trợ từ 15/8/2025 per NĐ 188/2025), (2) 10 chữ số = mã BHXH (từ 01/4/2021), (3) 15 ký tự = 2 chữ + 13 số format cũ (trước 2021). Cả 3 format đều được chấp nhận song song	$this.empty() or $this.matches('^[0-9]{12}$') or $this.matches('^[0-9]{10}$') or $this.matches('^[A-Z]{2}[0-9]{13}$')
vn-coverage-subscriberid-consistency	error	Coverage	Nếu đồng thời dùng subscriberId và identifier[BHYT] thì hai giá trị phải trùng nhau	subscriberId.empty() or identifier.where(system='http://fhir.hl7.org.vn/core/sid/bhyt').empty() or subscriberId = identifier.where(system='http://fhir.hl7.org.vn/core/sid/bhyt').first().value

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage	C	0..*	Coverage	Insurance or medical plan or a payment agreement Constraints: vn-coverage-subscriberid-consistency
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:bhytCardType	S	0..1	CodeableConcept	Loại đối tượng BHYT (DN, HC, HN, TE...) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-bhyt-card-type Binding: Loại đối tượng thẻ BHYT — Vietnam BHYT Card Type ValueSet (required)
extension:primaryCareFacility	S	0..1	Reference(Cơ sở y tế VN Core — VN Core Organization Profile)	Nơi ĐKKCB ban đầu (MA_DKBD) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-primary-care-facility
Slices for identifier	S	0..*	Identifier	Business Identifier for the coverage Slice: Unordered, Open by value:system
identifier:BHYT	S	0..1	Identifier	Business Identifier for the coverage
system		1..1	uri	The namespace for the identifier value Fixed Value: http://fhir.hl7.org.vn/core/sid/bhyt
value	C	1..1	string	Số thẻ BHYT Constraints: vn-bhyt-format
status	S	1..1	code	Trạng thái thẻ (active, cancelled)
type	S	1..1	CodeableConcept	Loại coverage theo ngữ nghĩa chuẩn FHIR
Slices for coding	S	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:coverageCategory	S	1..1	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/insurance-coverage-type
code		1..1	code	Symbol in syntax defined by the system Fixed Value: medical
text		0..1	string	Tên hiển thị tiếng Việt của loại coverage
subscriber	S	0..1	Reference(Bệnh nhân VN Core — VN Core Patient Profile | Người liên quan/người giám hộ VN Core — VN Core RelatedPerson Profile)	Người đứng tên/đối tượng subscriber theo Coverage
subscriberId	C	0..1	string	Số thẻ BHYT (deprecated — dùng identifier[BHYT]) Constraints: vn-bhyt-format
beneficiary	S	1..1	Reference(Bệnh nhân VN Core — VN Core Patient Profile)	Người thụ hưởng BHYT
relationship	S	0..1	CodeableConcept	Quan hệ giữa beneficiary và subscriber Binding: SubscriberPolicyholder Relationship Codes (required)
period	S	0..1	Period	Thời hạn thẻ BHYT
start	S	0..1	dateTime	Ngày bắt đầu hiệu lực
end	S	0..1	dateTime	Ngày hết hiệu lực
payor	S	1..*	Reference(Organization | Patient | RelatedPerson)	Cơ quan chi trả (BHXH Việt Nam)
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Coverage.relationship	Base	required	SubscriberPolicyholder Relationship Codes	📦1.0.1	THO v7.1

Constraints

Id	Grade	Path(s)	Description	Expression
vn-bhyt-format	warning	Coverage.identifier:BHYT.value, Coverage.subscriberId	Số thẻ BHYT phải theo 1 trong 3 format: (1) 12 chữ số = CCCD (hỗ trợ từ 15/8/2025 per NĐ 188/2025), (2) 10 chữ số = mã BHXH (từ 01/4/2021), (3) 15 ký tự = 2 chữ + 13 số format cũ (trước 2021). Cả 3 format đều được chấp nhận song song	$this.empty() or $this.matches('^[0-9]{12}$') or $this.matches('^[0-9]{10}$') or $this.matches('^[A-Z]{2}[0-9]{13}$')
vn-coverage-subscriberid-consistency	error	Coverage	Nếu đồng thời dùng subscriberId và identifier[BHYT] thì hai giá trị phải trùng nhau	subscriberId.empty() or identifier.where(system='http://fhir.hl7.org.vn/core/sid/bhyt').empty() or subscriberId = identifier.where(system='http://fhir.hl7.org.vn/core/sid/bhyt').first().value

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage	C	0..*	Coverage	Insurance or medical plan or a payment agreement Constraints: vn-coverage-subscriberid-consistency
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:bhytCardType	S	0..1	CodeableConcept	Loại đối tượng BHYT (DN, HC, HN, TE...) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-bhyt-card-type Binding: Loại đối tượng thẻ BHYT — Vietnam BHYT Card Type ValueSet (required)
extension:primaryCareFacility	S	0..1	Reference(Cơ sở y tế VN Core — VN Core Organization Profile)	Nơi ĐKKCB ban đầu (MA_DKBD) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-primary-care-facility
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	0..*	Identifier	Business Identifier for the coverage Slice: Unordered, Open by value:system
identifier:BHYT	SΣ	0..1	Identifier	Business Identifier for the coverage
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://fhir.hl7.org.vn/core/sid/bhyt
value	ΣC	1..1	string	Số thẻ BHYT Constraints: vn-bhyt-format Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	Trạng thái thẻ (active, cancelled) Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	SΣ	1..1	CodeableConcept	Loại coverage theo ngữ nghĩa chuẩn FHIR Binding: CoverageTypeAndSelf-PayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:coverageCategory	SΣ	1..1	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/insurance-coverage-type
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: medical
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Tên hiển thị tiếng Việt của loại coverage
policyHolder	Σ	0..1	Reference(Patient | RelatedPerson | Organization)	Owner of the policy
subscriber	SΣ	0..1	Reference(Bệnh nhân VN Core — VN Core Patient Profile | Người liên quan/người giám hộ VN Core — VN Core RelatedPerson Profile)	Người đứng tên/đối tượng subscriber theo Coverage
subscriberId	ΣC	0..1	string	Số thẻ BHYT (deprecated — dùng identifier[BHYT]) Constraints: vn-bhyt-format
beneficiary	SΣ	1..1	Reference(Bệnh nhân VN Core — VN Core Patient Profile)	Người thụ hưởng BHYT
dependent	Σ	0..1	string	Dependent number
relationship	S	0..1	CodeableConcept	Quan hệ giữa beneficiary và subscriber Binding: SubscriberPolicyholder Relationship Codes (required)
period	SΣ	0..1	Period	Thời hạn thẻ BHYT
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	0..1	dateTime	Ngày bắt đầu hiệu lực
end	SΣC	0..1	dateTime	Ngày hết hiệu lực
payor	SΣ	1..*	Reference(Organization | Patient | RelatedPerson)	Cơ quan chi trả (BHXH Việt Nam)
class		0..*	BackboneElement	Additional coverage classifications
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
value	Σ	1..1	string	Value associated with the type
name	Σ	0..1	string	Human readable description of the type and value
order	Σ	0..1	positiveInt	Relative order of the coverage
network	Σ	0..1	string	Insurer network
costToBeneficiary		0..*	BackboneElement	Patient payments for services/products
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	0..1	CodeableConcept	Cost category Binding: CoverageCopayTypeCodes (extensible): The types of services to which patient copayments are specified.
value[x]	Σ	1..1		The amount or percentage due from the beneficiary
valueQuantity			Quantity(SimpleQuantity)
valueMoney			Money
exception		0..*	BackboneElement	Exceptions for patient payments
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Exception category Binding: ExampleCoverageFinancialExceptionCodes (example): The types of exceptions from the part or full value of financial obligations such as copays.
period	Σ	0..1	Period	The effective period of the exception
subrogation		0..1	boolean	Reimbursement to insurer
contract		0..*	Reference(Contract)	Contract details
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Coverage.identifier:BHYT.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Coverage.identifier:BHYT.​type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
Coverage.status	Base	required	Financial Resource Status Codes	📍4.0.1	FHIR Std.
Coverage.type	Base	preferred	Coverage Type and Self-Pay Codes	📍4.0.1	FHIR Std.
Coverage.relationship	Base	required	SubscriberPolicyholder Relationship Codes	📦1.0.1	THO v7.1
Coverage.class.type	Base	extensible	Coverage Class Codes	📍4.0.1	FHIR Std.
Coverage.costToBeneficiary.​type	Base	extensible	Coverage Copay Type Codes	📍4.0.1	FHIR Std.
Coverage.costToBeneficiary.​exception.type	Base	example	Example Coverage Financial Exception Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Coverage	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Coverage	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Coverage	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
vn-bhyt-format	warning	Coverage.identifier:BHYT.value, Coverage.subscriberId	Số thẻ BHYT phải theo 1 trong 3 format: (1) 12 chữ số = CCCD (hỗ trợ từ 15/8/2025 per NĐ 188/2025), (2) 10 chữ số = mã BHXH (từ 01/4/2021), (3) 15 ký tự = 2 chữ + 13 số format cũ (trước 2021). Cả 3 format đều được chấp nhận song song	$this.empty() or $this.matches('^[0-9]{12}$') or $this.matches('^[0-9]{10}$') or $this.matches('^[A-Z]{2}[0-9]{13}$')
vn-coverage-subscriberid-consistency	error	Coverage	Nếu đồng thời dùng subscriberId và identifier[BHYT] thì hai giá trị phải trùng nhau	subscriberId.empty() or identifier.where(system='http://fhir.hl7.org.vn/core/sid/bhyt').empty() or subscriberId = identifier.where(system='http://fhir.hl7.org.vn/core/sid/bhyt').first().value

Summary

Mandatory: 5 elements(2 nested mandatory elements)
Must-Support: 15 elements
Fixed: 3 elements

Structures

This structure refers to these other structures:

• Bệnh nhân VN Core — VN Core Patient Profile (http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-patient)
• Người liên quan/người giám hộ VN Core — VN Core RelatedPerson Profile (http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-relatedperson)

Extensions

This structure refers to these extensions:

• http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-bhyt-card-type
• http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-primary-care-facility

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the values of Coverage.identifier
• The element 1 is sliced based on the values of Coverage.type.coding