# Coverage

> Generate Coverage and insurance resources with payer diversity including Medicare, Medicaid, commercial, Tricare, VA, and self-pay. Use when user mentions coverage, insurance, payer, Medicare, Medicaid, benefits, or coordination of benefits. For claims and EOB see the claims-eob skill.

- Skill: `majiayu000/coverage-4` (Agent Skill, multi-file: 2 files)
- Install (CLI): `npx skillmds add majiayu000/coverage-4`
- Raw SKILL.md: https://api.skillmd.com/api/skills/majiayu000/coverage-4/raw
- Safety review: pending
- Works with: Claude Code, Claude.ai, OpenAI Codex
- Category: Coding & Dev Tools
- Author: majiayu000 (https://skillmd.com/u/majiayu000)
- Updated: 2026-09-09
- Page: https://skillmd.com/skills/majiayu000/coverage-4

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# Coverage and Insurance

Model payer diversity:
- Coverage resource: Include subscriber, beneficiary, payor references.
- Payer types: Medicare (Part A, B, C, D), Medicaid, Commercial (BCBS, Aetna, UHC, Cigna),
  Tricare, VA, Self-pay/uninsured, Workers' Comp.
- Class: group, plan, subplan, class, subclass, sequence.
- Include Coverage.type codes from http://terminology.hl7.org/CodeSystem/v3-ActCode:
  EHCPOL (employee healthcare), PUBLICPOL (public policy), SUBSIDIZ, MANDPOL.
- Period: coverage start/end dates, with some patients having gaps in coverage.
- Include patients with multiple coverages (primary/secondary coordination).