ACA Medical

Quote an individual or family for medical health plans

Ideon's Individual Medical Quoting APIs deliver all available plans, their associated benefits, and premiums for an individual and their dependents. By default, all available plans are returned when quoting; both on-market and off-market plans are included. In our documentation and Postman Collections, this will commonly be referred to as "IFP Medical Quoting."

Integration Summary

The core integration for IFP Medical Quoting supports delivering available plans, their premiums, and complete benefits packages for an individual or family.

1. Cache Benefits (optional) - Individual Medical Quotes return member-specific plan availability, premiums, and benefit information directly in the response. However, users may optionally cache Ideon's full inventory of health plans and their associated benefits on a daily or weekly cadence. This allows client-side access to available plans prior to quoting, if necessary. A guide to caching plan benefit inventory is detailed in the Bulk Exports section, and an overview of the benefit grammar and schema can be found in the Medical Benefit Grammar Guide section.

2. Quote Applicants - quote all available plans and their premiums for an individual and their dependents. Optionally, include household income and size to evaluate available tax credits and subsidies.

Medicare Advantage Quoting

Medicare Advantage plans can be quoted using the same process as the above IFP Medical Quoting integration, with some small variations.

Decision Support Features

For both Individual Medical and Medicare Advantage quoting, provider and drug details can be included to check for in-network and formulary coverage within each plan. See the following sections for details on these use cases:

• Shop by Doc - check network participation for selected providers and optionally, their addresses, for each plan quoted.

• Shop by Drug - check formulary coverage for selected drugs for each plan quoted. A dedicated section for Shop by Drug is coming soon!