specification: API Commons Plans
specificationVersion: '0.1'
schema: https://raw.githubusercontent.com/api-evangelist/interface-research/main/schema/api-commons.yml#/$defs/Plans
provider: CVS Health
providerId: cvs-health
created: '2026-05-04'
# Provenance stamped 2026-08-11: this artifact was written by the API Evangelist
# bulk sweep dated 2026-05-04, not harvested from the provider. See roadmap#35.
method: generated
modified: '2026-05-05'
reconciled: false
tags:
  - Healthcare
  - Pharmacy
  - Health Insurance
  - Aetna
  - Caremark
  - FHIR
  - Interoperability
description: CVS Health is a healthcare conglomerate (CVS Pharmacy, MinuteClinic, Caremark, Aetna, Oak
  Street). Partner / payer interoperability APIs (FHIR, HL7, NCPDP, EDI) are exposed through B2B partner
  agreements rather than a public developer plan. Aetna patient-facing FHIR is offered without charge
  under CMS Patient Access rule; partner / payer integrations are contract-priced.
sources:
  - https://www.cvshealth.com/
notes: No public developer pricing portal. Payer-mandated patient-access FHIR endpoints are no-cost to
  members under CMS rule; partner integrations are contractual. Reconcile if a CVS Health developer
  portal or API marketplace appears.
plans:
  - id: cvs-health-patient-access
    name: Aetna Patient Access (FHIR)
    type: freemium
    description: Patient-facing FHIR endpoints exposed under the CMS Patient Access rule for Aetna members.
      No charge to members or registered third-party apps.
    entries:
      - label: Patient access
        description: Member-authorized FHIR access; no fee
        name: patient_access
        type: quota
        metric: request
        limit: -1
        timeFrame: month
        geo: US
        domains:
          - https://www.cvshealth.com
        unit: 1
        price: '0.00'
        userMultiplied: false
    elements:
      - name: FHIR Patient / Coverage / EOB
      - name: SMART on FHIR app registration
      - name: CVS Health Partner Integrations
  - id: cvs-health-partner
    name: Partner Integration
    type: enterprise
    description: Payer / pharmacy / provider B2B integrations (HL7, NCPDP, EDI 270/271/834/835, partner
      FHIR). Pricing is contractual.
    entries:
      - label: Partner contract
        description: Negotiated partner integration agreement
        name: partner_contract
        type: subscription
        metric: contract
        limit: -1
        timeFrame: year
        geo: US
        domains:
          - https://www.cvshealth.com
        unit: 1
        price: contact partner team
        userMultiplied: false
    elements:
      - name: HL7 / FHIR partner endpoints
      - name: NCPDP pharmacy claims
      - name: EDI healthcare transactions
      - name: CVS Health Partner Integrations
maintainers:
  - FN: Kin Lane
    email: kin@apievangelist.com
x-canonical:
  generated: '2026-10-08'
  vocabulary: all/0-working/economics/plans-canonical.yml
  models:
  - free
  - subscription
  units:
  - negotiated
  - request
  plans:
  - name: Aetna Patient Access (FHIR)
    access: freemium
    model: free
    model_how: derived
    units:
    - request
    periods:
    - month
  - name: Partner Integration
    access: enterprise
    model: subscription
    model_how: derived
    units:
    - negotiated
    periods:
    - year