specification: API Commons Plans
specificationVersion: '0.1'
schema: https://raw.githubusercontent.com/api-evangelist/interface-research/main/schema/api-commons.yml#/$defs/Plans
provider: Elevance Health
providerId: elevance-health
created: '2026-05-04'
modified: '2026-09-07'
generated: '2026-09-07'
method: searched
source: >-
  https://www.anthem.com/developers and the first-party "Interoperability API Endpoint Support
  Document" (IO105 v15.0, effective 2025-11-18) at
  https://www.anthem.com/content/dam/digital/developers-portal/Anthem-IOProviderDirectoryAndFormulary-API-Documentation.pdf
reconciled: true
tags:
  - Healthcare
  - Health Insurance
  - FHIR
  - Interoperability
description: >-
  Elevance Health publishes no price list, no plan tiers and no quotas for any of its APIs, and
  charges nothing. Every published API exists to satisfy the CMS Interoperability and Patient Access
  Final Rule (CMS-9115-F), which requires payers to make this data available to members and to
  third-party applications without charge. The gate on these APIs is registration and approval, not
  money. That is the finding: plan_count is 0 because there are no plans, not because none were found.
plan_count: 0
pricing_published: false
free_of_charge: true
currency: null
access_gates:
- api: Patient Access API
  gate: registration and member consent
  cost: none
  self_serve: false
  detail: >-
    Sandbox access is self-service on registration. Production requires the Patient Access API
    Production Environment request form, a documented security risk analysis, and acceptance of the
    Exhibit A terms of service; approval can take several weeks. At call time each member must
    consent, and the resulting token is valid for 90 days.
  registration_url: https://www.anthem.com/developers/request-anthem-io
  registration_status: 200
- api: Provider Directory API
  gate: registration
  cost: none
  self_serve: false
  detail: >-
    Described by Elevance as a public production environment that nonetheless requires registration.
    Client id, client secret and the access-token URL are delivered by secure email after the
    Provider Directory API Production Environment request form is approved.
  registration_url: https://www.anthem.com/developers/provider-directory-api-request
  registration_status: 200
- api: Formulary API
  gate: registration
  cost: none
  self_serve: false
  detail: Same client-credentials registration path as Provider Directory. Contract endpoints answer 403 until credentials are issued.
- api: Payer-to-Payer API
  gate: not yet available
  cost: none
  detail: Committed for 1/1/2027 under CMS-0057-F. No access path exists today.
notes:
- >-
  Supersedes the 2026-05-04 generated file, which invented four freemium/enterprise "plans" with
  quota entries and a "contact partner" price. Elevance publishes no such structure. The four
  entries above are access gates, not commercial plans, and are labelled as such.
- >-
  Elevance Health sells health insurance, not API access. There is no developer-facing commercial
  relationship to price, and no evidence of any paid or metered API product.