{
  "$schema": "https://json-schema.org/draft/2020-12/schema",
  "$id": "https://raw.githubusercontent.com/api-evangelist/unitedhealthcare/refs/heads/main/json-schema/provider-benefit-check-response-schema.json",
  "title": "UnitedHealthcare Benefit Check Response",
  "description": "Patient benefit check response with cost-sharing details",
  "type": "object",
  "properties": {
    "coveredBenefit": {
      "type": "boolean",
      "description": "Whether service is covered"
    },
    "authorizationRequired": {
      "type": "boolean",
      "description": "Prior auth required"
    },
    "referralRequired": {
      "type": "boolean",
      "description": "Referral required"
    },
    "estimatedPatientResponsibility": {
      "type": "number",
      "description": "Estimated patient cost"
    },
    "estimatedPlanPayment": {
      "type": "number",
      "description": "Estimated plan payment"
    },
    "costSharingDetails": {
      "type": "object",
      "description": "Cost-sharing breakdown",
      "properties": {
        "copay": {
          "type": "number"
        },
        "coinsurance": {
          "type": "number"
        },
        "deductibleApplies": {
          "type": "boolean"
        }
      }
    }
  }
}