Check a provider and plan

GEThttps://api.inplan.io/v1/check

Answers one question: does this plan's network directory list this provider? The answer comes with its evidence: the plan year, the network tier, the source type and the date we read it.

.mdView as MarkdownFree plan and up · 1 call

WHEN TO USE IT

Use it when you already know the plan, for example to confirm a booking or to mark the doctors a quoted plan keeps. To list every plan for a provider, call GET /v1/providers/{npi}/plans. To check many pairs, call POST /v1/check/batch.

QUERY PARAMETERS

Query parameters for GET /v1/check
NAME	DESCRIPTION
`npi` string · Required	The provider's 10-digit National Provider Identifier. We validate the check digit. Example: 1184617268
`plan_id` string · Required	A marketplace plan id (14 characters, or 16 with the variant) or a Medicare Advantage contract-plan-segment id. Example: 29276OH0970001 · H2526-001-000
`year` integer · Optional	A plan year. Narrows the answer to that year. Example: 2026

RESPONSE FIELDS

Every response has the envelope request_id, data_as_of, data, sources and notes (details). Fields of data:

Response fields
FIELD	DESCRIPTION
`npi` string	The NPI you checked.
`plan_id` string	The plan we checked. Marketplace ids are normalized to the 14-character plan id.
`input_plan_id` string	The plan id exactly as you sent it.
`market` string	`aca` for marketplace plans, `ma` for Medicare Advantage plans.
`plan_years_listed` integer[]	Plan years in which the directory lists the provider for this plan.
`in_network` true \| null	`true`: the directory lists the provider for this plan. `null`: no listing found in current directory data. It is never a statement that the provider is out of network.
`answer` string	`listed`, `not_found`, or `no_provider_network` for a prescription drug plan id (contract ids that start with S).
`explanation` string	One plain sentence that states the answer. Safe to show to users as it is.
`evidence` object[]	One entry for each listing we found. Empty when the answer is `not_found`.
`plan_year` integer \| null	The plan year this answer is about: the `year` you sent, else the newest year listed, else the newest plan year we hold.
`plan` object \| null	Plan details. `null` when we hold no details for this plan id.
`plan.plan_name` string	The plan name as the insurer publishes it.
`plan.issuer` object	Marketplace plans: the insurer.
`plan.issuer.id` string	The 5-digit insurer id (the first 5 characters of the plan id).
`plan.issuer.name` string	The insurer name.
`plan.state` string	Marketplace plans: the state the plan is sold in.
`plan.metal_level` string	Marketplace plans: Bronze, Expanded Bronze, Silver, Gold, Platinum or Catastrophic.
`plan.plan_type` string	HMO, PPO, EPO, POS and similar.
`plan.variant` string \| null	Marketplace plans: the 2-digit variant you sent (for example `01`), else `null`.
`plan.organization` string	Medicare Advantage plans: the organization that offers the plan.
`plan.service_area_states` string[]	Medicare Advantage plans: the states in the plan's service area.
`source` object	The source type of the answer and its date.
`source.type` string	`insurer_directory` or `plan_directory`.
`source.as_of` date \| null	The date we read the directory that gave this answer.
`as_of` date \| null	The date we read the directory that gave this answer (same as `source.as_of`).

EVIDENCE FIELDS

evidence[] holds one entry for each listing we found. It is empty when the answer is not_found. See Answers and evidence.

Evidence fields
FIELD	DESCRIPTION
`evidence[].plan_id` string	The plan of this listing.
`evidence[].plan_year` integer	The plan year of this listing.
`evidence[].network_tier` string	Marketplace plans: the tier the directory names, for example `PARTICIPATING` or `PREFERRED`. Several tiers are joined with commas.
`evidence[].source` object	Where this listing comes from.
`evidence[].source.type` string	`insurer_directory` for marketplace plans, `plan_directory` for Medicare Advantage plans.
`evidence[].source.as_of` date	The date we read that directory.
`evidence[].accepting_new_patients` boolean \| null	Medicare Advantage plans: whether the directory says the provider accepts new patients (`null` when it does not say).
`evidence[].provider_kind` string	Medicare Advantage plans: the kind of provider listed, for example `practitioner`.

RESPONSES

200 listed200 not_found400401429

The plan's directory lists the provider. The evidence block carries the plan year, tier, source type and date.

200 OK · application/json

{  "request_id": "req_ws7hhhC7uSWYqEye",  "data_as_of": "2026-07-27",  "data": {    "npi": "1184617268",    "plan_id": "29276OH0970001",    "input_plan_id": "29276OH0970001",    "market": "aca",    "plan_years_listed": [      2026    ],    "in_network": true,    "answer": "listed",    "explanation": "The insurer's network directory lists this provider for this plan.",    "evidence": [      {        "plan_id": "29276OH0970001",        "plan_year": 2026,        "network_tier": "PARTICIPATING",        "source": {          "type": "insurer_directory",          "as_of": "2026-07-27"        }      }    ],    "plan_year": 2026,    "plan": {      "plan_name": "Anthem Bronze Pathway 10600 ($0 Virtual PCP + $0 Select Drugs)",      "issuer": {        "id": "29276",        "name": "Anthem Blue Cross and Blue Shield"      },      "state": "OH",      "metal_level": "Bronze",      "plan_type": "HMO",      "variant": null    },    "source": {      "type": "insurer_directory",      "as_of": "2026-07-27"    },    "as_of": "2026-07-27"  },  "sources": [    {      "type": "insurer_directory",      "description": "Provider network directories published by health insurers",      "as_of": "2026-10-29"    },    {      "type": "plan_catalog",      "description": "Published health plan catalogs",      "as_of": "2026-10-28"    }  ],  "notes": [    "in_network=null means no listing was found in current directory data. It is not a statement that the provider is out of network.",    "Network directories change. Confirm with the plan or the provider before care."  ]}

No listing found in current directory data for this provider and plan. in_network is null and evidence is empty. Show it as unknown, not as out of network.

200 OK · application/json

{  "request_id": "req_p-wTVhm9dU50UsKb",  "data_as_of": "2026-10-28",  "data": {    "npi": "1376006148",    "plan_id": "13262AR0230002",    "input_plan_id": "13262AR0230002",    "market": "aca",    "plan_years_listed": [],    "in_network": null,    "answer": "not_found",    "explanation": "No listing found in current directory data for this provider and plan.",    "evidence": [],    "plan_year": 2026,    "plan": {      "plan_name": "HA Silver AH",      "issuer": {        "id": "13262",        "name": "Health Advantage"      },      "state": "AR",      "metal_level": "Silver",      "plan_type": "POS",      "variant": null    },    "source": {      "type": "insurer_directory",      "as_of": "2026-10-28"    },    "as_of": "2026-10-28"  },  "sources": [    {      "type": "insurer_directory",      "description": "Provider network directories published by health insurers",      "as_of": "2026-10-29"    },    {      "type": "plan_catalog",      "description": "Published health plan catalogs",      "as_of": "2026-10-28"    }  ],  "notes": [    "in_network=null means no listing was found in current directory data. It is not a statement that the provider is out of network.",    "Network directories change. Confirm with the plan or the provider before care."  ]}

The NPI fails its check digit, the plan id has an unknown format, or a parameter is invalid. The type is invalid_npi, invalid_plan_id or invalid_request.

400 Bad Request · application/problem+json

{  "type": "invalid_npi",  "title": "Invalid NPI",  "status": 400,  "detail": "\"1234567890\" fails the NPI check digit (Luhn with prefix 80840).",  "instance": "/v1/check",  "request_id": "req_tyeV9VkOEHSgXbbW",  "docs": "https://inplan.io/docs/errors#invalid_npi"}

The Authorization header is missing or malformed, or the key is unknown or revoked.

401 Unauthorized · application/problem+json

{  "type": "unauthorized",  "title": "Missing API key",  "status": 401,  "detail": "Send `Authorization: Bearer ip_live_...`.",  "instance": "/v1/check",  "request_id": "req_pctJoQwOrN-xK9Wp",  "docs": "https://inplan.io/docs/errors#unauthorized"}

You sent more requests a second than your key allows (rate_limited), or used this month's calls (quota_exceeded). Wait for Retry-After seconds. Calls over the quota are never billed.

Headers

HTTP/1.1 429 Too Many RequestsContent-Type: application/problem+json; charset=utf-8Retry-After: 1RateLimit-Limit: 2RateLimit-Remaining: 0RateLimit-Reset: 1RateLimit-Policy: 2;w=1;burst=5X-Request-Id: req_TrHd8LO8HNbLoZ_D

ERROR FORMAT

Errors use application/problem+json (RFC 7807) with type, title, status, detail, instance, request_id and docs. Other statuses this endpoint can return: 403 (plan, account or demo-key limit) and 503 (busy or timed out; retry after Retry-After). See Errors.

RATE-LIMIT HEADERS

Every response that passes the key and plan checks carries RateLimit-Limit, RateLimit-Remaining, RateLimit-Reset, RateLimit-Policy, X-Quota-Limit, X-Quota-Remaining, X-Quota-Reset and X-Request-Id. Limits apply to each key. See Rate limits and quotas.

Limits by plan
PLAN	REQUESTS A SECOND	CALLS A MONTH
Free	2	500
Builder	10	25,000
Growth	25	150,000
Scale	Set with you	Set with you