CARIN Digital Insurance Cards

A common, open standards-based model for issuing and verifying digital insurance cards.

SMART logo
CARIN Alliance logo
digital insurance card app on a mobile phone

Overview

The Commons Project, the CARIN Alliance, and SMART Health IT are leading an initiative to enable every provider, payor, and insurance beneficiary in the United States to use a free and open-standards based digital  insurance card. The SMART Health Insurance Card allows individuals to carry health insurance information in digital wallets, print them, and easily share insurance information with health care providers at check-in. The updated CARIN Digital Insurance Card Implementation Guide reflects the current state of this work.

Digital insurance cards offer significant benefits over existing plastic and paper cards:

  • Reduced cost and environmental impact of printing & mailing traditional cards.

  • Faster and easier access to care, streamlining check-in and eligibility verification

  • Reduced administrative burden, costs, and errors associated with manual entry of insurance information.

  • More effective capture of insurance information and more efficient eligibility checks reduces errors.

SMART health card app on a mobile phone showing a COVID-19 vaccination profile with a QR Code

Open Standards Based Approach

SMART Health Insurance Cards deliver many benefits to people, providers, health plans, states and CMS. But those benefits can only be realized if they are implemented in a common, standards-based way. Otherwise, the healthcare community will end up with a fragmented system of card types that hinder a seamless interoperable solution.



The use of community and consensus driven open standards means:

  • Insurance cards issued by any payor can work at any provider.

  • No additional fees or costs associated with the use of digital insurance cards.

  • No vendor can lock in customers or have an inherent advantage over another.

  • Consumers have the flexibility to keep and use their cards as they see fit.

Building On Existing Standards

The SMART Health Insurance Card relies on SMART Health Card technology and is fully described in the HL7 CARIN Digital Insurance Card Implementation Guide. 



The Commons Project worked with Apple, CARIN Alliance, Cigna/Evernorth, Mayo Clinic, Microsoft, MITRE and UCSD to launch the VCI coalition and develop the SMART Health Card standard to allow individuals to securely receive, store, and share health information in the form of verifiable credentials.

This technology was initially used for proof of COVID vaccination and test results, but was purposefully built to support any standardized, FHIR-based health data. SMART Health Links extend SMART Health Card technology to account for larger, dynamic data and can be used for digital insurance cards. 



The CARIN Alliance, with support from leading payors, providers, and technology vendors, developed the CARIN Digital Insurance Card Implementation Guide to define the required data elements for plastic insurance cards and map them to a standardized HL7 FHIR profile. The updated Implementation Guide follows HL7 consensus processes to include detailed specifications for combining this data profile with the SMART Health Card verifiable credential secure envelope. 


500 Million People Used SMART Health Cards Globally During the Pandemic

During COVID, The Commons Project and VCI worked with a diverse set of stakeholders to ensure that the newly created SMART Health Cards standard was adopted and supported. This effort was massively successful, making SMART Health Cards available to over 500 million people world wide.

This includes adoption by most US states, all leading pharmacy chains (CVS, Walgreens, Walmart), over 1000 health systems supported by leading health platforms (Epic, Cerner, Oracle, Microsoft), leading health plans (Cigna, United Healthcare), leading mobile platforms (Apple, Samsung, Google), and countries around the world.

female patient in a hospital bed with phone

Beyond COVID, the CARIN Alliance has a track record of building consensus among key industry stakeholders, creating and balloting standards, driving adoption of those standards, and ultimately seeing those standards become part of US policy. The most relevant example of this is Blue Button 2.0, the patient data access protocol required for any insurance plan providing Medicare and Medicaid services.



This initiative follows similar repeatable steps for successful adoption of new standards, including:


  1. Focus on community driven, easily adoptable, open standards.


  2. Publish clear and actionable implementation guides, including sample code and applications for issuing, storing, decoding, displaying, and verifying digital insurance cards. 

  3. Create web-based and distributable materials for payors, providers, and people with information, including how-tos, FAQs, and up to date directories of participating organizations.

  4. Work with the public and private sector to encourage and support early adopters. As adoption grows, work to include digital insurance cards in future policy.

How to Participate

two people reviewing health insurance documents
Doctor's office setting with a doctor and nurse looking at a patient's medical information and another doctor standing at a reception desk with a receptionist sitting
SMART health card logo with a patient profile on a mobile phone, and a state of California ID card with a patient's information on it

Participating as a Payor

Insurance providers can provide members and beneficiaries with digital copies of their insurance card following the new standard. Payors are well positioned to provide SMART Health Insurance Cards thanks to existing investments in FHIR-based patient access APIs and interoperability. Supporting digital insurance cards could include: 


  • Mail printed copies of QR codes and Links alongside other membership cards and materials.

  • Make QR codes and links available in the portal or mobile application where members already download or print copies of their cards.

  • Give members the ability to add digital insurance cards to the mobile wallet of their choice

What you can do now: Plan your support for SMART Health Insurance cards. Have technical teams review the Resources for Developers provided below. Reach out to us to express interest, provide feedback, and get looped into existing work streams.

Participating as a Healthcare Provider

Healthcare providers can prepare to receive and ingest SMART Health Insurance Cards. This means training staff as well as using and potentially investing in this new technology. Supporting digital insurance cards could include:

  • Allow patients to upload digital insurance cards during web or mobile check-in flows.

  • Scan digital insurance card QR codes during in-person check-in.

  • Incorporate information from the digital insurance card into existing admin workflows.

What you can do now: If you rely on your EHR or other technology vendor to receive and process insurance information, express your interest in using SMART Health Insurance Cards. If you maintain your own technology platform that handles insurance information, be sure your technical team is familiar with the Resources for Developers below. Reach out to us to express interest, provide feedback, and get looped into existing work streams.

Participating as a Technology Vendor

Technology vendors who provide electronic health records and insurance processing will want to ensure their customers are prepared to utilize SMART Health Insurance cards. Be sure your technical teams review the Resources for Developers below. 



Technology vendors building consumer applications and digital wallets can build tools for consumers to retrieve, store, and share digital insurance information with healthcare providers. 



Reach out to us to express interest, provide feedback, and get looped into existing work streams.

Resources for Developers

There is a wealth of information, example applications, and source code available for the various components of the Digital Insurance Card project. Some recommended resources:

  • CARIN Digital Insurance Card
    Contains the complete proposed guidance for how to build the FHIR profile then generate and share (or decode) the SMART Health Card and SMART Health Link.

  • SMART Health Card specification
    Provides the complete specification for issuing and verifying SMART Health Cards, along with links to validation tools, examples, and source code.