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Get Benefit Change

get_benefit_change
Read-onlyIdempotent

The locked 2027 Medicare Advantage benefit tables in one call: what each benefit was in 2026 and what it is in 2027 for the SAME members, member-weighted from the CMS Plan Benefit Package filings and CMS September 2026 county enrollment, inside ONE product type, for the market or a parent organization, nationally, in a state or in a county. Premium, MOOP, the medical and Part D deductibles, the medical copays and coinsurance, the Part D tier cost shares, dental / OTC / hearing / eyewear / flex card dollars and offered shares, the Part B giveback and the supplemental services.

ARGUMENTS: product_type (required unless group_by='product_type': non-SNP HMO | non-SNP PPO | D-SNP HMO | D-SNP PPO | C-SNP HMO | C-SNP PPO | I-SNP HMO | I-SNP PPO; 'ALL' is refused, types are never pooled), geography (national | state | county; inferred from the place when omitted), state (two letters), county (the name as CMS spells it, e.g. 'Maricopa', with state) or county_ssa (five digits, e.g. '03060'), parent (the parent organization; a partial name matches, e.g. 'UnitedHealth'), plan_type (default 'ALL'; HMO | HMOPOS | Local PPO | Regional PPO), group_by (none | parent | state | county | plan_type | product_type; state needs geography national, county needs geography state), benefits ('key' default | 'all' | a comma-separated list of benefit names, listed in value.benefits), limit (rows, default 50, max 500, largest 2026 membership first).

RETURNS value.summary (the market of the scope: every benefit for the scope's members) and value.rows (one per group, or per matching parent). Each row: members_2026 (every September 2026 member), members_continuing (the members on both sides of the change), plans, thin (true when the value rests on plans covering under 70% of the members or fewer than five plans) and, per benefit, {2026, 2027_same_members, change, coverage_2026, coverage_2027, 2026_all_members, unit}: 2026 is the continuing members' 2026 design, 2027_same_members those same members' 2027 design, change = 2027_same_members minus 2026; 2026_all_members is every 2026 member, context only, never one side of a change. coverage is the share of the row's members the value describes. A null value is unknown (no member filed it), never $0. Percent benefits are served 0-100. When an allowance is asked, like_for_like carries its dollars on the paired members (same form both years) with the share whose design changed form, which is a design change, never a raise or a cut.

D-SNP figures are the FILED design: a full dual generally pays $0 under Medicaid; the full-dual reading is the Plan Value tool's full-dual column. Employer group plans and stand-alone Part D are not in the tables.

SOURCE: Vlada locked benefit tables (Edition 1.1) from the CMS Plan Benefit Package filings, CMS county enrollment, the plan service area file and the CMS plan crosswalk.

Input Schema

TableJSON Schema
NameRequiredDescriptionDefault
limitNo
stateNo
countyNo
parentNo
benefitsNokey
group_byNonone
geographyNo
plan_typeNoALL
county_ssaNo
product_typeNo

Output Schema

TableJSON Schema
NameRequiredDescriptionDefault
unitNo
as_ofNo
valueYes
sourceYes
statusNocomplete
caveatsNo
failureNo
qualityNo
refusalNo
vintageNoas_restated
audit_idYesUUID; ties to medicare_silver.audit_log row.
signatureNo
tenant_idNoCalling tenant slug, resolved by the binding and stamped via the per-call tenant context. Defaults to the bootstrap 'internal' tenant for local/in-process callers.
timestampYes
confidenceNo
data_as_ofNo
request_idYes
methodologyNo
snapshot_setYes{table_fqn → iceberg_snapshot_id (int64)}. Per M-2 §2.2.
tool_versionYes
response_hashYesSHA-256 of canonicalized form per M-2 §2.4.
result_statusYes
vintage_basisNodefault_unmeasured
as_of_assertedNo
as_of_observedNo
parse_revisionNo
as_of_effectiveNo
freshness_stateNounknown
methodology_eraNo
confidence_basisNo
semantic_versionYes
invariants_appliedNo
finality_confidenceNo
cms_vintage_sequenceYes
parser_artifact_hashYes
methodology_blend_factorsNo
parser_artifact_hash_basisNonot_evaluated

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