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Plans that list a provider

plans_for_provider
Read-onlyIdempotent

Every Marketplace (ACA) and Medicare Advantage plan whose network directory lists the provider, one row per plan and plan year, each with plan name, insurer, state, network tier and source {type, as_of}. Medicare Advantage rows carry service_area_states and provider_state_in_service_area. Filter by market, state or year; page with limit and offset (next_offset is null on the last page). A plan missing from this list is not a statement that the provider is out of network. Costs 1 call per page.

Input Schema

NameRequiredDescriptionDefault
npiYes10-digit National Provider Identifier, as a string, e.g. "1184617268".
yearNoPlan year, e.g. 2026. Optional; by default all plan years we hold are considered.
limitNoPlans per page, 1 to 500. Default 50.
stateNo2-letter US state code, e.g. "OH". Optional.
marketNo"aca" = Marketplace plans, "ma" = Medicare Advantage plans. Optional; default both.
offsetNoRows to skip; pass next_offset from the previous page. Default 0.

Output Schema

NameRequiredDescriptionDefault
dataYesThe answer. Same shape as the matching InPlan API v1 endpoint.
notesNoHow to read the answer.
sourcesYesSource types behind the answer (insurer_directory, plan_directory, provider_registry, plan_catalog), each with its as_of date.
data_as_ofYesDate (YYYY-MM-DD) of the newest data behind this answer.
request_idYesRequest id; quote it when you contact support.

Schema Changelog

Changes observed during successful MCP inspections.

  1. First observed

TDQS

A4.4/5.0
Behavior5/5

Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?

Annotations already establish read-only, idempotent, non-destructive, closed-world behavior, and the description adds material details beyond them: pagination termination via null next_offset, a cost model ('1 call per page'), per-row source provenance with as_of timestamps, and the MA-specific service-area fields. The 'missing from this list' disclaimer prevents a dangerous misreading of absence.

Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.

Conciseness5/5

Is the description appropriately sized, front-loaded, and free of redundancy?

Front-loads what the tool returns before any operational details, and every sentence carries payload: row shape, filters, paging semantics, the absence caveat, and page cost. No filler or restatement of the name.

Shorter descriptions cost fewer tokens and are easier for agents to parse. Every sentence should earn its place.

Completeness4/5

Given the tool's complexity, does the description cover enough for an agent to succeed on first attempt?

An output schema exists, so return values need not be explained, yet the description still sketches them helpfully. It covers filtering, paging termination and cost, leaving only minor gaps (e.g., ordering of rows, behavior when no filters match) unstated.

Complex tools with many parameters or behaviors need more documentation. Simple tools need less. This dimension scales expectations accordingly.

Parameters3/5

Does the description clarify parameter syntax, constraints, interactions, or defaults beyond what the schema provides?

Schema coverage is 100%, so npi, year, limit, state, market and offset are all already documented in the schema. The description restates the filter axes and clarifies that offset should carry next_offset from the prior page, but adds little syntax or format detail beyond the schema. Baseline 3 is appropriate.

Input schemas describe structure but not intent. Descriptions should explain non-obvious parameter relationships and valid value ranges.

Purpose5/5

Does the description clearly state what the tool does and how it differs from similar tools?

States a specific resource (ACA Marketplace and Medicare Advantage plans whose network directory lists a provider) with the exact row granularity (one row per plan and plan year) and the fields returned. This is clearly distinguishable from point-check siblings like check_network or get_plan.

Agents choose between tools based on descriptions. A clear purpose with a specific verb and resource helps agents select the right tool.

Usage Guidelines4/5

Does the description explain when to use this tool, when not to, or what alternatives exist?

Gives concrete usage context: 'Filter by market, state or year; page with limit and offset', plus an important interpretive caveat that a missing plan does not mean the provider is out of network. It stops short of naming alternatives (e.g., when to prefer check_network or search_plan_providers), so it is clear context without explicit routing.

Agents often have multiple tools that could apply. Explicit usage guidance like "use X instead of Y when Z" prevents misuse.

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