Skip to main content
GET
/
eligibility-checks
/
{id}
/
benefits
List eligibility benefits
curl --request GET \
  --url https://api.usecobalt.com/v1/eligibility-checks/{id}/benefits \
  --header 'access_token: <api-key>' \
  --header 'client_id: <api-key>' \
  --header 'client_secret: <api-key>'
{
  "success": true,
  "benefits": [
    {
      "line_number": 123,
      "benefit_type": "<string>",
      "benefit_type_code": "<string>",
      "coverage_level": "<string>",
      "service_type_codes": [
        "<string>"
      ],
      "insurance_type": "<string>",
      "time_period": "<string>",
      "amount": 123,
      "percent": 123,
      "network_indicator": "<string>",
      "messages": [
        "<string>"
      ],
      "raw_segment": "<string>"
    }
  ],
  "pagination": {
    "page": 123,
    "page_size": 123,
    "total_records": 123,
    "total_pages": 123
  }
}
A 271 response breaks down into many benefit lines, one per service type and coverage level: deductibles, copays, coinsurance, out-of-pocket maximums, limitations, and exclusions. Get the check id from Get Eligibility Checks, then page the benefits here. Narrow results with benefit_type.

​
Example Request

curl -X GET "https://api.usecobalt.com/v1/eligibility-checks/abc123def4567890abcdef1234567890/benefits?benefit_type=Co-Payment&page=1&page_size=100" \
-H 'Content-Type: application/json' \
-H 'client_id: ci_live_198908HJDKJSH98789OHKJL' \
-H 'client_secret: cs_live_9827hofdsklOYYHJLJh' \
-H 'access_token: 493JKLHIU98789hLKH9HHJH'

​
Example Response

{
    "success": true,
    "benefits": [
        {
            "line_number": 17,
            "benefit_type": "Co-Payment",
            "benefit_type_code": "B",
            "coverage_level": "IND",
            "service_type_codes": ["98"],
            "insurance_type": null,
            "time_period": null,
            "amount": 25,
            "percent": null,
            "network_indicator": "in-network",
            "messages": ["Specialist Visit or Evaluation"],
            "raw_segment": "EB*B*IND*98****25*****Y"
        }
    ],
    "pagination": {
        "page": 1,
        "page_size": 100,
        "total_records": 1,
        "total_pages": 1
    }
}

​
Query Parameters

  • benefit_type: Filter by decoded benefit type (e.g. Deductible, Co-Payment, Co-Insurance, Out of Pocket).
  • page: Page number (default 1).
  • page_size: Results per page (default 100, max 500).

​
Response Parameters

  • line_number: Segment order within the 271.
  • benefit_type: Decoded benefit category, e.g. Active Coverage, Deductible, Co-Payment, Co-Insurance, Out of Pocket, Limitations, Non-Covered.
  • benefit_type_code: The raw X12 EB01 code.
  • coverage_level: IND (individual) or FAM (family).
  • service_type_codes: X12 service type codes the benefit applies to.
  • insurance_type: Insurance type code, when present.
  • time_period: Decoded time period, e.g. Calendar Year or Remaining.
  • amount: Monetary amount (deductible, copay, or out-of-pocket).
  • percent: Coinsurance percentage as a decimal (e.g. 0.2 = 20%).
  • network_indicator: in-network, out-of-network, unknown, or not-applicable.
  • messages: Payer free-text notes attached to the benefit line.
  • raw_segment: The raw X12 EB segment, retained for reference.
  • pagination: page, page_size, total_records, total_pages.

Authorizations

​
client_id
string
header
required
​
client_secret
string
header
required
​
access_token
string
header
required

Path Parameters

​
id
string
required

Cobalt eligibility check ID from the list endpoint.

Query Parameters

​
benefit_type
string

Filter by decoded benefit type (e.g. Deductible, Co-Payment, Co-Insurance, Out of Pocket).

​
page
integer
default:1

Page number (default 1).

​
page_size
integer
default:100

Results per page (default 100, max 500).

Required range: x <= 500

Response

Successful response

​
success
boolean
​
benefits
object[]
​
pagination
object