InPlan

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Is this US provider in this health plan? Network checks by NPI and plan ID, with dated sources.

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https://api.inplan.io/mcp

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Your InPlan API key as "Bearer ip_live_...". Free key: https://inplan.io/signup

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Tool list from our last check. Connect live to refresh it.

check_network Read-only

Answers whether one plan's network directory lists one provider. answer "listed" (in_network: true) comes with evidence: plan year, network tier and source {type, as_of}. answer "not_found" (in_network: null) means no listing was found in current directory data for this provider and plan; it is NOT a statement that the provider is out of network, so never report it as "out of network". answer "no_provider_network" is a drug-only plan. Directories change; tell users to confirm with the plan before care. Costs 1 call.

npistring, required

10-digit National Provider Identifier, as a string, e.g. "1184617268".

plan_idstring, required

Plan ID. Marketplace (ACA) plans: 14 characters like "29276OH0970001" (a 16-character "-01" variant form is accepted). Medicare Advantage plans: "H1234-001-000" (the segment "-000" is optional).

yearinteger

Plan year, e.g. 2026. Optional; by default all plan years we hold are considered.

Tools (7)

check_network

read-only

Argument	Type	Description
npi*	string	10-digit National Provider Identifier, as a string, e.g. "1184617268".
year	integer	Plan year, e.g. 2026. Optional; by default all plan years we hold are considered.
plan_id*	string	Plan ID. Marketplace (ACA) plans: 14 characters like "29276OH0970001" (a 16-character "-01" variant form is accepted). Medicare Advantage plans: "H1234-001-000" (the segment "-000" is optional).

Input schema (JSON)

{
  "type": "object",
  "required": [
    "npi",
    "plan_id"
  ],
  "properties": {
    "npi": {
      "type": "string",
      "description": "10-digit National Provider Identifier, as a string, e.g. \"1184617268\"."
    },
    "year": {
      "type": "integer",
      "maximum": 9007199254740991,
      "minimum": -9007199254740991,
      "description": "Plan year, e.g. 2026. Optional; by default all plan years we hold are considered."
    },
    "plan_id": {
      "type": "string",
      "description": "Plan ID. Marketplace (ACA) plans: 14 characters like \"29276OH0970001\" (a 16-character \"-01\" variant form is accepted). Medicare Advantage plans: \"H1234-001-000\" (the segment \"-000\" is optional)."
    }
  }
}

check_network_batch

The check_network answer for up to 100 (npi, plan_id) pairs in one request, with the same listed / not_found / no_provider_network semantics. Invalid pairs come back with a per-item error and are not charged; each accepted pair costs 1 call. Needs the Builder plan or higher.

read-only

Argument	Type	Description
year	integer	Default plan year for items that do not set one. Optional.
items*	array	1 to 100 pairs.

Input schema (JSON)

{
  "type": "object",
  "required": [
    "items"
  ],
  "properties": {
    "year": {
      "type": "integer",
      "maximum": 9007199254740991,
      "minimum": -9007199254740991,
      "description": "Default plan year for items that do not set one. Optional."
    },
    "items": {
      "type": "array",
      "items": {
        "type": "object",
        "required": [
          "npi",
          "plan_id"
        ],
        "properties": {
          "npi": {
            "type": "string",
            "description": "10-digit National Provider Identifier, as a string, e.g. \"1184617268\"."
          },
          "year": {
            "type": "integer",
            "maximum": 9007199254740991,
            "minimum": -9007199254740991,
            "description": "Plan year, e.g. 2026. Optional; by default all plan years we hold are considered."
          },
          "plan_id": {
            "type": "string",
            "description": "Plan ID. Marketplace (ACA) plans: 14 characters like \"29276OH0970001\" (a 16-character \"-01\" variant form is accepted). Medicare Advantage plans: \"H1234-001-000\" (the segment \"-000\" is optional)."
          }
        }
      },
      "maxItems": 100,
      "minItems": 1,
      "description": "1 to 100 pairs."
    }
  }
}

coverage

The markets, states and insurers InPlan holds directory listings for, with plan counts and as_of dates, by plan year. Filter by market, state or year. Use it to see which states and insurers you can query. Costs 1 call.

read-only

Argument	Type	Description
year	integer	Plan year, e.g. 2026. Optional; by default all plan years we hold are considered.
state	string	2-letter US state code, e.g. "OH". Optional.
market	string	"aca" = Marketplace plans, "ma" = Medicare Advantage plans. Optional; default both.

Input schema (JSON)

{
  "type": "object",
  "properties": {
    "year": {
      "type": "integer",
      "maximum": 9007199254740991,
      "minimum": -9007199254740991,
      "description": "Plan year, e.g. 2026. Optional; by default all plan years we hold are considered."
    },
    "state": {
      "type": "string",
      "description": "2-letter US state code, e.g. \"OH\". Optional."
    },
    "market": {
      "enum": [
        "aca",
        "ma"
      ],
      "type": "string",
      "description": "\"aca\" = Marketplace plans, \"ma\" = Medicare Advantage plans. Optional; default both."
    }
  }
}

get_plan

Details of one Marketplace (ACA) or Medicare Advantage plan by plan ID: name, insurer or organization, state or service area, plan type, metal level, the plan years we hold, and whether we hold its directory listings, with their as_of date. Costs 1 call.

read-only

Argument	Type	Description
year	integer	Plan year, e.g. 2026. Optional; by default all plan years we hold are considered.
plan_id*	string	Plan ID. Marketplace (ACA) plans: 14 characters like "29276OH0970001" (a 16-character "-01" variant form is accepted). Medicare Advantage plans: "H1234-001-000" (the segment "-000" is optional).

Input schema (JSON)

{
  "type": "object",
  "required": [
    "plan_id"
  ],
  "properties": {
    "year": {
      "type": "integer",
      "maximum": 9007199254740991,
      "minimum": -9007199254740991,
      "description": "Plan year, e.g. 2026. Optional; by default all plan years we hold are considered."
    },
    "plan_id": {
      "type": "string",
      "description": "Plan ID. Marketplace (ACA) plans: 14 characters like \"29276OH0970001\" (a 16-character \"-01\" variant form is accepted). Medicare Advantage plans: \"H1234-001-000\" (the segment \"-000\" is optional)."
    }
  }
}

lookup_provider

Identity of a US healthcare provider by NPI: name, credential, specialties, practice locations and groups, plus a summary of the Marketplace (ACA) and Medicare Advantage plans whose network directories list them (plan counts, states, plan years, as_of dates). Use it to confirm who an NPI is before checking networks. For the plan list itself use plans_for_provider. Costs 1 call.

read-only

Argument	Type	Description
npi*	string	10-digit National Provider Identifier, as a string, e.g. "1184617268".

Input schema (JSON)

{
  "type": "object",
  "required": [
    "npi"
  ],
  "properties": {
    "npi": {
      "type": "string",
      "description": "10-digit National Provider Identifier, as a string, e.g. \"1184617268\"."
    }
  }
}

plans_for_provider

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.

read-only

Argument	Type	Description
npi*	string	10-digit National Provider Identifier, as a string, e.g. "1184617268".
year	integer	Plan year, e.g. 2026. Optional; by default all plan years we hold are considered.
limit	integer	Plans per page, 1 to 500. Default 50.
state	string	2-letter US state code, e.g. "OH". Optional.
market	string	"aca" = Marketplace plans, "ma" = Medicare Advantage plans. Optional; default both.
offset	integer	Rows to skip; pass next_offset from the previous page. Default 0.

Input schema (JSON)

{
  "type": "object",
  "required": [
    "npi"
  ],
  "properties": {
    "npi": {
      "type": "string",
      "description": "10-digit National Provider Identifier, as a string, e.g. \"1184617268\"."
    },
    "year": {
      "type": "integer",
      "maximum": 9007199254740991,
      "minimum": -9007199254740991,
      "description": "Plan year, e.g. 2026. Optional; by default all plan years we hold are considered."
    },
    "limit": {
      "type": "integer",
      "maximum": 500,
      "minimum": 1,
      "description": "Plans per page, 1 to 500. Default 50."
    },
    "state": {
      "type": "string",
      "description": "2-letter US state code, e.g. \"OH\". Optional."
    },
    "market": {
      "enum": [
        "aca",
        "ma"
      ],
      "type": "string",
      "description": "\"aca\" = Marketplace plans, \"ma\" = Medicare Advantage plans. Optional; default both."
    },
    "offset": {
      "type": "integer",
      "maximum": 9007199254740991,
      "minimum": 0,
      "description": "Rows to skip; pass next_offset from the previous page. Default 0."
    }
  }
}

search_plan_providers

Providers that a Marketplace (ACA) plan's network directory lists, with name, credential, primary specialty, network tiers and up to 5 locations. Filter by state, specialty (substring, e.g. "cardiology"), zip, or zip plus radius in miles. Pages are cursor-based: pass next_cursor back unchanged until it is null; with filters a page can hold fewer than limit providers. Medicare Advantage plans: use check_network or plans_for_provider instead. Needs the Growth plan or higher. Costs 1 call per page.

read-only

Argument	Type	Description
zip	string	5-digit ZIP code, as a string. Optional.
year	integer	Plan year, e.g. 2026. Optional; by default all plan years we hold are considered.
limit	integer	Providers per page, 1 to 100. Default 25.
state	string	2-letter US state code, e.g. "OH". Optional.
cursor	string	next_cursor from the previous page.
radius	integer	Miles around zip, 1 to 100. Needs zip.
plan_id*	string	Plan ID. Marketplace (ACA) plans: 14 characters like "29276OH0970001" (a 16-character "-01" variant form is accepted). Medicare Advantage plans: "H1234-001-000" (the segment "-000" is optional).

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check_network Read-only

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check_network Read-only

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Tools (7)

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