# get_plan_hospitals

Get Plan Hospitals · v0.2.0 · medicare

The hospitals in a Medicare Advantage plan's published provider network for 2026 or 2027, by contract or CMS plan id: each hospital (CMS certification number, name, state, health system) with the evidence that it is in network: the hospital's own NPI listed in the directory, or how many of the clinicians CMS records as affiliated with it the plan lists (and the share). Narrow by hospital state or health system; choose the weakest evidence to return.

Use cases: 'Which hospitals are in H5938's 2027 network?'; 'Is the Cleveland Clinic in this plan?'; 'Which HCA hospitals does H1036 list in Florida?'.

A hospital's own NPI in the directory is strong evidence; many affiliated clinicians listed is good evidence; a few affiliated clinicians is weak and labelled so. A hospital absent from the list is 'no evidence in the published directory', never 'out of network'. The publish is pinned by dataset_id.

SOURCE: medicare_silver.ma_network_plan_hospital_v1 (the Data Tracker's directory table x CMS hospital enrollment NPI = CCN x CMS Doctors and Clinicians facility affiliation x the hospital system map).

**Inputs.**
- `contract_id`: CMS contract id (H5938). One of contract_id / cms_plan_id.
- `cms_plan_id`: CMS plan id H1234-001 or H1234-001-000.
- `plan_year` (required): 2026 or 2027 (the directory year).
- `limit`: Rows to return (default 50, max 500); summaries are always whole.
- `state`: 2-letter state of the hospital; optional.
- `system`: Health system name (contains match, e.g. 'HCA'); optional.
- `min_evidence`: Weakest evidence returned: 'strong' (the hospital's own NPI is in the directory), 'good' (default: strong, or 10+ of its affiliated clinicians and 20%+ of them listed), or 'any' (also hospitals with a few affiliated clinicians listed).

**Known limits.**
- Many directories list clinicians and not facilities: a hospital reached only through affiliated clinicians is inferred from CMS's affiliation file (2026-05-29), not printed by the plan.
- Affiliation covers hospitals where CMS records clinicians (4,606); a hospital with no affiliated clinicians can appear only by its own NPI.
- Coverage follows the directory build (stage 25); an uncovered contract answers no_coverage.

**A real answer** (customer seat, 2.9 s, args `{"cms_plan_id":"H5938-001","plan_year":2027,"limit":5}`):

```json
{
 "value": {
  "found": false,
  "not_found_reason": "uncovered_contract",
  "query": {
   "cms_plan_id": "H5938-001-000",
   "plan_year": 2027,
   "min_evidence": "good",
   "limit": 5
  },
  "dataset_id": "7bceef45cc9e5910e64caa428a1f3e40869f91d149c4e19f08cc55f5e468ba7c",
  "rows": [],
  "query_ids": [
   "1876253c-153b-41a7-8797-7542ef3f504b"
  ]
 },
 "unit": "plan_hospitals",
 "vintage": null,
 "source": {
  "dataset": "MA plan networks, 2026 and 2027 (Data Tracker): plan year x CMS plan x NPI x listed location",
  "publisher": "vlada",
  "catalog_updated_at": "2026-11-02"
 },
 "caveats": [
  "Absence is a claim only for a covered contract, and only 'not listed in the published directory'; a contract with no rows is UNCOVERED (the open-gap list), never 'no network'."
 ],
 "response_hash": "935a2214fad066505c21fd0f46a5048313a21d38ccd0ac8c30b6d47eca291965",
 "semantic_version": 1,
 "tool_version": "get_plan_hospitals@0.2.0",
 "explanation": null,
 "status": "complete",
 "audience": "customer",
 "answer": {
  "value_ref": "value",
  "unit": "plan_hospitals",
  "scope": {
   "tool": "get_plan_hospitals",
   "filters": {
    "cms_plan_id": "H5938-001",
    "plan_year": 2027,
    "limit": 5,
    "min_evidence": "good"
   }
  }
 },
 "method": "Computed over the filters shown in this answer's scope, from the sources listed in its evidence. Nothing outside those filters was included. You did not specify min_evidence; good was used.",
 "evidence": {
  "sources": [
   {
    "dataset": "MA plan networks, 2026 and 2027 (Data Tracker): plan year x CMS plan x NPI x listed location",
    "publisher": "vlada",
    "catalog_updated_at": "2026-11-02"
   }
  ],
  "response_hash": "935a2214fad066505c21fd0f46a5048313a21d38ccd0ac8c30b6d47eca291965"
 },
 "defaults_applied": [
  {
   "param": "min_evidence",
   "used": "good",
   "reason": "Weakest evidence returned: 'strong' (the hospital's own NPI is in the directory), 'good' (default: strong, or 10+ of its affiliated clinicians and 20%+ of them listed), or 'any' (a"
  }
 ],
 "freshness": {
  "state": "unknown",
  "why": "This tool does not report an edition for its answer, and the door could not derive one from what the answer reads. Treat the result as current to no stated date."
 }
}
```

REST: `POST https://api.vladahealth.com/v1/tools/get_plan_hospitals` with the inputs as the JSON body. MCP: the tool by name.