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hi
[p. 42]

HEALTH INSURANCE


These next questions are about health insurance

[] Und 65 (NP)


If 65 or over, ASK:
31a. Is -- covered by that part of social security Medicare which pays for hospital bills?
1[] Y
2[] N
9[] DK


b. Is -- covered by that part of Medicare which pays for doctor's bills, that is, the medicare plan for which he or some agency must pay $5.30 a month?

1[] Y
2[] N
9[] DK


We are interested in all kinds of health insurance plans except those which pay only for accidents.
(Not counting Medicare)
33a. Is anyone in the family covered by hospital insurance, that is, a health insurance plan which pays any part of a hospital bill?

[] Y (33b, c)
[]N (33d)


b. What is the name of the plan? (Record in Table HI) _________

c. Is anyone in the family covered by any other hospital insurance plan?
[] Y (33b, c)
[] N (33b)


d. Is anyone in the family covered by (any other) health insurance plan which pays any part of a doctor's or surgeon's bill?

[] Y
[] N (complete table HI for each plan. If no plans reported go to Q 34)


e. What is the name of the plan? (Record in table HI; reask 33d)

Table HI

[Table H.I. gives two lines "A" and "B" for the various plans. The questions are identical for each so the extra lines have been omitted here.]


1. Name of plan. ________

2. Which members of the family are covered by (name of plan)?
Circle column numbers.
Is anyone else in the family covered under this policy?

[]1
[]2
[]3
[]4
[]5
[]6
[]7
[]8
[]9
[]10


3. Was this insurance plan obtained through an employer, union, or place of work?
[] Y
[] No


4. Does -- pay any part of a hospital bill?

[] Y
[] N


5. Does -- pay any part of a surgeon's bill?
[] Y
[] N

6. Does this plan pay any part of a doctor's bill for office visits or home calls?

[]Y (Next plan)
[] N (Next plan)

7. Does this plan pay any part of a doctor's bill for office visits or home calls after a certain amount has been paid by the family?

[] Y
[] N

This format of this supplement on health insurance was revised several times during the experimental period, July 1967-December 1968. The format shown here was according to the final revision dated April 25, 1968