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hi

[p. 70]

HEALTH INSURANCE


These next questions are about health insurance.

If 65 or over ask:
1a. Is -- covered by that part of Social Security Medicare which pays for hospital bills?

[] Und. 65 (NP)
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 a certain amount each month?
1 [] Y (NP)
2 [] N (NP)
9 [] DK (NP)


For each person with "DK" in Q. 1a or b, ask:
2. May I please see the Social Security Medicare card(s) for -- to determine the type of coverage? (Transcribe the information from the card or mark the "Card not seen" box.)
1 [] Hospital
2 [] Medical
3 [] Card not seen


We are interested in all kinds of health insurance place except those which pay only for accidents.

3a. (Not counting Medicare) Is anyone in the family covered by hospital insurance, that is, a health insurance plan which pays any part of a hospital bill?

[] Y (3b, c)
[] N (3d)


b. What is the name of the plan? (Record in Table H.I) ____

c. Is anyone in the family covered by any other hospital insurance plan?
[] Y (3b, c)
[] N (3d)


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

[] Y
[] N


e. What is the name of the plan? ____
(Record in Table H.I.: reask 3d)

Table H.I.

[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.]


(Complete Table H.I. for each plan. If no plans reported, go to I)

a. Name of plan ____

b. Which members of the family are covered by (name of plan)?
Is anyone else in the family covered under this policy?
Circle person number.

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


c. Was this insurance plan obtained through an employer, union, or some other group?

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


d. Is this plan NOW carried through a group or as an individual plan?
1 [] Group
2 [] Ind.
9 [] DK


e. To receive services under this plan must you and your family to go certain clinics or doctors?

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


f. Does this -- plan pay any part of hospital expenses?

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


g. Does this -- plan pay any part of doctor's or surgeon's bills for operations?

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


h. Does this plan pay any part of a doctor's bill for office visits or home calls?
1 [] Y (j)
2 [] N
9 [] DK

i. 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?

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

j. What do you like most about this -- plan? ________

k. What do you like least about this -- plan? ________

l. When was the last time any member of your family used this -- plan?

000 [] Nev. used
2 [] Wks. ____
3 [] Mos. ____
4 [] Yrs. ____


[End Table H.I.]

I

For each person, review Q's. 1 and 2 and Table H.I. and determine if "Covered" by either Medicare or insurance or "Not covered."

1 [] Covered (NP)
2 [] Not Covered (NP)

Ask for each person "Not covered"

(Many people do not carry health insurance for various reasons)
4. Which of these statements (Hand Card N) best describes why -- is not covered by any health insurance plan? Any other Reason?
Circle all reasons given

Card N
1. Can't obtain insurance because of age, illness, or poor health
2. Don't believe in insurance
3. Dissatisfied with previous insurance
4. Don't need health insurance because care received through welfare or Medicaid
5. Have been healthy, not much sickness in the family, haven't needed health insurance
6. Too expensive, can't afford health insurance
7. Some other reason
[] 1
[] 2
[] 3
[] 4
[] 5
[] 6
[] 7 (specify) ____

5a. Is anyone in the family covered by an insurance plan which pays any part of a dentist bill for routine or regular care?

1 [] Y
2 [] N (41)

b. Which family members are covered? ____

[] Covered