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hi
[p. 62]

Health Insurance Page


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 1a or b, ask:
2. May I please see the Social Security Medicare card(s) for -- (and --) to determine the type of coverage? (Transcribe the information from the card or mark the "Card not seen" box.)

1 [] Hospital (NP)
2 [] Medical (NP)
3 [] Card not seen (NP)


We are interested in all kinds of health insurance 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
[] 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 (Reask 3b and c)
[] N


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 (4)

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

Ask for each Plan listed in Table H.I. If no plans, go to I


4. Is -- covered under this (name) Plan?

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


[Questions 5a-5e are answered on Table H.I. Recreating Table H.I. here may make following the survey more difficult, so Table H.I. has been omitted here. No information has been omitted. See survey if needed.]


5a. Was this (name) Plan obtained through an employer, union, or some other group?

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

b. Does this plan pay any part of hospital expenses?

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

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

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

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

1 [] Y (4)
2 [] N
9 [] DK

e. 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

I

For each person, review 1 and 2 and 4 for each plan and determine if "Covered" by either Medicare or insurance, or "Not covered."

Ask for each person "Not covered."

Many people do not carry health insurance for various reasons (Hand Card N)

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 Medicare, Medicaid or Welfare.
5. Have been healthy, not much sickness in the family, haven't needed health insurance.
6. Too expensive, can't afford health insurance.
7. Other reason.

6a. Which of those statements describes why -- is not covered by any health insurance plan? Any other reason?

Circle all reasons given.

[] 1
[] 2
[] 3
[] 4
[] 5
[] 6
[] Other (Specify) ____




Mark box or ask:


b. What is the MAIN reason -- is not covered by any health insurance plan?

[] Only one reason
[] 1
[] 2
[] 3
[] 4
[] 5
[] 6
[] Other (Specify) ____