Survey Text

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2020

No questionnaire text is available for this sample.


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2019
Survey form view entire document:  text  image
Question ID: INS.0140.00.1
Variable: MACHMN_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

The next questions are about Medicaid coverage. What is the name of your Medicaid health plan?
Response:
Verbatim Verbatim values
97 Refused
99 Do not Know
Universe:
Sample Adults 18+ with Medicaid coverage
Skip Instructions:
1,2,RF,DK [goto SINCOVVS_A]
Question ID: INS.0330.00.1
Variable: HIPNAM1_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

It is important that we record the complete and accurate name of each private health insurance plan. What is the COMPLETE name of your plan? Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service such as long term care, accidents, or dental care.

Read if necessary: Do you have a health plan card or something with the plan name on it?

Response:

97 Refused
99 Do not Know
Universe:
Sample Adults 18+ enrolled in a Medigap plan or private health insurance and the sample adult did not share or refused or did not know if they shared or did not have a value for both of the two listed private plans for the sample child
Skip Instructions:
allow 80,RF,DK = [goto MORPLAN_A]
Question ID: INS.0350.00.1
Variable: HIPNAM2_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

What is the name of that private health insurance plan?

Read if necessary: Do you have a health plan card or something with the plan name on it?

Response:

97 Refused
99 Do not Know
Universe:
Sample Adults 18+ with a second private health insurance plan
Skip Instructions:
allow 80,RF,DK = [goto bPlan[1].POLHLD_A]
Question ID: INS.0510.00.1
Variable: CHNAME_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Earlier I recorded that you are covered by the Children's Health Insurance Program or CHIP. What is the name of the plan?
Response:
Verbatim Verbatim values
97 Refused
99 Do not Know
Universe:
Sample Adults 18+ with a CHIP plan
Skip Instructions:
allow 80,RF,DK= [goto CHXCHNG_A]
Question ID: INS.0560.00.1
Variable: OPNAME_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Earlier I recorded that you are covered by a state-sponsored plan. What is the name of the plan?
Response:
Verbatim Verbatim values
97 Refused
99 Do not Know
Universe:
Sample Adults 18+ with a state-sponsored plan
Skip Instructions:
allow 80,RF,DK= [goto OPXCHNG_A]
Question ID: INS.0610.00.1
Variable: OGNAME_A
Interview Module: Adult
Content Type: Annual Core

Question Text:

Earlier I recorded that you are covered by an other government program. What is the name of the plan?
Response:
97 Refused
99 Do not Know
Universe:
Sample Adults 18+ who have an other government plan
Skip Instructions:
allow 80,RF,DK = [goto OGXCHNG_A]
Question ID: INS.0130.00.1
Variable: MACHMN_C
Interview Module: Child
Content Type: Annual Core

Question Text:
The next questions are about Medicaid coverage. What is the name of ^SCNAME's Medicaid health plan?
Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1
Response:
Verbatim Verbatim values
97 Refused
99 Do not Know
Universe:
Sample Children 0-17 with Medicaid coverage
Skip Instructions:
allow 80, RF, DK= [goto MAXCHNG_C]
Question ID: INS.0300.00.1

Variable: HIPNAM1_C
Interview Module: Child
Content Type: Annual Core

Question Text:

It is important that we record the complete and accurate name of each private health insurance plan. What is the COMPLETE name of ^SCNAME's plan? Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service such as long term care, accidents, or dental care.

Read if necessary: Do you have a health plan card or something with the plan name on it?

Fills:
^SCNAME

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1
Response:
Verbatim Verbatim values
97 Refused
99 Do not Know
Universe:
Sample Children 0-17 enrolled in a Medigap plan or private health insurance and the sample child did not share or refused or did not know if they shared or did not have a value for both of the two listed private plans for the sample adult
Skip Instructions:
allow 80,RF,DK= [goto MORPLAN_C]
Question ID: INS.0320.00.1
Variable: HIPNAM2_C
Interview Module: Child
Content Type: Annual Core

Question Text:
What is the name of that private health insurance plan?

Read if necessary: Do you have a health plan card or something with the plan name on it?

Response:

97 Refused
99 Do not Know
Universe:
Sample Children 0-17 with a second private health insurance plan
Skip Instructions:
allow 80,RF,DK = [goto bPlan[1].POLHLD_C]
Question ID: INS.0470.00.1
Variable: CHNAME_C
Interview Module: Child
Content Type: Annual Core


Question Text:

Earlier I recorded that ^SCNAME is covered by the Children's Health Insurance Program or CHIP. What is the name of the plan?
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1
Response:
97 Refused
99 Do not Know
Universe:
Sample Children 0-17 with a CHIP plan
Skip Instructions:
allow 80,RF,DK = [goto CHXCHNG_C]
Question ID: INS.0520.00.1
Variable: OPNAME_C
Interview Module: Child
Content Type: Annual Core


Question Text:

Earlier I recorded that ^SCNAME is covered by a state-sponsored plan. What is the name of the plan?
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1
Response:
97 Refused
99 Do not Know
Universe:
Sample Children 0-17 with a state-sponsored plan
Skip Instructions:
verbatim,RF,DK = [goto OPXCHNG_C]
Question ID: INS.0570.00.1
Variable: OGNAME_C
Interview Module: Child
Content Type: Annual Core


Question Text:

Earlier I recorded that ^SCNAME is covered by an other government program. What is the name of the plan?
Fills:
^SCNAME

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1
Response:
97 Refused
99 Do not Know
Universe:
Sample Children 0-17 who have an other government plan
Skip Instructions:
allow 80,RF,DK = [goto OGXCHNG_C]

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2018

No questionnaire text is available for this sample.


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2017

No questionnaire text is available for this sample.


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2016

No questionnaire text is available for this sample.


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2015

No questionnaire text is available for this sample.


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2014

No questionnaire text is available for this sample.