Codes and Frequencies
For persons in families with at least four private health insurance plans, HI4TYPE indicates if the fourth plan mentioned was some form of health maintenance organization (HMO) (either group or an Individual Practice Association, IPA) or a fee-for-service plan (Blue Cross/Blue Shield or other). Persons with single service plans are not included in the universe for HI4TYPE.
The definitions of HMO did not change substantially through 1996. HMOs and IPAs were defined as plans whose members are generally required to use only those health care providers within the health care organization, and usually, members do not have to submit claims for costs of medical care services.
Data Collection Process
For 1980 to 1989 this variable reflects plan type based on the plan name given. For 1993 to 1996, it reflects unedited responses to a question on plan type.
For 1980 to 1989, persons who had private insurance were asked for the name of the insurance plan. Based on the name reported, responses were matched against a master list and coded by NCHS staff to these types of plans. The Field Representative's Manuals instructed interviewers not to record the type of plan, such as family plan, major medical, or high or low option, and indicated that "plan names will be matched against a master list and coded." They also instructed interviewers not to include plans that pay only for accidents or single service plans.
In contrast, for 1993 to 1996, this variable reflects the direct answer to a question on plan type, i.e., "Is (plan name) an HMO (Health Maintenance Organization) or IPA (Individual Practice Association), or is it some other kind of plan?" For 1993 to 1996, respondents who indicated their plan only pays for one type of service did not receive the question for HI4TYPE.
Details about the characteristics of insurance plans (such as HI4TYPE) reflect plans for any family member in the household. In order to determine if the person (rather than someone else in the family) was covered by this plan, analysts should use the variable HI4PCOV (Health Insurance Plan 4: Person's Coverage Status), which indicates whether the person was covered by the plan.
Information was collected on the details of up to four plans per family for 1993 to 1996 and five plans per family for 1980, 1982, 1984, 1986, and 1989, and six plans in 1983.
Users may also want to see the variable HIPTYPER, created by IPUMS NHIS staff, which indicates whether a person had any plan that is an HMO.
Please use the IHIS drop-down menus and search function for other related variables.
Definition of Private Coverage
Private insurance was defined as insurance which pays any part of a hospital, doctor's, surgeon's, or dentist's bill, except plans which pay only for accidents.
The definition, order, and wording of private health insurance changed over time to reflect changes in the availability of different types of coverage and issues of interest. Users are strongly encouraged to review the user notes Insurance Data Collection and Private Insurance Definitions.
This variable is not comparable over time.
Prior to 1989, apart from changes in the survey quarters in which this question was asked, it is comparable. In 1989, changes in question wording to explicitly exclude single service coverage reduce comparability with earlier years.
In addition, for 1980 to 1989, this variable reflects editing procedures that reassigned respondents to plan type based on the verbatim plan name provided by the respondent. For 1993 to 1996, this variable reflects the verbatim response to a question on whether the plan was an HMO or non-HMO.
- 1980: Persons covered by 4 private health insurance plans that pays any part of a hospital, doctor's or surgeon's bill, or whose coverage was unknown.
- 1982; 1984: Persons covered by 4 private health insurance plans that pay any part of a hospital, doctor's, or surgeon's bill (excluding Medicare or single service plans)
- 1983: Persons in quarters 3 or 4 covered by 4 private health insurance plans
- 1986; 1989: Persons covered by 4 private health insurance plans that pay any part of a hospital, doctor's, surgeon's or dentist's bill (excluding Medicare or single service plans)
- 1993: Persons in quarters 3 or 4 whose 4th health insurance plan only pays for a variety of service, who didn't know what was paid for in the plan.
- 1994; 1995; 1996: Persons whose 4thhealth insurance plan only pays for a variety of service, who didn't know what was paid for in the plan.
- 1980, 1982-1984, 1986, 1989, 1993-1996