?[F1]
What kinds of health insurance or health care coverage do you have? Is it...Private health
insurance, Medicare, Medicare supplement, Medicaid, Children's Health Insurance Program or CHIP,
military related health care including TRICARE, CHAMPUS, VA health care and CHAMP-VA, Indian
Health Service, a state-sponsored health plan, or an other government program?
* Enter all that apply, separate with commas.

01 - Private health insurance
02 - Medicare
03 - Medigap
04 - Medicaid
05 - Children's Health Insurance Program (CHIP)
06 - Military related health care: TRICARE (CHAMPUS) / VA health care / CHAMPVA
07 - Indian Health Service
08 - State-sponsored health plan
09 - Other government program
10 - No coverage of any type
97 - Refused
99 - Don't Know

Sample Adults 18+ covered by any kind of health insurance or health care coverage or refused/don't know if they have insurance or health care coverage.

if more than 1 answer selected and (10 IN HIKIND_A) [goto ERR1_HIKIND_A]
elseif (GEN.AGE_FINAL[PX_A] ge 65 or (GEN.AGE_FINAL[PX_A] IN (RF,DK) and
Roster.HHC.tblAGE.blkPerson[PX_A]=2) and 2 NOT IN HIKIND_A [goto MCAREPRB_A]
elseif (GEN.AGE_FINAL[PX_A] lt 65 or (GEN.AGE_FINAL[PX_A] IN (RF,DK) and
Roster.HHC.tblAGE.blkPerson[PX_A].AGE65 IN (1,RF,DK,empty)) and HIKIND_A IN (10,RF,DK) [goto
MCAIDPRB_A]
else [goto SINCOVDE_A]

Check Text: ERR1_HIKIND_A
Check Description: Selecting no coverage and other categories hard edit
Check Text: {check ERR1_HIKIND_A}
Cannot mark "no coverage of any kind" and another type. Please correct.

?[F1]
What kinds of health insurance or health care coverage do you have? Is it...Private health insurance, Medicare, Medicare supplement, Medicaid, Children's Health Insurance Program or CHIP,
military related health care including TRICARE, CHAMPUS, VA health care and CHAMP-VA, Indian Health Service, a state-sponsored health plan, or an other government program?
Enter all that apply, separate with commas.

01 - Private health insurance
02 - Medicare
03 - Medigap
04 - Medicaid
05 - Children's Health Insurance Program (CHIP)
06 - Military related health care: TRICARE (CHAMPUS) / VA health care / CHAMPVA
07 - Indian Health Service
08 - State-sponsored health plan
09 - Other government program
10 - No coverage of any type
97 - Refused
99 - Don't Know

Sample Adults 18+ covered by any kind of health insurance or health care coverage or refused/don't know if they have insurance or health care coverage.

if more than 1 answer selected and (10 IN HIKIND_A) [goto ERR1_HIKIND_A]
elseif (GEN.AGE_FINAL[PX_A] ge 65 or (GEN.AGE_FINAL[PX_A] IN (RF,DK) and
Roster.HHC.tblAGE.blkPerson[PX_A]=2) and 2 NOT IN HIKIND_A [goto MCAREPRB_A]
elseif (GEN.AGE_FINAL[PX_A] lt 65 or (GEN.AGE_FINAL[PX_A] IN (RF,DK) and
Roster.HHC.tblAGE.blkPerson[PX_A].AGE65 IN (1,RF,DK,empty)) and HIKIND_A IN (10,RF,DK) [goto
MCAIDPRB_A]
else [goto SINCOVDE_A]

Check Text: ERR1_HIKIND_A
Check Description: Selecting no coverage and other categories hard edit
Check Text: {check ERR1_HIKIND_A}
Cannot mark "no coverage of any kind" and another type. Please correct.

During the past 12 months, did you receive any care at a Veteran's Health Administration facility or receive any other health care paid for by the VA?
Read if necessary: Veteran's Health Administration facilities include VA hospitals, VA medical centers, VA outpatient clinics, and VA nursing homes.

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Sample Adults 18+ who have ever served in the armed forces

1 [goto next section]
2,RF,DK if 1 IN Adult.INS.MILSPC_A [goto next section]
else [goto VACAREEV]

Have you ever enrolled in or used VA health care?

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Sample Adults 18+ who have ever served in the armed forces and did not receive care at a VHA facility or other health care paid for by the VA in the past 12 months and did not report VA health care when asked about insurance

1,2,RF,DK [goto next section]

?[F1]
What kinds of health insurance or health care coverage does ^SCNAME have? Is it...Private health insurance, Medicare, Medicare supplement, Medicaid, Children's Health Insurance Program or CHIP, military related health care including TRICARE, CHAMPUS, VA health care and CHAMP-VA, Indian Health Service, state-sponsored health plan, or an other government program?
Enter all that apply, separate with commas.

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

01 - Private health insurance
02 - Medicare
03 - Medigap
04 - Medicaid
05 - Children's Health Insurance Program (CHIP)
06 - Military related health care: TRICARE (CHAMPUS) / VA health care / CHAMPVA
07 - Indian Health Service
08 - State-sponsored health plan
09 - Other government program
10 - No coverage of any type
97 - Refused
99 - Don't Know

Sample Children 0-17 covered by any kind of health insurance or health care coverage or refused/don't know if they have insurance or health care coverage.

if 1 answer selected and (10> in HIKIND_C) [goto ERR1_HIKIND_C]
else if HIKIND_C=RF,DK or (10 in HIKIND_C) [goto MCAIDPRB_C]
else [goto SINCOVDE_C]

Check Text: ERR1_HIKIND_C
Check Description: Selecting no coverage and other categories hard edit
Check Text: {check ERR1_HIKIND_C}
Cannot mark "no coverage of any kind" and another type. Please correct.

?[F1]
What kinds of health insurance or health care coverage do you have? Is it...Private health
insurance, Medicare, Medicare supplement, Medicaid, Children's Health Insurance Program or CHIP,
military related health care including TRICARE, CHAMPUS, VA health care and CHAMP-VA, Indian
Health Service, a state-sponsored health plan, or an other government program?
* Enter all that apply, separate with commas.

01 - Private health insurance
02 - Medicare
03 - Medigap
04 - Medicaid
05 - Children's Health Insurance Program (CHIP)
06 - Military related health care: TRICARE (CHAMPUS) / VA health care / CHAMPVA
07 - Indian Health Service
08 - State-sponsored health plan
09 - Other government program
10 - No coverage of any type
97 - Refused
99 - Don't Know

Sample Adults 18+ covered by any kind of health insurance or health care coverage or refused/don't know if they have insurance or health care coverage.

if more than 1 answer selected and (10 IN HIKIND_A) [goto ERR1_HIKIND_A]
elseif (GEN.AGE_FINAL[PX_A] ge 65 or (GEN.AGE_FINAL[PX_A] IN (RF,DK) and
Roster.HHC.tblAGE.blkPerson[PX_A]=2) and 2 NOT IN HIKIND_A [goto MCAREPRB_A]
elseif (GEN.AGE_FINAL[PX_A] lt 65 or (GEN.AGE_FINAL[PX_A] IN (RF,DK) and
Roster.HHC.tblAGE.blkPerson[PX_A].AGE65 IN (1,RF,DK,empty)) and HIKIND_A IN (10,RF,DK) [goto
MCAIDPRB_A]
else [goto SINCOVDE_A]

Check Text: ERR1_HIKIND_A
Check Description: Selecting no coverage and other categories hard edit
Check Text: {check ERR1_HIKIND_A}
Cannot mark "no coverage of any kind" and another type. Please correct.

During the past 12 months, did you receive any care at a Veteran's Health Administration
facility or receive any other health care paid for by the VA?
* Read if necessary: Veteran's Health Administration facilities include VA hospitals, VA medical
centers, VA outpatient clinics, and VA nursing homes.

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Sample Adults 18+ who have ever served in the armed forces

1 [goto next section]
2,RF,DK if 1 IN Adult.INS.MILSPC_A [goto next section]
else [goto VACAREEV]

Have you ever enrolled in or used VA health care?

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Sample Adults 18+ who have ever served in the armed forces and did not recieve care at a VHA facility or other health care paid for by the VA in the past 12 months and did not report VA health care when asked about insurance

1,2,RF,DK [goto next section]

?[F1]
What kinds of health insurance or health care coverage does ^SCNAME have? Is it...Private health
insurance, Medicare, Medicare supplement, Medicaid, Children's Health Insurance Program or CHIP,
military related health care including TRICARE, CHAMPUS, VA health care and CHAMP-VA, Indian
Health Service, state-sponsored health plan, or an other government program?
* Enter all that apply, separate with commas.

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

01 - Private health insurance
02 - Medicare
03 - Medigap
04 - Medicaid
05 - Children's Health Insurance Program (CHIP)
06 - Military related health care: TRICARE (CHAMPUS) / VA health care / CHAMPVA
07 - Indian Health Service
08 - State-sponsored health plan
09 - Other government program
10 - No coverage of any type
97 - Refused
99 - Don't Know

Sample Children 0-17 covered by any kind of health insurance or health care coverage or refused/don't know if they have insurance or health care coverage.

if 1 answer selected and (10> in HIKIND_C) [goto ERR1_HIKIND_C]
else if HIKIND_C=RF,DK or (10 in HIKIND_C) [goto MCAIDPRB_C]
else [goto SINCOVDE_C]

Check Text: ERR1_HIKIND_C
Check Description: Selecting no coverage and other categories hard edit
Check Text: {check ERR1_HIKIND_C}
Cannot mark "no coverage of any kind" and another type. Please correct.

What kinds of health insurance or health care coverage do you have? Is it...Private health insurance, Medicare, Medicare supplement, Medicaid, Children's Health Insurance Program or CHIP, military related health care including TRICARE, CHAMPUS, VA health care and CHAMP-VA, Indian Health Service, a state-sponsored health plan, or an other government program?
Enter all that apply, separate with commas.

1 Private health insurance
2 Medicare
3 Medigap
4 Medicaid
5 Children's Health Insurance Program (CHIP)
6 Military related health care: TRICARE (CHAMPUS) / VA health care / CHAMP- VA
7 Indian Health Service
8 State-sponsored health plan
9 Other government program
10 No coverage of any type
97 Refused
99 Do not Know

Sample Adults 18+ covered by any kind of health insurance or health care coverage or refused/do not know if they have insurance or health care coverage.

if more than 1 answer selected and (10 IN HIKIND_A) [goto ERR1_HIKIND_A] elseif (GEN.AGE_FINAL[PX_A] ge 65 or (GEN.AGE_FINAL[PX_A] IN (RF,DK) and
Roster.HHC.tblAGE.blkPerson[PX_A]=2) and 2 NOT IN HIKIND_A [goto MCAREPRB_A] elseif (GEN.AGE_FINAL[PX_A] lt 65 or (GEN.AGE_FINAL[PX_A] IN (RF,DK) and
Roster.HHC.tblAGE.blkPerson[PX_A].AGE65 IN (1,RF,DK,empty)) and HIKIND_A IN (10,RF,DK) [goto MCAIDPRB_A]
else [goto SINCOVDE_A]

Check Description: Selecting no coverage and other categories hard edit
Check Text: check ERR1_HIKIND_A

Cannot mark "no coverage of any kind" and another type.

Please correct.

What kinds of health insurance or health care coverage does ^SCNAME have? Is it...Private health insurance, Medicare, Medicare supplement, Medicaid, Children's Health Insurance Program or CHIP, military related health care including TRICARE, CHAMPUS, VA health care and CHAMP-VA, Indian Health Service, state-sponsored health plan, or an other government program?

Enter all that apply, separate with commas.

Description: Sample child's name
Instruction: Fill ALIAS of HHSTAT_C=1

01 Private health insurance
02 Medicare
03 Medigap
04 Medicaid
05 Children's Health Insurance Program (CHIP)
06 Military related health care: TRICARE (CHAMPUS) / VA health care / CHAMP- VA
07 Indian Health Service
08 State-sponsored health plan
09 Other government program
10 No coverage of any type
97 Refused
99 Do not Know

Sample Children 0-17 covered by any kind of health insurance or health care coverage or refused/do not know if they have insurance or health care coverage.

if 1 answer selected and (10 in HIKIND_C) [goto ERR1_HIKIND_C] else if HIKIND_C=RF,DK or (10 in HIKIND_C) [goto MCAIDPRB_C]
else [goto SINCOVDE_C]

Check Text: ERR1_HIKIND_C
Check Description: Selecting no coverage and other categories hard edit
Check Text: {check ERR1_HIKIND_C}

Cannot mark "no coverage of any kind" and another type. Please correct.

Instrument Variable Name: HIKIND
Questionnaire File Name: Family
Question Text:

(book) F12 and (book) F14 ? [F1]
What kind of health insurance or health care coverage [fill: do you/does ALIAS] have? INCLUDE those that pay for only one type of service (nursing home care, accidents, or dental care). EXCLUDE private plans that only provide extra cash while hospitalized.
* Enter all that apply, separate with commas.

01 Private health insurance
02 Medicare
03 Medi-Gap
04 Medicaid
05 SCHIP (CHIP/Children's Health Insurance Program)
06 Military health care (TRICARE/VA/CHAMP-VA)
07 Indian Health Service
08 State-sponsored health plan
09 Other government program
10 Single service plan (e.g., dental, vision, prescriptions)
11 No coverage of any type
97 Refused
99 Don't know

Universe Text: All persons in families where FHICOV= yes, don't know, or refused
Skip Instructions:

(R,D) [goto HCSPFYR]
(1-10) [if AGE ge 65 and HIKIND ne 2, goto MCAREPRB; else, if HIKIND ne 10 goto SINCOV; else, goto
HICHANGE]
(11) [if HIKIND = 1-10, goto ERR_HIKIND; else, if AGE ge 65 goto MCAREPRB; else, goto MCAIDPRB]
Hard Edit: ERR_HIKIND:
* Cannot mark "No coverage of any kind" and another type.
* Please correct.

Instrument Variable Name: VACOV
Questionnaire File Name: Person
Question Text:

[fill1: Have you/ Has alias] ever enrolled in or used VA health care?
*Read if necessary: VA refers to Veterans Health Administration.

1 Yes
2 No
7 Refused
9 Don't know

Universe Text: All families with a person age 18 or older who has ever served in the armed forces and are not covered by VA military health care
Skip Instructions:

(1,2,R,D) [goto DOINGLW]

Instrument Variable Name: HIKIND
Question Text:

(book) F12 and (book) F14 ? [F1] What kind of health insurance or health care coverage [fill: do you/does ALIAS] have? INCLUDE those that pay for only one type of service (nursing home care, accidents, or dental care). EXCLUDE private plans that only provide extra cash while hospitalized.
* Enter all that apply, separate with commas.

01 Private health insurance
02 Medicare
03 Medi-Gap
04 Medicaid
05 SCHIP (CHIP/Children's Health Insurance Program)
06 Military health care (TRICARE/VA/CHAMP-VA)
07 Indian Health Service
08 State-sponsored health plan
09 Other government program
10 Single service plan (e.g., dental, vision, prescriptions)
11 No coverage of any type
97 Refused
99 Don't know

Universe Text All persons in families where FHICOV= yes, don't know, or refused
Skip Instructions:

(R,D) [go to HCSPFYR]
(1-10) [if AGE ge 65 and HIKIND ne 2, go to MCAREPRB; else, if HIKIND ne 10 go to SINCOV; else, go to HICHANGE]
(11) [if HIKIND = 1-10, go to ERR_HIKIND; else, if AGE ge 65 go to MCAREPRB; else, go to MCAIDPRB]

Hard Edit: ERR_HIKIND:

* Cannot mark "No coverage of any kind" and another type.
* Please correct.

Instrument Variable Name: MILSPC
Question Text:

? [F1] * Enter all that apply, separate with commas. Earlier I recorded that [fill1: you are/ALIAS is] covered by military health care. What types of military health care [fill2:
are you/is ALIAS] covered by?

1 TRICARE
2 VA
3 CHAMP-VA
4 Other military coverage (specify)
7 Refused
9 Don't know

Universe Text All persons with military health care
Skip Instructions:

(1) [go to MILMAN]
(2,3,R,D) [repeat question for next person with military health care; else, go to HILAST]
(4) [go to MILSPCOT]

Instrument Variable Name: HIKIND
Question Text:

(book) F12 and (book) F14 ? [F1] What kind of health insurance or health care coverage [fill: do you/does ALIAS] have? INCLUDE those that pay for only one type of service (nursing home care, accidents, or dental care). EXCLUDE private plans that only provide extra cash while hospitalized.
* Enter all that apply, separate with commas.

01 Private health insurance
02 Medicare
03 Medi-Gap
04 Medicaid
05 SCHIP (CHIP/Children's Health Insurance Program)
06 Military health care (TRICARE/VA/CHAMP-VA)
07 Indian Health Service
08 State-sponsored health plan
09 Other government program
10 Single service plan (e.g., dental, vision, prescriptions)
11 No coverage of any type
97 Refused
99 Don't know

Universe Text All persons in families where FHICOV= yes, don't know, or refused
Skip Instructions:

(R,D) [go to HCSPFYR]
(1-10) [if AGE ge 65 and HIKIND ne 2, go to MCAREPRB; else, if HIKIND ne 10 go to SINCOV; else, go to HICHANGE]
(11) [if HIKIND = 1-10, go to ERR_HIKIND; else, if AGE ge 65 go to MCAREPRB; else, go to MCAIDPRB]

Hard Edit: ERR_HIKIND:

* Cannot mark "No coverage of any kind" and another type.
* Please correct.

Instrument Variable Name: MILSPC
Question Text:

? [F1] * Enter all that apply, separate with commas. Earlier I recorded that [fill1: you are/ALIAS is] covered by military health care. What types of military health care [fill2:
are you/is ALIAS] covered by?

1 TRICARE
2 VA
3 CHAMP-VA
4 Other military coverage (specify)
7 Refused
9 Don't know

Universe Text All persons with military health care
Skip Instructions:

(1) [go to MILMAN]
(2,3,R,D) [repeat question for next person with military health care; else, go to HILAST]
(4) [go to MILSPCOT]

Instrument Variable Name: HIKIND
Question Text:

(book) F12 and (book) F14 ? [F1] What kind of health insurance or health care coverage [fill: do you/does ALIAS] have? INCLUDE those that pay for only one type of service (nursing home care, accidents, or dental care). EXCLUDE private plans that only provide extra cash while hospitalized.
* Enter all that apply, separate with commas.

01 Private health insurance
02 Medicare
03 Medi-Gap
04 Medicaid
05 SCHIP (CHIP/Children's Health Insurance Program)
06 Military health care (TRICARE/VA/CHAMP-VA)
07 Indian Health Service
08 State-sponsored health plan
09 Other government program
10 Single service plan (e.g., dental, vision, prescriptions)
11 No coverage of any type
97 Refused
99 Don't know

Universe Text All persons in families where FHICOV= yes, don't know, or refused
Skip Instructions:

(R,D) [go to HCSPFYR]
(1-10) [if AGE ge 65 and HIKIND ne 2, go to MCAREPRB; else, if HIKIND ne 10 go to SINCOV; else, go to HICHANGE]
(11) [if HIKIND = 1-10, go to ERR_HIKIND; else, if AGE ge 65 go to MCAREPRB; else, go to MCAIDPRB]

Hard Edit: ERR_HIKIND:

* Cannot mark "No coverage of any kind" and another type.
* Please correct.

Instrument Variable Name: MILSPC
Question Text:

? [F1] * Enter all that apply, separate with commas. Earlier I recorded that [fill1: you are/ALIAS is] covered by military health care. What types of military health care [fill2:
are you/is ALIAS] covered by?

1 TRICARE
2 VA
3 CHAMP-VA
4 Other military coverage (specify)
7 Refused
9 Don't know

Universe Text All persons with military health care
Skip Instructions:

(1) [go to MILMAN]
(2,3,R,D) [repeat question for next person with military health care; else, go to HILAST]
(4) [go to MILSPCOT]

Instrument Variable Name: HIKIND
Question Text:

(book) F12 and (book) F14 ? [F1] What kind of health insurance or health care coverage [fill: do you/does ALIAS] have? INCLUDE those that pay for only one type of service (nursing home care, accidents, or dental care). EXCLUDE private plans that only provide extra cash while hospitalized.
* Enter all that apply, separate with commas.

01 Private health insurance
02 Medicare
03 Medi-Gap
04 Medicaid
05 SCHIP (CHIP/Children's Health Insurance Program)
06 Military health care (TRICARE/VA/CHAMP-VA)
07 Indian Health Service
08 State-sponsored health plan
09 Other government program
10 Single service plan (e.g., dental, vision, prescriptions)
11 No coverage of any type
97 Refused
99 Don't know

Universe Text All persons in families where FHICOV= yes, don't know, or refused
Skip Instructions:

(R,D) [go to HCSPFYR]
(1-10) [if AGE ge 65 and HIKIND ne 2, go to MCAREPRB; else, if HIKIND ne 10 go to SINCOV; else, go to HICHANGE]
(11) [if HIKIND = 1-10, go to ERR_HIKIND; else, if AGE ge 65 go to MCAREPRB; else, go to MCAIDPRB]

Hard Edit: ERR_HIKIND:

* Cannot mark "No coverage of any kind" and another type.
* Please correct.

Instrument Variable Name: MILSPC
Question Text:

? [F1] * Enter all that apply, separate with commas. Earlier I recorded that [fill1: you are/ALIAS is] covered by military health care. What types of military health care [fill2:
are you/is ALIAS] covered by?

1 TRICARE
2 VA
3 CHAMP-VA
4 Other military coverage (specify)
7 Refused
9 Don't know

Universe Text All persons with military health care
Skip Instructions:

(1) [go to MILMAN]
(2,3,R,D) [repeat question for next person with military health care; else, go to HILAST]
(4) [go to MILSPCOT]

Instrument Variable Name: HIKIND
Question Text:

(book) F12 and (book) F14 ? [F1] What kind of health insurance or health care coverage [fill: do you/does ALIAS] have? INCLUDE those that pay for only one type of service (nursing home care, accidents, or dental care). EXCLUDE private plans that only provide extra cash while hospitalized.
* Enter all that apply, separate with commas.

01 Private health insurance
02 Medicare
03 Medi-Gap
04 Medicaid
05 SCHIP (CHIP/Children's Health Insurance Program)
06 Military health care (TRICARE/VA/CHAMP-VA)
07 Indian Health Service
08 State-sponsored health plan
09 Other government program
10 Single service plan (e.g., dental, vision, prescriptions)
11 No coverage of any type
97 Refused
99 Don't know

Universe Text All persons in families where FHICOV= yes, don't know, or refused
Skip Instructions:

(R,D) [go to HCSPFYR]
(1-10) [if AGE ge 65 and HIKIND ne 2, go to MCAREPRB; else, if HIKIND ne 10 go to SINCOV; else, go to HICHANGE]
(11) [if HIKIND = 1-10, go to ERR_HIKIND; else, if AGE ge 65 go to MCAREPRB; else, go to MCAIDPRB]

Hard Edit: ERR_HIKIND:

* Cannot mark "No coverage of any kind" and another type.
* Please correct.

Instrument Variable Name: MILSPC
Question Text:

? [F1] * Enter all that apply, separate with commas. Earlier I recorded that [fill1: you are/ALIAS is] covered by military health care. What types of military health care [fill2:
are you/is ALIAS] covered by?

1 TRICARE
2 VA
3 CHAMP-VA
4 Other military coverage (specify)
7 Refused
9 Don't know

Universe Text All persons with military health care
Skip Instructions:

(1) [go to MILMAN]
(2,3,R,D) [repeat question for next person with military health care; else, go to HILAST]
(4) [go to MILSPCOT]

Instrument Variable Name: HIKIND
Question Text:

(book) F12 and (book) F14 ? [F1] What kind of health insurance or health care coverage [fill: do you/does ALIAS] have? INCLUDE those that pay for only one type of service (nursing home care, accidents, or dental care). EXCLUDE private plans that only provide extra cash while hospitalized.
* Enter all that apply, separate with commas.

01 Private health insurance
02 Medicare
03 Medi-Gap
04 Medicaid
05 SCHIP (CHIP/Children's Health Insurance Program)
06 Military health care (TRICARE/VA/CHAMP-VA)
07 Indian Health Service
08 State-sponsored health plan
09 Other government program
10 Single service plan (e.g., dental, vision, prescriptions)
11 No coverage of any type
97 Refused
99 Don't know

Universe Text All persons in families where FHICOV= yes, don't know, or refused
Skip Instructions:

(R,D) [go to HCSPFYR]
(1-10) [if AGE ge 65 and HIKIND ne 2, go to MCAREPRB; else, if HIKIND ne 10 go to SINCOV; else, go to HICHANGE]
(11) [if HIKIND = 1-10, go to ERR_HIKIND; else, if AGE ge 65 go to MCAREPRB; else, go to MCAIDPRB]

Hard Edit: ERR_HIKIND:

* Cannot mark "No coverage of any kind" and another type.
* Please correct.

Instrument Variable Name: MILSPC
Question Text:

? [F1] * Enter all that apply, separate with commas. Earlier I recorded that [fill1: you are/ALIAS is] covered by military health care. What types of military health care [fill2:
are you/is ALIAS] covered by?

1 TRICARE
2 VA
3 CHAMP-VA
4 Other military coverage (specify)
7 Refused
9 Don't know

Universe Text All persons with military health care
Skip Instructions:

(1) [go to MILMAN]
(2,3,R,D) [repeat question for next person with military health care; else, go to HILAST]
(4) [go to MILSPCOT]

Instrument Variable Name: HIKIND
Question Text:

(book) F12 and (book) F14 ? [F1] What kind of health insurance or health care coverage [fill: do you/does ALIAS] have? INCLUDE those that pay for only one type of service (nursing home care, accidents, or dental care). EXCLUDE private plans that only provide extra cash while hospitalized.
* Enter all that apply, separate with commas.

01 Private health insurance
02 Medicare
03 Medi-Gap
04 Medicaid
05 SCHIP (CHIP/Children's Health Insurance Program)
06 Military health care (TRICARE/VA/CHAMP-VA)
07 Indian Health Service
08 State-sponsored health plan
09 Other government program
10 Single service plan (e.g., dental, vision, prescriptions)
11 No coverage of any type
97 Refused
99 Don't know

Universe Text All persons in families where FHICOV= yes, don't know, or refused
Skip Instructions:

(R,D) [go to HCSPFYR]
(1-10) [if AGE ge 65 and HIKIND ne 2, go to MCAREPRB; else, if HIKIND ne 10 go to SINCOV; else, go to HICHANGE]
(11) [if HIKIND = 1-10, go to ERR_HIKIND; else, if AGE ge 65 go to MCAREPRB; else, go to MCAIDPRB]

Hard Edit: ERR_HIKIND:

* Cannot mark "No coverage of any kind" and another type.
* Please correct.

Instrument Variable Name: MILSPC
Question Text:

? [F1] * Enter all that apply, separate with commas. Earlier I recorded that [fill1: you are/ALIAS is] covered by military health care. What types of military health care [fill2:
are you/is ALIAS] covered by?

1 TRICARE
2 VA
3 CHAMP-VA
4 Other military coverage (specify)
7 Refused
9 Don't know

Universe Text All persons with military health care
Skip Instructions:

(1) [go to MILMAN]
(2,3,R,D) [repeat question for next person with military health care; else, go to HILAST]
(4) [go to MILSPCOT]

Instrument Variable Name: MILSPCOT
Question Text:

* Other military coverage

Verbatim Verbatim response
7 Refused
9 Don't know

Universe Text All persons with "other" military coverage
Skip Instructions:

if MILSPC eq 1, go to MILMAN; else, go to MILSPC for the next person with military health care; else, go to HILAST

Instrument Variable Name: HIKIND
Question Text:

(book) F12 and (book) F14 ? [F1] What kind of health insurance or health care coverage [fill: do you/does ALIAS] have? INCLUDE those that pay for only one type of service (nursing home care, accidents, or dental care). EXCLUDE private plans that only provide extra cash while hospitalized.
* Enter all that apply, separate with commas.

01 Private health insurance
02 Medicare
03 Medi-Gap
04 Medicaid
05 SCHIP (CHIP/Children's Health Insurance Program)
06 Military health care (TRICARE/VA/CHAMP-VA)
07 Indian Health Service
08 State-sponsored health plan
09 Other government program
10 Single service plan (e.g., dental, vision, prescriptions)
11 No coverage of any type
97 Refused
99 Don't know

Universe Text All persons in families where FHICOV= yes, don't know, or refused
Skip Instructions:

(R,D) [go to HCSPFYR]
(1-10) [if AGE ge 65 and HIKIND ne 2, go to MCAREPRB; else, if HIKIND ne 10 go to SINCOV; else, go to HICHANGE]
(11) [if HIKIND = 1-10, go to ERR_HIKIND; else, if AGE ge 65 go to MCAREPRB; else, go to MCAIDPRB]

Hard Edit: ERR_HIKIND:

* Cannot mark "No coverage of any kind" and another type.
* Please correct.

Instrument Variable Name: MILSPC
Question Text:

? [F1] * Enter all that apply, separate with commas. Earlier I recorded that [fill1: you are/ALIAS is] covered by military health care. What types of military health care [fill2:
are you/is ALIAS] covered by?

1 TRICARE
2 VA
3 CHAMP-VA
4 Other military coverage (specify)
7 Refused
9 Don't know

Universe Text All persons with military health care
Skip Instructions:

(1) [go to MILMAN]
(2,3,R,D) [repeat question for next person with military health care; else, go to HILAST]
(4) [go to MILSPCOT]

Instrument Variable Name: MILSPCOT
Question Text:

* Other military coverage

Verbatim Verbatim response
7 Refused
9 Don't know

Universe Text All persons with "other" military coverage
Skip Instructions:

if MILSPC eq 1, go to MILMAN; else, go to MILSPC for the next person with military health care; else, go to HILAST

Instrument Variable Name: HIKIND
Question Text:

(book) F12 and (book) F14 ? [F1] What kind of health insurance or health care coverage [fill: do you/does ALIAS] have? INCLUDE those that pay for only one type of service (nursing home care, accidents, or dental care). EXCLUDE private plans that only provide extra cash while hospitalized.
* Enter all that apply, separate with commas.

01 Private health insurance
02 Medicare
03 Medi-Gap
04 Medicaid
05 SCHIP (CHIP/Children's Health Insurance Program)
06 Military health care (TRICARE/VA/CHAMP-VA)
07 Indian Health Service
08 State-sponsored health plan
09 Other government program
10 Single service plan (e.g., dental, vision, prescriptions)
11 No coverage of any type
97 Refused
99 Don't know

Universe Text All persons in families where FHICOV= yes, don't know, or refused
Skip Instructions:

(R,D) [go to HCSPFYR]
(1-10) [if AGE ge 65 and HIKIND ne 2, go to MCAREPRB; else, if HIKIND ne 10 go to SINCOV; else, go to HICHANGE]
(11) [if HIKIND = 1-10, go to ERR_HIKIND; else, if AGE ge 65 go to MCAREPRB; else, go to MCAIDPRB]

Hard Edit: ERR_HIKIND:

* Cannot mark "No coverage of any kind" and another type.
* Please correct.

Instrument Variable Name: MILSPC
Question Text:

? [F1] * Enter all that apply, separate with commas. Earlier I recorded that [fill1: you are/ALIAS is] covered by military health care. What types of military health care [fill2:
are you/is ALIAS] covered by?

1 TRICARE
2 VA
3 CHAMP-VA
4 Other military coverage (specify)
7 Refused
9 Don't know

Universe Text All persons with military health care
Skip Instructions:

(1) [go to MILMAN]
(2,3,R,D) [repeat question for next person with military health care; else, go to HILAST]
(4) [go to MILSPCOT]

Instrument Variable Name: MILSPCOT
Question Text:

* Other military coverage

Verbatim Verbatim response
7 Refused
9 Don't know

Universe Text All persons with "other" military coverage
Skip Instructions:

if MILSPC eq 1, go to MILMAN; else, go to MILSPC for the next person with military health care; else, go to HILAST

Instrument Variable Name: HIKIND
Question Text:

(book) F12 and (book) F14 ? [F1] What kind of health insurance or health care coverage [fill: do you/does ALIAS] have? INCLUDE those that pay for only one type of service (nursing home care, accidents, or dental care). EXCLUDE private plans that only provide extra cash while hospitalized.
* Enter all that apply, separate with commas.

01 Private health insurance
02 Medicare
03 Medi-Gap
04 Medicaid
05 SCHIP (CHIP/Children's Health Insurance Program)
06 Military health care (TRICARE/VA/CHAMP-VA)
07 Indian Health Service
08 State-sponsored health plan
09 Other government program
10 Single service plan (e.g., dental, vision, prescriptions)
11 No coverage of any type
97 Refused
99 Don't know

Universe Text All persons in families where FHICOV= yes, don't know, or refused
Skip Instructions:

(R,D) [go to HCSPFYR]
(1-10) [if AGE ge 65 and HIKIND ne 2, go to MCAREPRB; else, if HIKIND ne 10 go to SINCOV; else, go to HICHANGE]
(11) [if HIKIND = 1-10, go to ERR_HIKIND; else, if AGE ge 65 go to MCAREPRB; else, go to MCAIDPRB]

Hard Edit: ERR_HIKIND:

* Cannot mark "No coverage of any kind" and another type.
* Please correct.

Instrument Variable Name: MILSPC
Question Text:

? [F1] * Enter all that apply, separate with commas. Earlier I recorded that [fill1: you are/ALIAS is] covered by military health care. What types of military health care [fill2:
are you/is ALIAS] covered by?

1 TRICARE
2 VA
3 CHAMP-VA
4 Other military coverage (specify)
7 Refused
9 Don't know

Universe Text All persons with military health care
Skip Instructions:

(1) [go to MILMAN]
(2,3,R,D) [repeat question for next person with military health care; else, go to HILAST]
(4) [go to MILSPCOT]

Instrument Variable Name: HIKIND
Question Text:

(book) F12 and (book) F14 ? [F1] What kind of health insurance or health care coverage [fill: do you/does ALIAS] have? INCLUDE those that pay for only one type of service (nursing home care, accidents, or dental care). EXCLUDE private plans that only provide extra cash while hospitalized.
* Enter all that apply, separate with commas.

01 Private health insurance
02 Medicare
03 Medi-Gap
04 Medicaid
05 SCHIP (CHIP/Children's Health Insurance Program)
06 Military health care (TRICARE/VA/CHAMP-VA)
07 Indian Health Service
08 State-sponsored health plan
09 Other government program
10 Single service plan (e.g., dental, vision, prescriptions)
11 No coverage of any type
97 Refused
99 Don't know

Universe Text All persons in families where FHICOV= yes, don't know, or refused
Skip Instructions:

(R,D) [go to HCSPFYR]
(1-10) [if AGE ge 65 and HIKIND ne 2, go to MCAREPRB; else, if HIKIND ne 10 go to SINCOV; else, go to HICHANGE]
(11) [if HIKIND = 1-10, go to ERR_HIKIND; else, if AGE ge 65 go to MCAREPRB; else, go to MCAIDPRB]

Hard Edit: ERR_HIKIND:

* Cannot mark "No coverage of any kind" and another type.
* Please correct.

Instrument Variable Name: MILSPC
Question Text:

? [F1] * Enter all that apply, separate with commas. Earlier I recorded that [fill1: you are/ALIAS is] covered by military health care. What types of military health care [fill2:
are you/is ALIAS] covered by?

1 TRICARE
2 VA
3 CHAMP-VA
4 Other military coverage (specify)
7 Refused
9 Don't know

Universe Text All persons with military health care
Skip Instructions:

(1) [go to MILMAN]
(2,3,R,D) [repeat question for next person with military health care; else, go to HILAST]
(4) [go to MILSPCOT]

Instrument Variable Name: HIKIND
Question Text:

(book) F12 and (book) F14 ? [F1] What kind of health insurance or health care coverage [fill: do you/does ALIAS] have? INCLUDE those that pay for only one type of service (nursing home care, accidents, or dental care). EXCLUDE private plans that only provide extra cash while hospitalized.
* Enter all that apply, separate with commas.

01 Private health insurance
02 Medicare
03 Medi-Gap
04 Medicaid
05 SCHIP (CHIP/Children's Health Insurance Program)
06 Military health care (TRICARE/VA/CHAMP-VA)
07 Indian Health Service
08 State-sponsored health plan
09 Other government program
10 Single service plan (e.g., dental, vision, prescriptions)
11 No coverage of any type
97 Refused
99 Don't know

Universe Text All persons in families where FHICOV= yes, don't know, or refused
Skip Instructions:

(R,D) [go to HCSPFYR]
(1-10) [if AGE ge 65 and HIKIND ne 2, go to MCAREPRB; else, if HIKIND ne 10 go to SINCOV; else, go to HICHANGE]
(11) [if HIKIND = 1-10, go to ERR_HIKIND; else, if AGE ge 65 go to MCAREPRB; else, go to MCAIDPRB]

Hard Edit: ERR_HIKIND:

* Cannot mark "No coverage of any kind" and another type.
* Please correct.

Instrument Variable Name: MILSPC
Question Text:

? [F1] * Enter all that apply, separate with commas. Earlier I recorded that [fill1: you are/ALIAS is] covered by military health care. What types of military health care [fill2:
are you/is ALIAS] covered by?

1 TRICARE
2 VA
3 CHAMP-VA
4 Other military coverage (specify)
7 Refused
9 Don't know

Universe Text All persons with military health care
Skip Instructions:

(1) [go to MILMAN]
(2,3,R,D) [repeat question for next person with military health care; else, go to HILAST]
(4) [go to MILSPCOT]

Instrument Variable Name: HIKIND
Question Text:

(book) F12 and (book) F14 ? [F1] What kind of health insurance or health care coverage [fill: do you/does ALIAS] have? INCLUDE those that pay for only one type of service (nursing home care, accidents, or dental care). EXCLUDE private plans that only provide extra cash while hospitalized.
* Enter all that apply, separate with commas.

01 Private health insurance
02 Medicare
03 Medi-Gap
04 Medicaid
05 SCHIP (CHIP/Children's Health Insurance Program)
06 Military health care (TRICARE/VA/CHAMP-VA)
07 Indian Health Service
08 State-sponsored health plan
09 Other government program
10 Single service plan (e.g., dental, vision, prescriptions)
11 No coverage of any type
97 Refused
99 Don't know

Universe Text All persons in families where FHICOV= yes, don't know, or refused
Skip Instructions:

(R,D) [go to HCSPFYR]
(1-10) [if AGE ge 65 and HIKIND ne 2, go to MCAREPRB; else, if HIKIND ne 10 go to SINCOV; else, go to HICHANGE]
(11) [if HIKIND = 1-10, go to ERR_HIKIND; else, if AGE ge 65 go to MCAREPRB; else, go to MCAIDPRB]

Hard Edit: ERR_HIKIND:

* Cannot mark "No coverage of any kind" and another type.
* Please correct.

Instrument Variable Name: MILSPC
Question Text:

? [F1] * Enter all that apply, separate with commas. Earlier I recorded that [fill1: you are/ALIAS is] covered by military health care. What types of military health care [fill2:
are you/is ALIAS] covered by?

1 TRICARE
2 VA
3 CHAMP-VA
4 Other military coverage (specify)
7 Refused
9 Don't know

Universe Text All persons with military health care
Skip Instructions:

(1) [go to MILMAN]
(2,3,R,D) [repeat question for next person with military health care; else, go to HILAST]
(4) [go to MILSPCOT]

Instrument Variable Name: HIKIND
Question Text:

(book) F12 and (book) F14 ? [F1] What kind of health insurance or health care coverage [fill: do you/does ALIAS] have? INCLUDE those that pay for only one type of service (nursing home care, accidents, or dental care). EXCLUDE private plans that only provide extra cash while hospitalized.
* Enter all that apply, separate with commas.

01 Private health insurance
02 Medicare
03 Medi-Gap
04 Medicaid
05 SCHIP (CHIP/Children's Health Insurance Program)
06 Military health care (TRICARE/VA/CHAMP-VA)
07 Indian Health Service
08 State-sponsored health plan
09 Other government program
10 Single service plan (e.g., dental, vision, prescriptions)
11 No coverage of any type
97 Refused
99 Don't know

Universe Text All persons in families where FHICOV= yes, don't know, or refused
Skip Instructions:

(R,D) [go to HCSPFYR]
(1-10) [if AGE ge 65 and HIKIND ne 2, go to MCAREPRB; else, if HIKIND ne 10 go to SINCOV; else, go to HICHANGE]
(11) [if HIKIND = 1-10, go to ERR_HIKIND; else, if AGE ge 65 go to MCAREPRB; else, go to MCAIDPRB]

Hard Edit: ERR_HIKIND:

* Cannot mark "No coverage of any kind" and another type.
* Please correct.

Instrument Variable Name: MILSPC
Question Text:

? [F1] * Enter all that apply, separate with commas. Earlier I recorded that [fill1: you are/ALIAS is] covered by military health care. What types of military health care [fill2:
are you/is ALIAS] covered by?

1 TRICARE
2 VA
3 CHAMP-VA
4 Other military coverage (specify)
7 Refused
9 Don't know

Universe Text All persons with military health care
Skip Instructions:

(1) [go to MILMAN]
(2,3,R,D) [repeat question for next person with military health care; else, go to HILAST]
(4) [go to MILSPCOT]

What kind of health insurance or health care coverage {do/does} {you/subject name} have? INCLUDE those that pay for only one type of service (nursing home care, accidents, or dental care), exclude private plans that only provide extra cash while hospitalized.

FR: ENTER (N) FOR NO MORE ENTER EACH NUMBER THAT APPLIES. PLEASE REFER TO FLASHCARDS F10, AND F11 FOR YOUR STATE.

1. Private health insurance plan from employer or workplace*
2. Private health insurance plan purchased directly*
3. Private health insurance plan through a state or local government program or community program
4. Medicare
5. Medi-Gap
6. Medicaid
7. Children's Health Insurance Program (CHIP/SCHIP)
8. Military health care/VA
9. TRICARE/CHAMPUS/CHAMP-VA
10. Indian Health Service
11. State-sponsored health plan
12. Other government program
13. Single service plan (e.g., dental, vision, prescriptions)
14. No coverage of any type
*EXCLUDE private plans that only provide extra cash while hospitalized.

[ ] HIKINDA (01) Private health insurance plan from employer or workplace
[ ] HIKINDB (02) Private health insurance plan purchased directly
[ ] HIKINDC (03) Private health insurance plan through a state or local government or community program
[ ] HIKINDD (04) Medicare
[ ] HIKINDE (05) Medi-Gap
[ ] HIKINDF (06) Medicaid
[ ] HIKINDG (07) CHIP (Children's Health Insurance Program)
[ ] HIKINDH (08) Military health care/VA
[ ] HIKINDI (09) TRICARE/CHAMPUS/CHAMP-VA
[ ] HIKINDJ (10) Indian Health Service
[ ] HIKINDK (11) State-sponsored health plan
[ ] HIKINDL (12) Other government program
[ ] HIKINDM (13) Single Service Plan (e.g. dental, vision, prescriptions)
[ ] HIKINDN (14) No coverage of any type

(Anything else?)

What kind of health insurance or health care coverage {do/does} {you/subject name} have? INCLUDE those that pay for only one type of service (nursing home care, accidents, or dental care), exclude private plans that only provide extra cash while hospitalized.

FR: ENTER (N) FOR NO MORE ENTER EACH NUMBER THAT APPLIES. PLEASE REFER TO FLASHCARDS F10, AND F11 FOR YOUR STATE.

1. Private health insurance plan from employer or workplace*
2. Private health insurance plan purchased directly*
3. Private health insurance plan through a state or local government program or community program
4. Medicare
5. Medi-Gap
6. Medicaid
7. Children's Health Insurance Program (CHIP/SCHIP)
8. Military health care/VA
9. TRICARE/CHAMPUS/CHAMP-VA
10. Indian Health Service
11. State-sponsored health plan
12. Other government program
13. Single service plan (e.g., dental, vision, prescriptions)
14. No coverage of any type
*EXCLUDE private plans that only provide extra cash while hospitalized.

[ ] HIKINDA (01) Private health insurance plan from employer or workplace
[ ] HIKINDB (02) Private health insurance plan purchased directly
[ ] HIKINDC (03) Private health insurance plan through a state or local government or community program
[ ] HIKINDD (04) Medicare
[ ] HIKINDE (05) Medi-Gap
[ ] HIKINDF (06) Medicaid
[ ] HIKINDG (07) CHIP (Children's Health Insurance Program)
[ ] HIKINDH (08) Military health care/VA
[ ] HIKINDI (09) TRICARE/CHAMPUS/CHAMP-VA
[ ] HIKINDJ (10) Indian Health Service
[ ] HIKINDK (11) State-sponsored health plan
[ ] HIKINDL (12) Other government program
[ ] HIKINDM (13) Single Service Plan (e.g. dental, vision, prescriptions)
[ ] HIKINDN (14) No coverage of any type

(Anything else?)

What kind of health insurance or health care coverage {do/does} {you/subject name} have? INCLUDE those that pay for only one type of service (nursing home care, accidents, or dental care), exclude private plans that only provide extra cash while hospitalized.

FR: ENTER (N) FOR NO MORE ENTER EACH NUMBER THAT APPLIES. PLEASE REFER TO FLASHCARDS F10, AND F11 FOR YOUR STATE.

1. Private health insurance plan from employer or workplace*
2. Private health insurance plan purchased directly*
3. Private health insurance plan through a state or local government program or community program
4. Medicare
5. Medi-Gap
6. Medicaid
7. Children's Health Insurance Program (CHIP/SCHIP)
8. Military health care/VA
9. TRICARE/CHAMPUS/CHAMP-VA
10. Indian Health Service
11. State-sponsored health plan
12. Other government program
13. Single service plan (e.g., dental, vision, prescriptions)
14. No coverage of any type
*EXCLUDE private plans that only provide extra cash while hospitalized.

[ ] HIKINDA (01) Private health insurance plan from employer or workplace
[ ] HIKINDB (02) Private health insurance plan purchased directly
[ ] HIKINDC (03) Private health insurance plan through a state or local government or community program
[ ] HIKINDD (04) Medicare
[ ] HIKINDE (05) Medi-Gap
[ ] HIKINDF (06) Medicaid
[ ] HIKINDG (07) CHIP (Children's Health Insurance Program)
[ ] HIKINDH (08) Military health care/VA
[ ] HIKINDI (09) TRICARE/CHAMPUS/CHAMP-VA
[ ] HIKINDJ (10) Indian Health Service
[ ] HIKINDK (11) State-sponsored health plan
[ ] HIKINDL (12) Other government program
[ ] HIKINDM (13) Single Service Plan (e.g. dental, vision, prescriptions)
[ ] HIKINDN (14) No coverage of any type

(Anything else?)

What kind of health insurance or health care coverage {do/does} {you/subject name} have? INCLUDE those that pay for only one type of service (nursing home care, accidents, or dental care), exclude private plans that only provide extra cash while hospitalized.

FR: ENTER (N) FOR NO MORE ENTER EACH NUMBER THAT APPLIES. PLEASE REFER TO FLASHCARDS F10, AND F11 FOR YOUR STATE.

1. Private health insurance plan from employer or workplace*
2. Private health insurance plan purchased directly*
3. Private health insurance plan through a state or local government program or community program
4. Medicare
5. Medi-Gap
6. Medicaid
7. Children's Health Insurance Program (CHIP/SCHIP)
8. Military health care/VA
9. TRICARE/CHAMPUS/CHAMP-VA
10. Indian Health Service
11. State-sponsored health plan
12. Other government program
13. Single service plan (e.g., dental, vision, prescriptions)
14. No coverage of any type
*EXCLUDE private plans that only provide extra cash while hospitalized.

[ ] HIKINDA (01) Private health insurance plan from employer or workplace
[ ] HIKINDB (02) Private health insurance plan purchased directly
[ ] HIKINDC (03) Private health insurance plan through a state or local government or community program
[ ] HIKINDD (04) Medicare
[ ] HIKINDE (05) Medi-Gap
[ ] HIKINDF (06) Medicaid
[ ] HIKINDG (07) CHIP (Children's Health Insurance Program)
[ ] HIKINDH (08) Military health care/VA
[ ] HIKINDI (09) TRICARE/CHAMPUS/CHAMP-VA
[ ] HIKINDJ (10) Indian Health Service
[ ] HIKINDK (11) State-sponsored health plan
[ ] HIKINDL (12) Other government program
[ ] HIKINDM (13) Single Service Plan (e.g. dental, vision, prescriptions)
[ ] HIKINDN (14) No coverage of any type

(Anything else?)

What kind of health insurance or health care coverage {do/does} {you/subject's name} have? INCLUDE those that pay for only one type of service (nursing home care, accidents, or dental care), exclude private plans that only provide extra cash while hospitalized.

FR: SHOW CARD F9 AND CARD F10.
MARK "X" ALL THAT APPLY.

1. Private health insurance plan from employer or workplace*
2. Private health insurance plan purchased directly*
3. Private health insurance plan through a state or local government program or community
4. Medicare
5. Medi-Gap
6. Medicaid
7. CHIP (Children's Health Insurance Program)
8. Military health care/VA
9. CHAMPUS/TRICARE/CHAMP-VA
10. Indian Health Service
11. State-sponsored health plan
12. Other government program
13. Single service plan (e.g., dental, vision, prescriptions)
*EXCLUDE private plans that only provide extra cash while hospitalized.

[ ] HIKINDA (01) Private health insurance plan from employer or workplace
[ ] HIKINDB (02) Private health insurance plan purchased directly
[ ] HIKINDC (03) Private health insurance plan through a State or local government program or community program
[ ] HIKINDD (04) Medicare
[ ] HIKINDE (05) Medi-GAP
[ ] HIKINDF (06) Medicaid
[ ] HIKINDG (07) CHIP (Children's Health Insurance Program)
[ ] HIKINDH (08) Military health care/VA
[ ] HIKINDI (09) CHAMPUS/TRICARE/CHAMP-VA
[ ] HIKINDJ (10) Indian Health Service
[ ] HIKINDK (11) State-sponsored health plan
[ ] HIKINDL (12) Other government program
[ ] HIKINDM (13) Single Service Plan (e.g. dental, vision, prescriptions)

Check item FHICCI3: (Medicare Coverage) Loop through every non-deleted and non Armed Forces family member roster:
1. If the person in FHI.070 marked 5 and not 4, mark HIKINDD=X and go to FHI.080.
2. If the person in FHI.070 marked 4, go to FHI.080.
3. If the person in FHI.070 did not mark 4, go to Check item FHICCI4

What kind of health insurance or health care coverage {do/does} {you/subject's name} have? EXCLUDE private plans that only provide extra cash while hospitalized or pay for only one type of service (nursing home care, accidents, or dental care). (Anything else?)

FR: SHOW CARD F9.
MARK "X" ALL THAT APPLY.

1. Private health insurance plan from employer or workplace*
2. Private health insurance plan purchased directly*
3. Private health insurance plan through a state or local government program or community
4. Medicare
5. Medi-Gap
6. Medicaid
7. Military health care/VA
8.CHAMPUS/TRICARE/CHAMP-VA
9. Indian Health Service
10.State-sponsored health plan
11. Other government program

*EXCLUDE private plans that only provide extra cash while hospitalized or pay for only one type
of service (nursing home care, accidents, or dental care).

[ ]HIKINDA (01) Private health insurance plan from employer or workplace
[ ]HIKINDB (02) Private health insurance plan purchased directly
[ ]HIKINDC (03) Private health insurance plan through a State or local government program or community program
[ ]HIKINDD (04) Medicare
[ ]HIKINDE (05) Medi-GAP
[ ]HIKINDF (06) Medicaid
[ ]HIKINDG (08) Military health care/VA
[ ]HIKINDH (09) CHAMPUS/TRICARE/CHAMP-VA
[ ]HIKINDI (10) Indian Health Service
[ ]HIKINDJ (11) State-sponsored health plan
[ ]HIKINDK (12) Other government program

Check item FHICCI3: (Medicare Coverage) Loop through every non-deleted and non Armed Forces family member roster:
1. If the person in FHI.070 marked 5 and not 4, mark HIKINDD=X and go to FHI.080.
2. If the person in FHI.070 marked 4, go to FHI.080.
3. If the person in FHI.070 did not mark 4, go to Check item FHICCI4

What kind of health insurance or health care coverage {do/does} {you/subject's name} have? EXCLUDE private plans that only provide extra cash while hospitalized or pay for only one type of service (nursing home care, accidents, or dental care).

FR: ENTER EACH NUMBER THAT APPLIES. (Anything else?)

[ ] HIKINDA (01) Private health insurance plan from employer or workplace
[ ] HIKINDB (02) Private health insurance plan purchased directly
[ ] HIKINDC (03) Medicare
[ ] HIKINDD (04) Medi-Gap
[ ] HIKINDE (05) Medicaid
[ ] HIKINDF (06) Military health care/VA
[ ] HIKINDG (07) CHAMPUS/TRICARE/CHAMP-VA
[ ] HIKINDH (08) Indian Health Service
[ ] HIKINDI (09) State-sponsored health plan
[ ] HIKINDJ (10) Other government program

Check item FHICCI3: (Medicare Coverage) Loop through every non-deleted and non Armed Forces family member roster:
1. If the person in FHI.070 marked 4 and not 3, go to FHI.080.
2. If the person in FHI.070 marked 3, go to FHI.080.
3. If the person in FHI.070 did not mark 3, go to Check item FHICCI4