Codes and Frequencies
For all persons, HIMILVA indicates whether the individual had military health care or insurance coverage from the Department of Veterans' Affairs (VA) through a program providing health care for military dependents other than CHAMP-VA or CHAMPUS (or TRICARE for 1995 forward).
Military Health Care provides medical care on military bases to current armed forces members and their dependents. Medical care from the VA is available to honorably discharged veterans who either have a service-connected illness, injury, or disability, or whose incomes are near or below poverty.
For 1982 to 1996, interviewers first asked about coverage under CHAMPUS and CHAMP-VA. Then, to collect the information reported in HIMILVA, they asked about coverage by any other program that provides health care for military dependents or survivors of military persons.
For 1997 forward, interviewers handed out a flashcard that listed various types of insurance and asked respondents to identify their kind(s) of coverage. For 1997 to 2003, this list included separate categories for "Military health care/VA" and "TRICARE/CHAMPUS/CHAMP-VA" coverage. Persons with an affirmative response in HIMILVA chose the category "Military health care/VA."
Beginning in 2004, the response categories on the flashcard changed, so all military health care categories were collapsed into one: "Military health care (TRICARE/VA/CHAMP-VA)." For persons who selected this category, interviewers asked a follow-up question about their type of military health care, with possible choices being TRICARE, VA, CHAMP-VA, or other military coverage. For 2004 forward, HIMILVA identifies those who chose "Has other military health care" and "Has Military health care/VA insurance."
The Field Representative's Manual for 1997 to 2003 referred to military health care/VA as "health care available to active duty personnel and their dependents; in addition, the VA provides medical assistance to veterans of the Armed Forces, particularly those with service-connected ailments." For a description of the various types of Military Health Care, see HICHAMPANY.
Wording of the questions about Military Health Care coverage changed over time.
1982, 1984 1986, 1989To ascertain military coverage, questions in these years asked about each of several types of military health care, including benefits from the Armed Forces or Veterans' Administration (1989), receipt of military retirement payments from any branch of the Armed Forces or a pension from the Veterans' Administration (excluding VA disability compensation), coverage by CHAMPUS (1986 and 1989), coverage by CHAMP-VA, or any other type of coverage for military dependents or survivors of military personnel. Interviewers also asked about whether the person had a disability related to military service and whether they receive compensation from the Veterans' Administration.
For 1993 to 1996 interviewers asked about coverage in the previous month by military health care, including armed forces retirement benefits, the VA CHAMPUS or TRICARE (in 1995 and 1996), or CHAMP-VA. Interviewers then asked whether whether the care was either CHAMPUS or CHAMP-VA and other military health care.
For 1997 forward, interviewers first asked, "Are you covered by health insurance or some other kind of health care plan?" Individuals who had an affirmative response were asked, "What kind of health insurance or health care coverage do you have?" Respondents selected the appropriate response from a flashcard listing the following types of insurance coverage:
- Private health insurance (2004 forward)
- Private health insurance plan from employer or workplace (1997-2003)
- Private health insurance plan purchased directly (1997-2003)
- Private health insurance plan through a State or local government program or community program (1998-2003)
- Medicare (1997 forward)
- Medi-Gap (1997 forward)
- Medicaid (1997 forward)
- CHIP (Children's Health Insurance Program) (1999 forward)
- Military Health Care/VA (1997-2003)
- Military Health Care (CHAMPUS/TRICARE/CHAMP-VA) (1997 forward)
- Indian Health Service (1997 forward)
- State-sponsored health plan (1997 forward)
- Other government program (1997 forward)
- Single Service Plan (e.g., dental, vision, prescriptions) (1999 forward)
- No coverage of any type (2000 forward)
Respondents could pick more than one type of insurance, and interviewers were instructed to mark all that applied.
In 2000, another change in the question format occurred, relating to the treatment of people who did not initially report having insurance.
For 1997 forward, interviewers first asked whether the person was covered by any kind of health insurance or some other kind of health care plan, before asking about the details of private insurance coverage. For 1997 to 1999, only people with an affirmative answer to this initial question have responses to follow-up questions about their kind of health insurance and the details of coverage; for 1997 to 1999, those who did not say "yes" are coded NIU (not in universe) for follow-up questions on insurance characteristics. Beginning in 2000, the response "no insurance" was included as a valid response to the initial question. Thus, for 2000 forward, the universe for follow-up questions on insurance coverage type and details was "all persons" (including those with an affirmative response to HINONE or "no insurance").
Along with universe changes, changes in question wording (presented in the variable description) slightly limit HIMILVA's comparability over time.
Users are strongly encouraged to review the user note Insurance Data Collection .
HIMILVA is not comparable with the recoded variable HIMILITE (Covered by military health insurance: Recode), because the latter contains responses edited for accuracy by the NCHS.
Beginning in 1997, errors in the reported type of insurance coverage, evidenced by a mismatch between the verbatim name of an insurance plan and the category chosen by the respondent from a flashcard, were corrected by NCHS staff, who reclassified some survey participants. Due to the greater accuracy imposed by back-editing, the NCHS strongly advises researchers to use corrected data like that in HIMILITE.
HIMILVA is based on variables reporting respondents' answers without correction by NCHS staff. Because back-editing was only introduced in 1997, using the original responses increases comparability over a longer time span. Analysts studying military health care both before and after 1997 should thus use HIMILVA.
- 1997-1999: Persons covered by some type of health care plan.
- 2000-2003: All persons.
- 2004-2017: Persons covered by some type of military health care (TRICARE/VA/CHAMP-VA).
- 1982-1984, 1986, 1989, 1993-2017