Codes and Frequencies
For sample adults who have a private insurance plan (HIPRIVATEE), HIP1CARE indicates if the person's first plan was paid for by Medicare. Prior to 2019, this variable is available for all persons who have a private insurance plan. As enacted in the Balanced Budget Act of 1997, Medicare beneficiaries can enroll in private health insurance plans, instead of through the original Medicare plans (Parts A and B). These programs were known as "Medicare + Choice" or "Part C" plans. Part C is known as "Medicare Advantage" (MA). For people who choose to enroll in a Medicare Advantage health plan, their coverage is provided through private insurance companies. Medicare pays a private health insurance company plan a fixed amount every month. Users may want to review information provided by the Centers for Medicare and Medicaid Services (CMS) for more information.
For all years HIP1CARE is available the definition of private insurance coverage remained relatively consistent and excluded single service plans or plans which paid only for accidents. However, the definition, order, and wording of private health insurance changed over time. Users are strongly encouraged to review the user note Private Insurance Definitions.
Information was collected on up to four plans per family until 2019; for 2004-2018, only data for the first and second plans are publicly available. Users may want to see the related variables HIP2CARE, HIP3CARE, and HIP4CARE.
Persons with three or more plans have a "yes" response to the HIPRIVGT2 variable (available for 2004-2018). A very small number of persons have more than two private insurance plans. Additional information for the third and fourth plans for a person is available through a Data Research Center. Beginning in 2019, information is only collected on up to two private plans.
IPUMS NHIS has also created the variable HIPCARER, which indicates if the respondent had any plan paid for by Medicare.
HIP1CARE reflects responses that have been edited by the NCHS based on plan name. Only respondents verified to have private insurance are included in the universe for HIP1CARE. A full description of the editing process and changes in definition is provided under the variable descriptions for private insurance in HIPRIVATEE; a brief description is provided below.
During the course of data editing, the NCHS discovered errors in the responses to questions about insurance coverage. This might be shown, for example, by a mismatch between the verbatim name of an insurance plan and the type of insurance coverage the person selected from the categories on the card. The NCHS created a series of recoded insurance variables, which are edited to correct for mistakenly reported insurance information. The NCHS strongly advises analysts to use these recoded insurance variables as a more reliable source of information about the types of insurance coverage than is provided by respondents' original and unedited answers about their insurance type. See HIPRIVATEE for a list of the recoded health insurance variables.
This variable is mostly comparable over time. Slight changes were made to the response categories as new insurance programs became available. For all years, the categories of self or family (living in the household), employer or union, someone outside the household, Medicare, and Medicaid were available. For 1999-2018, the category Children's Health Insurance Program was added to the survey. From 1998-2018, the category, "state or local government or community program" was used in place of the 1997 category of "government program." Beginning in 2019, the "state or local government or community program" category was changed to "Other government program."
This variable is completely comparable for 2004 forward and for 1997 to 2003. Information was collected on up to four plans per family until 2019; for 2004-2018, only data for plans one and two are publicly available. However, this reduction in the number of plans publicly available does not greatly reduce comparability as very few individuals have more than two private insurance plans. Persons with more than two plans have a "yes" response to the HIPRIVGT2 variable (available for 2004-2018).
The NHIS questionnaire was substantially redesigned in 2019 to introduce a different data collection structure and new content. For more information on changes in terminology, universes, and data collection methods beginning in 2019, please see the user note.
- 1997-2018: All persons with a private health insurance plan.
- 2019-2022: Sample adults age 18+ with private health insurance plans (HIPRIVATEE).