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Plan 4: Paid for by Medicare

Codes and Frequencies

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For persons who have at least four private insurance plans, HIP4CARE indicates if the person's fourth plan was paid for by Medicare. 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.

Information was collected on up to four plans per family; for 2004 forward, only data for the first and second plans are publicly available. Users may want to see the related variables HIP1CARE through HIP3CARE. Users may also want to use the variable HIPCARER, a recoded variable created by the IPUMS NHIS staff that indicates if the respondent had any plan paid for by Medicare.

Please see HIP1CARE (Plan 1: Paid for by Medicare) for more information on collection and editing of private health insurance plan data.


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 forward, the category Children's Health Insurance Program was added to the survey. From 1998 forward, the category, "state or local government or community program" was used in place of the 1997 category of "government program."


  • 1997: Persons who provided an answer for HITYPE4 (persons with at least 4 health insurance plans obtained from an employer or workplace or purchased directly, or have Medi-gap)
  • 1998-2003: Persons who provided an answer for HITYPE4 (persons with at least 4 health insurance plans obtained from an employer or workplace, purchased directly, through a State or local government or community program, or have Medi-gap)


  • 1997-2003