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Has any private plan that pays for a doctor not in plan network

Codes and Frequencies

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HIPMDOPR is a recoded variable created by the IPUMS NHIS staff, which indicates whether the person had a private insurance plan that would pay any costs for a doctor who was not on the plan's preferred list. The question related to persons with at least one general purpose health insurance plan who must select a doctor from a preferred list of doctors (i.e., for whom HIPMDLISR equals 2).

Data Collection Process

While information was consistently collected on up to four private plans per family, data are publicly available only for plans one and two beginning in 2004. Changes in the number of plans considered should have little effect on the results for HIPMDOPR.


Persons with three or more plans have a "yes" response to HIPRIVGT2 (available for 2004 forward). Analysis by IHIS staff indicates that a very small number of persons (less than 0.2 percent of the total number of individuals with private health insurance per year for 2004 to 2009) had three or more private insurance plans.

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").

Survey text

In all years, the relevant survey question asked for each private plan was the following:

  • If [you/family member] select a doctor who is not in the plan, will (plan name) pay for any part of the cost?
Definition of Private Insurance

The definition of private insurance changed over time, as described in detail in the User Note on "Changes in the Definition of Private Insurance."


For 1993 to 1996, single service plans counted as health insurance; however, only individuals with a plan that "pays for a variety of services" (as indicated, for example, by HI1VARSS) or a general purpose plan were asked the question for HIPMDOPR. For 1997 forward, the definition of private health insurance coverage excluded single service plans. This distinction between comprehensive and single service plans was further emphasized beginning in 1999, when a separate category for single service plans was added to the flashcard given respondents when they were asked to indicate their insurance type(s).

These various changes had little effect on responses for HIPMDOPR; consistently, only people with comprehensive private insurance were asked about payments to doctors on their plan's preferred list.


HIPMDOPR is largely comparable over time. The variable universe and question wording were consistent, and changes in the number of private plans covered would have little effect, given the rarity of people with more than two private plans.

The back-editing of insurance data to correct respondents' misreporting of insurance type reduces the comparability of HIPMDOPR's data from before and after 1997.


Beginning in 1997, NCHS staff evaluated mismatches between verbatim insurance plan names and the type of coverage reported by respondents, and reclassified misreported cases into the proper category (e.g., from private insurance into Medicaid, or vice versa). (See HIPRIVATEE for a detailed description of the back-editing process.) Analysis by IHIS staff indicates that each year from 2004 to 2009, around 1.6 percent of respondents who reported having private insurance did not have private insurance.

For 1997 forward, details on private plan coverage, such as HIPMDOPR, reflect responses for which the coverage type was back-edited. Prior to 1997, respondents may have misreported what type of insurance they had, and these errors were not corrected. Users should thus exercise caution in comparing results for HIPMDOPR from before and after 1997.


  • 1993: Persons in quarters 3 and 4 covered by a general health insurance plan (excludes single service plans) who must choose a doctor from a group or list of doctors.
  • 1994-1996: Persons who are covered by a general health insurance plan (excludes single service plans) who must choose a doctor from a group or list of doctors.
  • 1998-2018: Persons who are covered by a general health insurance plan (excludes single service plans) who must choose a doctor from a group or list of doctors.


  • 1993-1996, 1998-2018