Survey Text

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top
2018
Survey form view entire document:  text  image

Question ID:FHI.070_00.000

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.
Question ID:FHI.158_00.000

Instrument Variable Name: FHICCI6
Question Text:
The next questions are about private health insurance plans [fill1: /including Medi-Gap]. These plans can be obtained through work, purchased directly, or through a state or local government program or community program. [fill2: We have the following persons listed as being covered by such plans:
* Read names. (display roster of eligible persons)]
* Enter 1 to continue
1 Continue
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
go to HIPNAM1
Question ID:FHI.160_00.000

Instrument Variable Name: HIPNAM1
Question Text:
It is important that we record the complete and accurate name of each health insurance plan. What is the COMPLETE name of the first plan? Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service, such as nursing home care, accidents, or dental care.
* Read if necessary: Do you have your health plan card or something with the plan name on it?
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
(verbatim) [go to PCARD1]
(R,D) [prefill PCARD1 with a "2" and go to HIPNAM1B]
Question ID:FHI.160_01.000

Instrument Variable Name: PCARD1
Question Text:
* Do not read. Was the health plan name obtained from a health plan card or something with the health plan name on it?
1 Yes
2 No
Universe Text All private health insurance plans where the plan name was entered at HIPNAM1
Skip Instructions:
go to HIPNAM1B
Question ID:FHI.170_00.000

Instrument Variable Name: HIPNAM1B
Question Text:

* Ask or verify. Enter all that apply, separate with commas. Which family members are covered by this plan?
* Indicate each family member covered by this plan.
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families with a private health insurance plan and the plan name, refused, or don't know was entered at
HIPNAM1
Skip Instructions:
(R,D) [if HIPNAM1= R or D, go to STNAME]
go to MORPLAN

NOTE: In the instrument, interviewers enter the line numbers associated with the persons reported by the respondent. As shown above, each eligible person receives an edited response code in subsequent data processing.
Question ID:FHI.171_00.000

Instrument Variable Name: MORPLAN
Question Text:
* Ask if necessary Are there any more private health insurance plans?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families where a private health insurance plan name was entered at HIPNAM1 or a person number was entered at HIPNAM1B

Skip Instructions:
(1) [go to HIPNAM2]
(2,R,D) [if no persons selected at HIPNAM1B, go to FHICCI8; else, if persons selected at HIPNAM1B, but not all persons with HIKIND = 1 or 3 selected at HIPNAM1B, go to HIVER1]
Question ID:FHI.172_00.000

Instrument Variable Name: HIPNAM2
Question Text:

What is the name of the next plan? *Read if necessary: Do you have a health plan card or something with the plan name on it?
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All families with a second private health insurance plan
Skip Instructions:
(verbatim) [go to PCARD2]
(R,D) [prefill PCARD2 with a "2" and go to HIPNAM2B]
Question ID:FHI.172_01.000

Instrument Variable Name: PCARD2
Question Text:
* Do not read. Was the health plan name obtained from a health plan card or something with the health plan name on it?
1 Yes
2 No
Universe Text All private health insurance plans where the plan name was entered at HIPNAM2
Skip Instructions:

go to HIPNAM2B
Question ID:FHI.173_00.000

Instrument Variable Name: HIPNAM2B
Question Text:
* Ask or verify. Enter all that apply, separate with commas. Which family members are covered by that plan?
* Indicate each family member covered by this plan.
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families with a second private health insurance plan and the plan name, refused, or don't know was entered at HIPNAM2
Skip Instructions:
(R,D) [if HIPNAM2 eq R or D and persons selected at HIPNAM1B, but not all persons with HIKIND eq 1 or 3 selected at HIPNAM1B, go to HIVER1; else, if HIPNAM2 eq R or D and persons selected at HIPNAM1B, and all persons with HIKIND eq 1 or 3 selected at HIPNAM1B, go to FHICCI8; else, if HIPNAM2 eq R or D and persons not selected at HIPNAM1B, go to FHICCI8; else, if a health plan name recorded in HIPNAM2, go to MORPLAN2] go to MORPLAN2

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2017
Survey form view entire document:  text  image

Question ID:FHI.070_00.000

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.
Question ID:FHI.158_00.000

Instrument Variable Name: FHICCI6
Question Text:
The next questions are about private health insurance plans [fill1: /including Medi-Gap]. These plans can be obtained through work, purchased directly, or through a state or local government program or community program. [fill2: We have the following persons listed as being covered by such plans:
* Read names. (display roster of eligible persons)]
* Enter 1 to continue
1 Continue
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
go to HIPNAM1
Question ID:FHI.160_00.000

Instrument Variable Name: HIPNAM1
Question Text:
It is important that we record the complete and accurate name of each health insurance plan. What is the COMPLETE name of the first plan? Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service, such as nursing home care, accidents, or dental care.
* Read if necessary: Do you have your health plan card or something with the plan name on it?
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
(verbatim) [go to PCARD1]
(R,D) [prefill PCARD1 with a "2" and go to HIPNAM1B]
Question ID:FHI.160_01.000

Instrument Variable Name: PCARD1
Question Text:
* Do not read. Was the health plan name obtained from a health plan card or something with the health plan name on it?
1 Yes
2 No
Universe Text All private health insurance plans where the plan name was entered at HIPNAM1
Skip Instructions:
go to HIPNAM1B
Question ID:FHI.170_00.000

Instrument Variable Name: HIPNAM1B
Question Text:

* Ask or verify. Enter all that apply, separate with commas. Which family members are covered by this plan?
* Indicate each family member covered by this plan.
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families with a private health insurance plan and the plan name, refused, or don't know was entered at
HIPNAM1
Skip Instructions:
(R,D) [if HIPNAM1= R or D, go to STNAME]
go to MORPLAN

NOTE: In the instrument, interviewers enter the line numbers associated with the persons reported by the respondent. As shown above, each eligible person receives an edited response code in subsequent data processing.
Question ID:FHI.171_00.000

Instrument Variable Name: MORPLAN
Question Text:
* Ask if necessary Are there any more private health insurance plans?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families where a private health insurance plan name was entered at HIPNAM1 or a person number was entered at HIPNAM1B

Skip Instructions:
(1) [go to HIPNAM2]
(2,R,D) [if no persons selected at HIPNAM1B, go to FHICCI8; else, if persons selected at HIPNAM1B, but not all persons with HIKIND = 1 or 3 selected at HIPNAM1B, go to HIVER1]
Question ID:FHI.172_00.000

Instrument Variable Name: HIPNAM2
Question Text:

What is the name of the next plan? *Read if necessary: Do you have a health plan card or something with the plan name on it?
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All families with a second private health insurance plan
Skip Instructions:
(verbatim) [go to PCARD2]
(R,D) [prefill PCARD2 with a "2" and go to HIPNAM2B]
Question ID:FHI.172_01.000

Instrument Variable Name: PCARD2
Question Text:
* Do not read. Was the health plan name obtained from a health plan card or something with the health plan name on it?
1 Yes
2 No
Universe Text All private health insurance plans where the plan name was entered at HIPNAM2
Skip Instructions:

go to HIPNAM2B
Question ID:FHI.173_00.000

Instrument Variable Name: HIPNAM2B
Question Text:
* Ask or verify. Enter all that apply, separate with commas. Which family members are covered by that plan?
* Indicate each family member covered by this plan.
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families with a second private health insurance plan and the plan name, refused, or don't know was entered at HIPNAM2
Skip Instructions:
(R,D) [if HIPNAM2 eq R or D and persons selected at HIPNAM1B, but not all persons with HIKIND eq 1 or 3 selected at HIPNAM1B, go to HIVER1; else, if HIPNAM2 eq R or D and persons selected at HIPNAM1B, and all persons with HIKIND eq 1 or 3 selected at HIPNAM1B, go to FHICCI8; else, if HIPNAM2 eq R or D and persons not selected at HIPNAM1B, go to FHICCI8; else, if a health plan name recorded in HIPNAM2, go to MORPLAN2] go to MORPLAN2

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2016
Survey form view entire document:  text  image

Question ID:FHI.070_00.000

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.
Question ID:FHI.158_00.000

Instrument Variable Name: FHICCI6
Question Text:
The next questions are about private health insurance plans [fill1: /including Medi-Gap]. These plans can be obtained through work, purchased directly, or through a state or local government program or community program. [fill2: We have the following persons listed as being covered by such plans:
* Read names. (display roster of eligible persons)]
* Enter 1 to continue
1 Continue
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
go to HIPNAM1
Question ID:FHI.160_00.000

Instrument Variable Name: HIPNAM1
Question Text:
It is important that we record the complete and accurate name of each health insurance plan. What is the COMPLETE name of the first plan? Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service, such as nursing home care, accidents, or dental care.
* Read if necessary: Do you have your health plan card or something with the plan name on it?
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
(verbatim) [go to PCARD1]
(R,D) [prefill PCARD1 with a "2" and go to HIPNAM1B]
Question ID:FHI.160_01.000

Instrument Variable Name: PCARD1
Question Text:
* Do not read. Was the health plan name obtained from a health plan card or something with the health plan name on it?
1 Yes
2 No
Universe Text All private health insurance plans where the plan name was entered at HIPNAM1
Skip Instructions:
go to HIPNAM1B
Question ID:FHI.170_00.000

Instrument Variable Name: HIPNAM1B
Question Text:

* Ask or verify. Enter all that apply, separate with commas. Which family members are covered by this plan?
* Indicate each family member covered by this plan.
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families with a private health insurance plan and the plan name, refused, or don't know was entered at
HIPNAM1
Skip Instructions:
(R,D) [if HIPNAM1= R or D, go to STNAME]
go to MORPLAN

NOTE: In the instrument, interviewers enter the line numbers associated with the persons reported by the respondent. As shown above, each eligible person receives an edited response code in subsequent data processing.
Question ID:FHI.171_00.000

Instrument Variable Name: MORPLAN
Question Text:
* Ask if necessary Are there any more private health insurance plans?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families where a private health insurance plan name was entered at HIPNAM1 or a person number was entered at HIPNAM1B

Skip Instructions:
(1) [go to HIPNAM2]
(2,R,D) [if no persons selected at HIPNAM1B, go to FHICCI8; else, if persons selected at HIPNAM1B, but not all persons with HIKIND = 1 or 3 selected at HIPNAM1B, go to HIVER1]
Question ID:FHI.172_00.000

Instrument Variable Name: HIPNAM2
Question Text:

What is the name of the next plan? *Read if necessary: Do you have a health plan card or something with the plan name on it?
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All families with a second private health insurance plan
Skip Instructions:
(verbatim) [go to PCARD2]
(R,D) [prefill PCARD2 with a "2" and go to HIPNAM2B]
Question ID:FHI.172_01.000

Instrument Variable Name: PCARD2
Question Text:
* Do not read. Was the health plan name obtained from a health plan card or something with the health plan name on it?
1 Yes
2 No
Universe Text All private health insurance plans where the plan name was entered at HIPNAM2
Skip Instructions:

go to HIPNAM2B
Question ID:FHI.173_00.000

Instrument Variable Name: HIPNAM2B
Question Text:
* Ask or verify. Enter all that apply, separate with commas. Which family members are covered by that plan?
* Indicate each family member covered by this plan.
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families with a second private health insurance plan and the plan name, refused, or don't know was entered at HIPNAM2
Skip Instructions:
(R,D) [if HIPNAM2 eq R or D and persons selected at HIPNAM1B, but not all persons with HIKIND eq 1 or 3 selected at HIPNAM1B, go to HIVER1; else, if HIPNAM2 eq R or D and persons selected at HIPNAM1B, and all persons with HIKIND eq 1 or 3 selected at HIPNAM1B, go to FHICCI8; else, if HIPNAM2 eq R or D and persons not selected at HIPNAM1B, go to FHICCI8; else, if a health plan name recorded in HIPNAM2, go to MORPLAN2] go to MORPLAN2

top
2015
Survey form view entire document:  text  image

Question ID:FHI.070_00.000

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.
Question ID:FHI.158_00.000

Instrument Variable Name: FHICCI6
Question Text:
The next questions are about private health insurance plans [fill1: /including Medi-Gap]. These plans can be obtained through work, purchased directly, or through a state or local government program or community program. [fill2: We have the following persons listed as being covered by such plans:
* Read names. (display roster of eligible persons)]
* Enter 1 to continue
1 Continue
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
go to HIPNAM1
Question ID:FHI.160_00.000

Instrument Variable Name: HIPNAM1
Question Text:
It is important that we record the complete and accurate name of each health insurance plan. What is the COMPLETE name of the first plan? Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service, such as nursing home care, accidents, or dental care.
* Read if necessary: Do you have your health plan card or something with the plan name on it?
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
(verbatim) [go to PCARD1]
(R,D) [prefill PCARD1 with a "2" and go to HIPNAM1B]
Question ID:FHI.160_01.000

Instrument Variable Name: PCARD1
Question Text:
* Do not read. Was the health plan name obtained from a health plan card or something with the health plan name on it?
1 Yes
2 No
Universe Text All private health insurance plans where the plan name was entered at HIPNAM1
Skip Instructions:
go to HIPNAM1B
Question ID:FHI.170_00.000

Instrument Variable Name: HIPNAM1B
Question Text:

* Ask or verify. Enter all that apply, separate with commas. Which family members are covered by this plan?
* Indicate each family member covered by this plan.
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families with a private health insurance plan and the plan name, refused, or don't know was entered at
HIPNAM1
Skip Instructions:
(R,D) [if HIPNAM1= R or D, go to STNAME]
go to MORPLAN

NOTE: In the instrument, interviewers enter the line numbers associated with the persons reported by the respondent. As shown above, each eligible person receives an edited response code in subsequent data processing.
Question ID:FHI.171_00.000

Instrument Variable Name: MORPLAN
Question Text:
* Ask if necessary Are there any more private health insurance plans?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families where a private health insurance plan name was entered at HIPNAM1 or a person number was entered at HIPNAM1B

Skip Instructions:
(1) [go to HIPNAM2]
(2,R,D) [if no persons selected at HIPNAM1B, go to FHICCI8; else, if persons selected at HIPNAM1B, but not all persons with HIKIND = 1 or 3 selected at HIPNAM1B, go to HIVER1]
Question ID:FHI.172_00.000

Instrument Variable Name: HIPNAM2
Question Text:

What is the name of the next plan? *Read if necessary: Do you have a health plan card or something with the plan name on it?
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All families with a second private health insurance plan
Skip Instructions:
(verbatim) [go to PCARD2]
(R,D) [prefill PCARD2 with a "2" and go to HIPNAM2B]
Question ID:FHI.172_01.000

Instrument Variable Name: PCARD2
Question Text:
* Do not read. Was the health plan name obtained from a health plan card or something with the health plan name on it?
1 Yes
2 No
Universe Text All private health insurance plans where the plan name was entered at HIPNAM2
Skip Instructions:

go to HIPNAM2B
Question ID:FHI.173_00.000

Instrument Variable Name: HIPNAM2B
Question Text:
* Ask or verify. Enter all that apply, separate with commas. Which family members are covered by that plan?
* Indicate each family member covered by this plan.
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families with a second private health insurance plan and the plan name, refused, or don't know was entered at HIPNAM2
Skip Instructions:
(R,D) [if HIPNAM2 eq R or D and persons selected at HIPNAM1B, but not all persons with HIKIND eq 1 or 3 selected at HIPNAM1B, go to HIVER1; else, if HIPNAM2 eq R or D and persons selected at HIPNAM1B, and all persons with HIKIND eq 1 or 3 selected at HIPNAM1B, go to FHICCI8; else, if HIPNAM2 eq R or D and persons not selected at HIPNAM1B, go to FHICCI8; else, if a health plan name recorded in HIPNAM2, go to MORPLAN2] go to MORPLAN2

top
2014
Survey form view entire document:  text  image

Question ID:FHI.070_00.000

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.
Question ID:FHI.158_00.000

Instrument Variable Name: FHICCI6
Question Text:
The next questions are about private health insurance plans [fill1: /including Medi-Gap]. These plans can be obtained through work, purchased directly, or through a state or local government program or community program. [fill2: We have the following persons listed as being covered by such plans:
* Read names. (display roster of eligible persons)]
* Enter 1 to continue
1 Continue
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
go to HIPNAM1
Question ID:FHI.160_00.000

Instrument Variable Name: HIPNAM1
Question Text:
It is important that we record the complete and accurate name of each health insurance plan. What is the COMPLETE name of the first plan? Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service, such as nursing home care, accidents, or dental care.
* Read if necessary: Do you have your health plan card or something with the plan name on it?
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
(verbatim) [go to PCARD1]
(R,D) [prefill PCARD1 with a "2" and go to HIPNAM1B]
Question ID:FHI.160_01.000

Instrument Variable Name: PCARD1
Question Text:
* Do not read. Was the health plan name obtained from a health plan card or something with the health plan name on it?
1 Yes
2 No
Universe Text All private health insurance plans where the plan name was entered at HIPNAM1
Skip Instructions:
go to HIPNAM1B
Question ID:FHI.170_00.000

Instrument Variable Name: HIPNAM1B
Question Text:

* Ask or verify. Enter all that apply, separate with commas. Which family members are covered by this plan?
* Indicate each family member covered by this plan.
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families with a private health insurance plan and the plan name, refused, or don't know was entered at
HIPNAM1
Skip Instructions:
(R,D) [if HIPNAM1= R or D, go to STNAME]
go to MORPLAN

NOTE: In the instrument, interviewers enter the line numbers associated with the persons reported by the respondent. As shown above, each eligible person receives an edited response code in subsequent data processing.
Question ID:FHI.171_00.000

Instrument Variable Name: MORPLAN
Question Text:
* Ask if necessary Are there any more private health insurance plans?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families where a private health insurance plan name was entered at HIPNAM1 or a person number was entered at HIPNAM1B

Skip Instructions:
(1) [go to HIPNAM2]
(2,R,D) [if no persons selected at HIPNAM1B, go to FHICCI8; else, if persons selected at HIPNAM1B, but not all persons with HIKIND = 1 or 3 selected at HIPNAM1B, go to HIVER1]
Question ID:FHI.172_00.000

Instrument Variable Name: HIPNAM2
Question Text:

What is the name of the next plan? *Read if necessary: Do you have a health plan card or something with the plan name on it?
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All families with a second private health insurance plan
Skip Instructions:
(verbatim) [go to PCARD2]
(R,D) [prefill PCARD2 with a "2" and go to HIPNAM2B]
Question ID:FHI.172_01.000

Instrument Variable Name: PCARD2
Question Text:
* Do not read. Was the health plan name obtained from a health plan card or something with the health plan name on it?
1 Yes
2 No
Universe Text All private health insurance plans where the plan name was entered at HIPNAM2
Skip Instructions:

go to HIPNAM2B
Question ID:FHI.173_00.000

Instrument Variable Name: HIPNAM2B
Question Text:
* Ask or verify. Enter all that apply, separate with commas. Which family members are covered by that plan?
* Indicate each family member covered by this plan.
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families with a second private health insurance plan and the plan name, refused, or don't know was entered at HIPNAM2
Skip Instructions:
(R,D) [if HIPNAM2 eq R or D and persons selected at HIPNAM1B, but not all persons with HIKIND eq 1 or 3 selected at HIPNAM1B, go to HIVER1; else, if HIPNAM2 eq R or D and persons selected at HIPNAM1B, and all persons with HIKIND eq 1 or 3 selected at HIPNAM1B, go to FHICCI8; else, if HIPNAM2 eq R or D and persons not selected at HIPNAM1B, go to FHICCI8; else, if a health plan name recorded in HIPNAM2, go to MORPLAN2] go to MORPLAN2

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2013
Survey form view entire document:  text  image

Question ID:FHI.070_00.000

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.
Question ID:FHI.158_00.000

Instrument Variable Name: FHICCI6
Question Text:
The next questions are about private health insurance plans [fill1: /including Medi-Gap]. These plans can be obtained through work, purchased directly, or through a state or local government program or community program. [fill2: We have the following persons listed as being covered by such plans:
* Read names. (display roster of eligible persons)]
* Enter 1 to continue
1 Continue
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
go to HIPNAM1
Question ID:FHI.160_00.000

Instrument Variable Name: HIPNAM1
Question Text:
It is important that we record the complete and accurate name of each health insurance plan. What is the COMPLETE name of the first plan? Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service, such as nursing home care, accidents, or dental care.
* Read if necessary: Do you have your health plan card or something with the plan name on it?
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
(verbatim) [go to PCARD1]
(R,D) [prefill PCARD1 with a "2" and go to HIPNAM1B]
Question ID:FHI.160_01.000

Instrument Variable Name: PCARD1
Question Text:
* Do not read. Was the health plan name obtained from a health plan card or something with the health plan name on it?
1 Yes
2 No
Universe Text All private health insurance plans where the plan name was entered at HIPNAM1
Skip Instructions:
go to HIPNAM1B
Question ID:FHI.170_00.000

Instrument Variable Name: HIPNAM1B
Question Text:

* Ask or verify. Enter all that apply, separate with commas. Which family members are covered by this plan?
* Indicate each family member covered by this plan.
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families with a private health insurance plan and the plan name, refused, or don't know was entered at
HIPNAM1
Skip Instructions:
(R,D) [if HIPNAM1= R or D, go to STNAME]
go to MORPLAN

NOTE: In the instrument, interviewers enter the line numbers associated with the persons reported by the respondent. As shown above, each eligible person receives an edited response code in subsequent data processing.
Question ID:FHI.171_00.000

Instrument Variable Name: MORPLAN
Question Text:
* Ask if necessary Are there any more private health insurance plans?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families where a private health insurance plan name was entered at HIPNAM1 or a person number was entered at HIPNAM1B

Skip Instructions:
(1) [go to HIPNAM2]
(2,R,D) [if no persons selected at HIPNAM1B, go to FHICCI8; else, if persons selected at HIPNAM1B, but not all persons with HIKIND = 1 or 3 selected at HIPNAM1B, go to HIVER1]
Question ID:FHI.172_00.000

Instrument Variable Name: HIPNAM2
Question Text:

What is the name of the next plan? *Read if necessary: Do you have a health plan card or something with the plan name on it?
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All families with a second private health insurance plan
Skip Instructions:
(verbatim) [go to PCARD2]
(R,D) [prefill PCARD2 with a "2" and go to HIPNAM2B]
Question ID:FHI.172_01.000

Instrument Variable Name: PCARD2
Question Text:
* Do not read. Was the health plan name obtained from a health plan card or something with the health plan name on it?
1 Yes
2 No
Universe Text All private health insurance plans where the plan name was entered at HIPNAM2
Skip Instructions:

go to HIPNAM2B
Question ID:FHI.173_00.000

Instrument Variable Name: HIPNAM2B
Question Text:
* Ask or verify. Enter all that apply, separate with commas. Which family members are covered by that plan?
* Indicate each family member covered by this plan.
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families with a second private health insurance plan and the plan name, refused, or don't know was entered at HIPNAM2
Skip Instructions:
(R,D) [if HIPNAM2 eq R or D and persons selected at HIPNAM1B, but not all persons with HIKIND eq 1 or 3 selected at HIPNAM1B, go to HIVER1; else, if HIPNAM2 eq R or D and persons selected at HIPNAM1B, and all persons with HIKIND eq 1 or 3 selected at HIPNAM1B, go to FHICCI8; else, if HIPNAM2 eq R or D and persons not selected at HIPNAM1B, go to FHICCI8; else, if a health plan name recorded in HIPNAM2, go to MORPLAN2] go to MORPLAN2

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2012
Survey form view entire document:  text  image

Question ID:FHI.070_00.000

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.
Question ID:FHI.158_00.000

Instrument Variable Name: FHICCI6
Question Text:
The next questions are about private health insurance plans [fill1: /including Medi-Gap]. These plans can be obtained through work, purchased directly, or through a state or local government program or community program. [fill2: We have the following persons listed as being covered by such plans:
* Read names. (display roster of eligible persons)]
* Enter 1 to continue
1 Continue
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
go to HIPNAM1
Question ID:FHI.160_00.000

Instrument Variable Name: HIPNAM1
Question Text:
It is important that we record the complete and accurate name of each health insurance plan. What is the COMPLETE name of the first plan? Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service, such as nursing home care, accidents, or dental care.
* Read if necessary: Do you have your health plan card or something with the plan name on it?
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
(verbatim) [go to PCARD1]
(R,D) [prefill PCARD1 with a "2" and go to HIPNAM1B]
Question ID:FHI.160_01.000

Instrument Variable Name: PCARD1
Question Text:
* Do not read. Was the health plan name obtained from a health plan card or something with the health plan name on it?
1 Yes
2 No
Universe Text All private health insurance plans where the plan name was entered at HIPNAM1
Skip Instructions:
go to HIPNAM1B
Question ID:FHI.170_00.000

Instrument Variable Name: HIPNAM1B
Question Text:

* Ask or verify. Enter all that apply, separate with commas. Which family members are covered by this plan?
* Indicate each family member covered by this plan.
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families with a private health insurance plan and the plan name, refused, or don't know was entered at
HIPNAM1
Skip Instructions:
(R,D) [if HIPNAM1= R or D, go to STNAME]
go to MORPLAN

NOTE: In the instrument, interviewers enter the line numbers associated with the persons reported by the respondent. As shown above, each eligible person receives an edited response code in subsequent data processing.
Question ID:FHI.171_00.000

Instrument Variable Name: MORPLAN
Question Text:
* Ask if necessary Are there any more private health insurance plans?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families where a private health insurance plan name was entered at HIPNAM1 or a person number was entered at HIPNAM1B

Skip Instructions:
(1) [go to HIPNAM2]
(2,R,D) [if no persons selected at HIPNAM1B, go to FHICCI8; else, if persons selected at HIPNAM1B, but not all persons with HIKIND = 1 or 3 selected at HIPNAM1B, go to HIVER1]
Question ID:FHI.172_00.000

Instrument Variable Name: HIPNAM2
Question Text:

What is the name of the next plan? *Read if necessary: Do you have a health plan card or something with the plan name on it?
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All families with a second private health insurance plan
Skip Instructions:
(verbatim) [go to PCARD2]
(R,D) [prefill PCARD2 with a "2" and go to HIPNAM2B]
Question ID:FHI.172_01.000

Instrument Variable Name: PCARD2
Question Text:
* Do not read. Was the health plan name obtained from a health plan card or something with the health plan name on it?
1 Yes
2 No
Universe Text All private health insurance plans where the plan name was entered at HIPNAM2
Skip Instructions:

go to HIPNAM2B
Question ID:FHI.173_00.000

Instrument Variable Name: HIPNAM2B
Question Text:
* Ask or verify. Enter all that apply, separate with commas. Which family members are covered by that plan?
* Indicate each family member covered by this plan.
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families with a second private health insurance plan and the plan name, refused, or don't know was entered at HIPNAM2
Skip Instructions:
(R,D) [if HIPNAM2 eq R or D and persons selected at HIPNAM1B, but not all persons with HIKIND eq 1 or 3 selected at HIPNAM1B, go to HIVER1; else, if HIPNAM2 eq R or D and persons selected at HIPNAM1B, and all persons with HIKIND eq 1 or 3 selected at HIPNAM1B, go to FHICCI8; else, if HIPNAM2 eq R or D and persons not selected at HIPNAM1B, go to FHICCI8; else, if a health plan name recorded in HIPNAM2, go to MORPLAN2] go to MORPLAN2

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2011
Survey form view entire document:  text  image

Question ID:FHI.180_00.000

Instrument Variable Name: HIVER1
Question Text:
? [F1] [fill1: You are/ALIAS is] listed as having private insurance but [fill2: were/was] not mentioned as being covered by any of the plans we just discussed. [fill3: Are you/Is ALIAS] covered by private insurance?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All persons who have private health insurance coverage, but were not mentioned as being covered by any of the reported plans
Skip Instructions:
(1) [ go to HIVER2]
(2,R,D) [go to ERR_HIVER1]
Hard Edit: ERR_HIVER1

*Press ENTER to go back to HIKIND to update health insurance coverage.
Question ID:FHI.190_00.000

Instrument Variable Name: HIVER2
Question Text:
? [F1] * Enter all that apply, separate with commas.
Is [fill: your/ALIAS's] health insurance plan the same as one of those already mentioned?
1 1st plan mentioned (^HIPNAM1)
2 2nd plan mentioned (^HIPNAM2)
3 3rd plan mentioned (^HIPNAM3)
4 4th plan mentioned (^HIPNAM4)
5 Some other plan not already mentioned
7 Refused
9 Don't know
Universe Text All persons for whom it was verified they have private health insurance coverage, but were not mentioned as being covered by any of the reported plans
Skip Instructions:
(1-4) [update responses for HIPNAM1B/HIPNAM2B/HIPNAM3B/HIPNAM4B and go to FHICCI8]
(5) [if 4 plans were reported, ignore this 5th plan and go to FHICCI8; else, go to HIPNAM2, or HIPNAM3, or HIPNAM4 accordingly to enter information on this plan]
(R,D) [go to FHICCI8]

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2010
Survey form view entire document:  text  image

Question ID:FHI.050_00.000

Instrument Variable Name: FHICOV
Question Text:

(book) F12 and (book) F14 The next questions are about health insurance. Include health insurance obtained through employment or purchased directly as well as government programs like Medicare and Medicaid that provide Medical care or help pay medical bills. [fill: Are you/Is anyone in the family] covered by any kind of health insurance or some other kind of health care plan?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families
Skip Instructions:
(1,R,D) [go to HIKIND]
(2) [if AGE ge 65, go to MCAREPRB; else, go to MCAIDPRB]
Question ID:FHI.070_00.000

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.
Question ID:FHI.158_00.000

Instrument Variable Name: FHICCI6
Question Text:
The next questions are about private health insurance plans [fill1: /including Medi-Gap]. These plans can be obtained through work, purchased directly, or through a state or local government program or community program. [fill2: We have the following persons listed as being covered by such plans:
* Read names. (display roster of eligible persons)]
* Enter 1 to continue
1 Continue
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
go to HIPNAM1
Question ID:FHI.160_00.000

Instrument Variable Name: HIPNAM1
Question Text:
It is important that we record the complete and accurate name of each health insurance plan. What is the COMPLETE name of the first plan? Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service, such as nursing home care, accidents, or dental care.
* Read if necessary: Do you have your health plan card or something with the plan name on it?
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
(verbatim) [go to PCARD1]
(R,D) [prefill PCARD1 with a "2" and go to HIPNAM1B]

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2009
Survey form view entire document:  text  image

Question ID:FHI.070_00.000

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.
Question ID:FHI.158_00.000

Instrument Variable Name: FHICCI6
Question Text:
The next questions are about private health insurance plans [fill1: /including Medi-Gap]. These plans can be obtained through work, purchased directly, or through a state or local government program or community program. [fill2: We have the following persons listed as being covered by such plans:
* Read names. (display roster of eligible persons)]
* Enter 1 to continue
1 Continue
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
go to HIPNAM1
Question ID:FHI.160_00.000

Instrument Variable Name: HIPNAM1
Question Text:
It is important that we record the complete and accurate name of each health insurance plan. What is the COMPLETE name of the first plan? Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service, such as nursing home care, accidents, or dental care.
* Read if necessary: Do you have your health plan card or something with the plan name on it?
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
(verbatim) [go to PCARD1]
(R,D) [prefill PCARD1 with a "2" and go to HIPNAM1B]
Question ID:FHI.160_01.000

Instrument Variable Name: PCARD1
Question Text:
* Do not read. Was the health plan name obtained from a health plan card or something with the health plan name on it?
1 Yes
2 No
Universe Text All private health insurance plans where the plan name was entered at HIPNAM1
Skip Instructions:
go to HIPNAM1B
Question ID:FHI.170_00.000

Instrument Variable Name: HIPNAM1B
Question Text:

* Ask or verify. Enter all that apply, separate with commas. Which family members are covered by this plan?
* Indicate each family member covered by this plan.
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families with a private health insurance plan and the plan name, refused, or don't know was entered at
HIPNAM1
Skip Instructions:
(R,D) [if HIPNAM1= R or D, go to STNAME]
go to MORPLAN

NOTE: In the instrument, interviewers enter the line numbers associated with the persons reported by the respondent. As shown above, each eligible person receives an edited response code in subsequent data processing.

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2008
Survey form view entire document:  text  image

Question ID:FHI.070_00.000

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.
Question ID:FHI.158_00.000

Instrument Variable Name: FHICCI6
Question Text:
The next questions are about private health insurance plans [fill1: /including Medi-Gap]. These plans can be obtained through work, purchased directly, or through a state or local government program or community program. [fill2: We have the following persons listed as being covered by such plans:
* Read names. (display roster of eligible persons)]
* Enter 1 to continue
1 Continue
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
go to HIPNAM1
Question ID:FHI.160_00.000

Instrument Variable Name: HIPNAM1
Question Text:
It is important that we record the complete and accurate name of each health insurance plan. What is the COMPLETE name of the first plan? Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service, such as nursing home care, accidents, or dental care.
* Read if necessary: Do you have your health plan card or something with the plan name on it?
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
(verbatim) [go to PCARD1]
(R,D) [prefill PCARD1 with a "2" and go to HIPNAM1B]
Question ID:FHI.160_01.000

Instrument Variable Name: PCARD1
Question Text:
* Do not read. Was the health plan name obtained from a health plan card or something with the health plan name on it?
1 Yes
2 No
Universe Text All private health insurance plans where the plan name was entered at HIPNAM1
Skip Instructions:
go to HIPNAM1B
Question ID:FHI.170_00.000

Instrument Variable Name: HIPNAM1B
Question Text:

* Ask or verify. Enter all that apply, separate with commas. Which family members are covered by this plan?
* Indicate each family member covered by this plan.
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families with a private health insurance plan and the plan name, refused, or don't know was entered at
HIPNAM1
Skip Instructions:
(R,D) [if HIPNAM1= R or D, go to STNAME]
go to MORPLAN

NOTE: In the instrument, interviewers enter the line numbers associated with the persons reported by the respondent. As shown above, each eligible person receives an edited response code in subsequent data processing.
Question ID:FHI.171_00.000

Instrument Variable Name: MORPLAN
Question Text:
* Ask if necessary Are there any more private health insurance plans?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families where a private health insurance plan name was entered at HIPNAM1 or a person number was entered at HIPNAM1B

Skip Instructions:
(1) [go to HIPNAM2]
(2,R,D) [if no persons selected at HIPNAM1B, go to FHICCI8; else, if persons selected at HIPNAM1B, but not all persons with HIKIND = 1 or 3 selected at HIPNAM1B, go to HIVER1]
Question ID:FHI.172_00.000

Instrument Variable Name: HIPNAM2
Question Text:

What is the name of the next plan? *Read if necessary: Do you have a health plan card or something with the plan name on it?
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All families with a second private health insurance plan
Skip Instructions:
(verbatim) [go to PCARD2]
(R,D) [prefill PCARD2 with a "2" and go to HIPNAM2B]
Question ID:FHI.172_01.000

Instrument Variable Name: PCARD2
Question Text:
* Do not read. Was the health plan name obtained from a health plan card or something with the health plan name on it?
1 Yes
2 No
Universe Text All private health insurance plans where the plan name was entered at HIPNAM2
Skip Instructions:

go to HIPNAM2B
Question ID:FHI.173_00.000

Instrument Variable Name: HIPNAM2B
Question Text:
* Ask or verify. Enter all that apply, separate with commas. Which family members are covered by that plan?
* Indicate each family member covered by this plan.
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families with a second private health insurance plan and the plan name, refused, or don't know was entered at HIPNAM2
Skip Instructions:
(R,D) [if HIPNAM2 eq R or D and persons selected at HIPNAM1B, but not all persons with HIKIND eq 1 or 3 selected at HIPNAM1B, go to HIVER1; else, if HIPNAM2 eq R or D and persons selected at HIPNAM1B, and all persons with HIKIND eq 1 or 3 selected at HIPNAM1B, go to FHICCI8; else, if HIPNAM2 eq R or D and persons not selected at HIPNAM1B, go to FHICCI8; else, if a health plan name recorded in HIPNAM2, go to MORPLAN2] go to MORPLAN2

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2007
Survey form view entire document:  text  image

Question ID:FHI.050_00.000

Instrument Variable Name: FHICOV
Question Text:

(book) F12 and (book) F14 The next questions are about health insurance. Include health insurance obtained through employment or purchased directly as well as government programs like Medicare and Medicaid that provide Medical care or help pay medical bills. [fill: Are you/Is anyone in the family] covered by any kind of health insurance or some other kind of health care plan?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families
Skip Instructions:
(1,R,D) [go to HIKIND]
(2) [if AGE ge 65, go to MCAREPRB; else, go to MCAIDPRB]
Question ID:FHI.070_00.000

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.
Question ID:FHI.158_00.000

Instrument Variable Name: FHICCI6
Question Text:
The next questions are about private health insurance plans [fill1: /including Medi-Gap]. These plans can be obtained through work, purchased directly, or through a state or local government program or community program. [fill2: We have the following persons listed as being covered by such plans:
* Read names. (display roster of eligible persons)]
* Enter 1 to continue
1 Continue
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
go to HIPNAM1
Question ID:FHI.160_00.000

Instrument Variable Name: HIPNAM1
Question Text:
It is important that we record the complete and accurate name of each health insurance plan. What is the COMPLETE name of the first plan? Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service, such as nursing home care, accidents, or dental care.
* Read if necessary: Do you have your health plan card or something with the plan name on it?
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
(verbatim) [go to PCARD1]
(R,D) [prefill PCARD1 with a "2" and go to HIPNAM1B]

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2006
Survey form view entire document:  text  image

Question ID:FHI.070_00.000

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.
Question ID:FHI.158_00.000

Instrument Variable Name: FHICCI6
Question Text:
The next questions are about private health insurance plans [fill1: /including Medi-Gap]. These plans can be obtained through work, purchased directly, or through a state or local government program or community program. [fill2: We have the following persons listed as being covered by such plans:
* Read names. (display roster of eligible persons)]
* Enter 1 to continue
1 Continue
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
go to HIPNAM1
Question ID:FHI.160_00.000

Instrument Variable Name: HIPNAM1
Question Text:
It is important that we record the complete and accurate name of each health insurance plan. What is the COMPLETE name of the first plan? Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service, such as nursing home care, accidents, or dental care.
* Read if necessary: Do you have your health plan card or something with the plan name on it?
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
(verbatim) [go to PCARD1]
(R,D) [prefill PCARD1 with a "2" and go to HIPNAM1B]
Question ID:FHI.160_01.000

Instrument Variable Name: PCARD1
Question Text:
* Do not read. Was the health plan name obtained from a health plan card or something with the health plan name on it?
1 Yes
2 No
Universe Text All private health insurance plans where the plan name was entered at HIPNAM1
Skip Instructions:
go to HIPNAM1B
Question ID:FHI.170_00.000

Instrument Variable Name: HIPNAM1B
Question Text:

* Ask or verify. Enter all that apply, separate with commas. Which family members are covered by this plan?
* Indicate each family member covered by this plan.
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families with a private health insurance plan and the plan name, refused, or don't know was entered at
HIPNAM1
Skip Instructions:
(R,D) [if HIPNAM1= R or D, go to STNAME]
go to MORPLAN

NOTE: In the instrument, interviewers enter the line numbers associated with the persons reported by the respondent. As shown above, each eligible person receives an edited response code in subsequent data processing.

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2005
Survey form view entire document:  text  image

Question ID:FHI.070_00.000

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.
Question ID:FHI.158_00.000

Instrument Variable Name: FHICCI6
Question Text:
The next questions are about private health insurance plans [fill1: /including Medi-Gap]. These plans can be obtained through work, purchased directly, or through a state or local government program or community program. [fill2: We have the following persons listed as being covered by such plans:
* Read names. (display roster of eligible persons)]
* Enter 1 to continue
1 Continue
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
go to HIPNAM1
Question ID:FHI.160_00.000

Instrument Variable Name: HIPNAM1
Question Text:
It is important that we record the complete and accurate name of each health insurance plan. What is the COMPLETE name of the first plan? Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service, such as nursing home care, accidents, or dental care.
* Read if necessary: Do you have your health plan card or something with the plan name on it?
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
(verbatim) [go to PCARD1]
(R,D) [prefill PCARD1 with a "2" and go to HIPNAM1B]
Question ID:FHI.160_01.000

Instrument Variable Name: PCARD1
Question Text:
* Do not read. Was the health plan name obtained from a health plan card or something with the health plan name on it?
1 Yes
2 No
Universe Text All private health insurance plans where the plan name was entered at HIPNAM1
Skip Instructions:
go to HIPNAM1B
Question ID:FHI.170_00.000

Instrument Variable Name: HIPNAM1B
Question Text:

* Ask or verify. Enter all that apply, separate with commas. Which family members are covered by this plan?
* Indicate each family member covered by this plan.
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families with a private health insurance plan and the plan name, refused, or don't know was entered at
HIPNAM1
Skip Instructions:
(R,D) [if HIPNAM1= R or D, go to STNAME]
go to MORPLAN

NOTE: In the instrument, interviewers enter the line numbers associated with the persons reported by the respondent. As shown above, each eligible person receives an edited response code in subsequent data processing.

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2004
Survey form view entire document:  text  image

Question ID:FHI.070_00.000

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.
Question ID:FHI.158_00.000

Instrument Variable Name: FHICCI6
Question Text:
The next questions are about private health insurance plans [fill1: /including Medi-Gap]. These plans can be obtained through work, purchased directly, or through a state or local government program or community program. [fill2: We have the following persons listed as being covered by such plans:
* Read names. (display roster of eligible persons)]
* Enter 1 to continue
1 Continue
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
go to HIPNAM1
Question ID:FHI.160_00.000

Instrument Variable Name: HIPNAM1
Question Text:
It is important that we record the complete and accurate name of each health insurance plan. What is the COMPLETE name of the first plan? Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service, such as nursing home care, accidents, or dental care.
* Read if necessary: Do you have your health plan card or something with the plan name on it?
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All families with at least one person covered by private health insurance
Skip Instructions:
(verbatim) [go to PCARD1]
(R,D) [prefill PCARD1 with a "2" and go to HIPNAM1B]
Question ID:FHI.160_01.000

Instrument Variable Name: PCARD1
Question Text:
* Do not read. Was the health plan name obtained from a health plan card or something with the health plan name on it?
1 Yes
2 No
Universe Text All private health insurance plans where the plan name was entered at HIPNAM1
Skip Instructions:
go to HIPNAM1B
Question ID:FHI.170_00.000

Instrument Variable Name: HIPNAM1B
Question Text:

* Ask or verify. Enter all that apply, separate with commas. Which family members are covered by this plan?
* Indicate each family member covered by this plan.
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All families with a private health insurance plan and the plan name, refused, or don't know was entered at
HIPNAM1
Skip Instructions:
(R,D) [if HIPNAM1= R or D, go to STNAME]
go to MORPLAN

NOTE: In the instrument, interviewers enter the line numbers associated with the persons reported by the respondent. As shown above, each eligible person receives an edited response code in subsequent data processing.

top
2003
Survey form view entire document:  text  image

FHI.070

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.
Card F10
You may choose more than one.

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?)

FHI.160

It is important that we record the complete and accurate name of each health insurance plan.
What is the COMPLETE name of the first plan?

FR: REMIND RESPONDENT IF NECESSARY:

Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service, such as nursing home care, accidents, or dental care.

FR: READ IF NECESSARY:
DO YOU HAVE A HEALTH PLAN CARD OR SOMETHING WITH THE PLAN NAME ON IT?
HIPNAM_N Name: _____________________________

FHI.160.1

FR: DO NOT READ TO RESPONDENT:
WAS THE HEALTH PLAN NAME OBTAINED FROM A HEALTH PLAN CARD OR SOMETHING WITH THE HEALTH PLAN NAME ON IT?
PCARD1
(1) Yes
(2) No

FHI.170

Which family members are covered by that plan?

FR: MARK "X" ALL THAT APPLY.
HIPNAM_B
[Enter person #s]

[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]

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2002
Survey form view entire document:  text  image

FHI.070

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.
Card F10
You may choose more than one.

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?)

FHI.160

It is important that we record the complete and accurate name of each health insurance plan.
What is the COMPLETE name of the first plan?

FR: REMIND RESPONDENT IF NECESSARY:

Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service, such as nursing home care, accidents, or dental care.

FR: READ IF NECESSARY:
DO YOU HAVE A HEALTH PLAN CARD OR SOMETHING WITH THE PLAN NAME ON IT?
HIPNAM_N Name: _____________________________

FHI.160.1

FR: DO NOT READ TO RESPONDENT:
WAS THE HEALTH PLAN NAME OBTAINED FROM A HEALTH PLAN CARD OR SOMETHING WITH THE HEALTH PLAN NAME ON IT?
PCARD1
(1) Yes
(2) No

FHI.170

Which family members are covered by that plan?

FR: MARK "X" ALL THAT APPLY.
HIPNAM_B
[Enter person #s]

[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]

top
2001
Survey form view entire document:  text  image

FHI.070

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.
Card F10
You may choose more than one.

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?)

FHI.160

It is important that we record the complete and accurate name of each health insurance plan.
What is the COMPLETE name of the first plan?

FR: REMIND RESPONDENT IF NECESSARY:

Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service, such as nursing home care, accidents, or dental care.

FR: READ IF NECESSARY:
DO YOU HAVE A HEALTH PLAN CARD OR SOMETHING WITH THE PLAN NAME ON IT?
HIPNAM_N Name: _____________________________

FHI.160.1

FR: DO NOT READ TO RESPONDENT:
WAS THE HEALTH PLAN NAME OBTAINED FROM A HEALTH PLAN CARD OR SOMETHING WITH THE HEALTH PLAN NAME ON IT?
PCARD1
(1) Yes
(2) No

FHI.170

Which family members are covered by that plan?

FR: MARK "X" ALL THAT APPLY.
HIPNAM_B
[Enter person #s]

[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]

top
2000
Survey form view entire document:  text  image

FHI.070

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.
Card F10
You may choose more than one.

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?)

FHI.160

It is important that we record the complete and accurate name of each health insurance plan.
What is the COMPLETE name of the first plan?

FR: REMIND RESPONDENT IF NECESSARY:

Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service, such as nursing home care, accidents, or dental care.

FR: READ IF NECESSARY:
DO YOU HAVE A HEALTH PLAN CARD OR SOMETHING WITH THE PLAN NAME ON IT?
HIPNAM_N Name: _____________________________

FHI.160.1

FR: DO NOT READ TO RESPONDENT:
WAS THE HEALTH PLAN NAME OBTAINED FROM A HEALTH PLAN CARD OR SOMETHING WITH THE HEALTH PLAN NAME ON IT?
PCARD1
(1) Yes
(2) No

FHI.170

Which family members are covered by that plan?

FR: MARK "X" ALL THAT APPLY.
HIPNAM_B
[Enter person #s]

[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]

top
1999
Survey form view entire document:  text  image

FHI.070

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.
Card F9
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

FHI.160

It is important that we record the complete and accurate name of each health insurance plan. What is the COMPLETE name of the first plan?

FR: REMIND RESPONDENT IF NECESSARY:

Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service, such as nursing home care, accidents, or dental care.

FR: IF NECESSARY:

Do you have something with the plan name on it?
HIPNAM_N Name: _______________

FHI.170

Which family members are covered by that plan?
HIPNAM_B
[Enter person #s]

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1998
Survey form view entire document:  text  image

FHI.070

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.
Card F9
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

FHI.160

It is important that we record the complete and accurate name of each health insurance plan. What is the COMPLETE name of the first plan?

FR: REMIND RESPONDENT IF NECESSARY:

Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service, such as nursing home care, accidents, or dental care.

FR: IF NECESSARY:

Do you have something with the plan name on it?
HIPNAM_N Name: _______________

FHI.170

Which family members are covered by that plan?
HIPNAM_B
[Enter person #s]

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[ ]
[ ]
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1997
Survey form view entire document:  text  image

FHI.070

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

FHI.160

It is important that we record the complete and accurate name of each health insurance plan. What is the COMPLETE name of the first plan?

FR: REMIND RESPONDENT IF NECESSARY: Do NOT include plans that only provide extra cash while in the hospital or plans that pay for only one type of service, such as nursing home care, accidents, or dental care.

FR: IF NECESSARY: DO YOU HAVE SOMETHING WITH THE PLAN NAME ON IT?
HIPNAM_N Name: _________________________ (FHI.160)

FHI.170

Which family members are covered by that plan?
HIPNAM_B
[Enter person #s]

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