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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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?)

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.

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?)

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.

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?)

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.

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?)

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.

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