Survey Text

1994
1993
top
1994
Survey form view entire document:  text  image
Ask 2d for each person with "Has Card" box marked in 2b.
d. May I please see -- (and [other sample persons']) card(s)?
Mark (X) appropriate box in person's column. Record expiration date for each Medicaid card seen.

[] 1 Medicaid card seen
Expiration date --
Month____
Day ____
[] 2 No card seen
[] 8 Other card seen (Specify) ____

top
1993
Survey form view entire document:  text  image
There is a program called Medicaid that pays for health care for persons in need. In this State it is also called (State name).

2a. Does anyone in the family NOW have a Medicaid or (state name) card?

[] 1 Yes (2b)
[] 2 No (3)
[] 9 DK (3)

b. Who is this?
Mark (X) "Has Card" box in person's column.

[] 1 Has card

c. Anyone else?

[] Yes (Reask 2b and c)
[] No

Ask 2d for each person with "Has Card" box marked in 2b.
d. May I please see -- (and [other sample persons']) card(s)?
Mark (X) appropriate box in person's column. Record expiration date for each Medicaid card seen.

[] 1 Medicaid card seen
Expiration date --
Month____
Day ____
[] 2 No card seen
[] 8 Other card seen (Specify) ____