Read to respondent(s):
Medicare is a Social Security health insurance program for disabled persons and for persons 65 years old and older. People covered by Medicare have a card that looks like this. Show card.

1a. Is anyone in this family, that is (read names), now covered by Medicare?

b. Is -- now covered?

Ask only if persons under age 20 in family:
9a. Does anyone in this family now receive assistance through the "Aid to Families with Dependent Children" Program, sometimes called "AFDC" or "ADC"?

b. Does -- now receive AFDC or ADC?

10a. Does anyone in this family now receive the "Supplemental Security Income" of "SSI" gold-colored check?

b. Does -- now receive this check?

11a. There is a national program called Medicaid which pays for health care for persons in need. (In this State it is also called (name).)
During the past 12 months, has anyone in this family received health care which has been or will be paid for by Medicaid (or (name))?

b. Has -- received this care in the past 12 months?

13a. Is anyone in the family now covered by any other public assistance program that pays for health care?

b. Is -- now covered?

Read to respondent(s):
Medicare is a Social Security health insurance program for disabled persons and for persons 65 years old and older. People covered by Medicare have a card that looks like this. Show card.

1a. Is anyone in this family, that is (read names), now covered by Medicare?

b. Is -- now covered?

Ask for each person "Not covered" in M1. If "Not covered 65 and over," include "or Medicare."
8a. (Many people do not carry health insurance for various reasons.)

Hand Card M.

[Card M not found in flashcards]

Which of these statements describes why -- is not covered by any health insurance (or Medicare)? Any other reason? Circle all responses given.

Mark box if only one reason. If "Not covered 65 and over" in M1, include "or Medicare."
b. What is the MAIN reason -- is not covered by any health insurance (or Medicare)?

Ask only if persons under age 20 in family:
9a. Does anyone in this family now receive assistance through the "Aid to Families with Dependent Children" Program, sometimes called "AFDC" or "ADC"?

b. Does -- now receive AFDC or ADC?

12a. Does anyone in the family now have a Medicaid (or (name)) card which looks like this?
Show Medicaid card(s).

b. Does -- now have this card?

Read to respondent(s):
Medicare is a Social Security health insurance program for disabled persons and for persons 65 years old and older. People covered by Medicare have a card that looks like this. Show card.

1a. Is anyone in this family, that is (read names), now covered by Medicare?

b. Is -- now covered? Mark box in person's column.

9a. Does anyone in this family now receive assistance through the "Aid to Families with Dependent Children" Program, sometimes called "AFDC" or "ADC"?

b. Which (other) family members are included in the AFDC assistance payment?
Mark "AFDC" box in person's column.

c. Are any other family members included in this program?

10a. Does anyone in this family now receive the "Supplemental Security Income" of "SSI" gold-colored check?

b. Who (else) received this check? Mark "SSI" box in person's column.

c. Anyone else?

11a. There is a national program called Medicaid which pays for health care for persons in need. (In this State it is also called (name)). During the past 12 months, has anyone in this family received health care which has been or will be paid for by Medicaid (or (name))?

b. Who was this? Mark "Medicaid" box in person's column.

c. Anyone else?

13a. Is anyone in the family now covered by any other public assistance program that pays for health care?

b. Who is this? Mark "Other PA" box in person's column.

c. Anyone else?

Read to respondent(s):
Medicare is a Social Security health insurance program for disabled persons and for persons 65 years
old and older. People covered by Medicare have a card that looks like this. Show card.
1a. Is anyone in this family, that is (read names), now covered by Medicare?

b. Is -- now covered? Mark box in person's column.

9a. Does anyone in this family now receive assistance through the "Aid to Families with Dependent Children" Program, sometimes called "AFDC" or "ADC"?

b. Which (other) family members are included in the AFDC assistance payment?
Mark "AFDC" box in person's column.

c. Are any other family members included in this program?

10a. Does anyone in this family now receive the "Supplemental Security Income" of "SSI" gold-colored check?

b. Who (else) received this check? Mark "SSI" box in person's column.

c. Anyone else?

11a. There is a national program called Medicaid which pays for health care for persons in need. (In this State it is also called (name).) During the past 12 months, has anyone in this family received health care which has been or will be paid for by Medicaid (or (name))?

b. Who was this? Mark "Medicaid" box in person's column.

c. Anyone else?

12a. Does anyone in the family now have a Medicaid (or (name)) card which looks like this? Show Medicaid card.

b. Who is this? Mark "Card" box in person's column.

c. Anyone else?

Ask for each person with "Card" in 12b:
d. May I please see --'s (and --) card(s)?
Mark appropriate box(es) in person's column.

13a. Is anyone in the family now covered by any other public assistance program that pays for health care?

b. Who is this? Mark "Other PA" box in person's column.

c. Anyone else?