SIPP Home > Survey Content > Core Content > SIPP 1996 Panel Questionnaires > SIPP 1996 Panel Wave 2-12 Questionnaires > Health Insurance
Now I'm going to ask you about health insurance.
PRESS "ENTER" TO CONTINUE
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-MCARE-
(SHOW FLASHCARD H)
At any time between [FIRST MONTH OF REFERENCE PERIOD] 1st and today
[WAS/WERE] [NAME OF PERSON/YOU] covered by Medicare?
(1) Yes
(2) No
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-CARETHEN-
In which months [WAS/WERE] [NAME OF PERSON/YOU]
covered by Medicare?
(1) Yes
(2) No
___ In this month?
___ In [FOURTH MONTH OF REFERENCE PERIOD]?
___ In [THIRD MONTH OF REFERENCE PERIOD]?
___ In [SECOND MONTH OF REFERENCE PERIOD]?
___ In [FIRST MONTH OF REFERENCE PERIOD]?
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-MCNUMB-
May I see [YOUR/HIS/HER] Medicare card to record the
claim number and type of coverage?
FLASHCARD H PROVIDES EXAMPLES OF MEDICARE CARDS
WHICH IS TO BE SHOWN TO THE RESPONDENT.
(N) Card Not Available
(A) Railroad Retirement Card (FR: DO NOT RECORD NUMBER)
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-MCBACK-
If I were to call later would you be able to provide me
with [YOUR/HIS/HER] Medicare number?
(1) Yes
(2) No
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-CAIDNOW-
[Last time I recorded that [NAME OF PERSON/YOU] [WAS/WERE] covered by
[Medicaid/OTHER NAME FOR MEDICAID.]]
At any time between [FIRST MONTH OF REFERENCE PERIOD] 1st and the
end of [FOURTH MONTH OF REFERENCE PERIOD] [WAS/WERE] [NAME OF
PERSON/YOU] covered by Medicaid [which you may also know as OTHER NAME
FOR MEDICAID]?
(1) Yes
(2) No
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-CAIDOTH-
[Last time I recorded that [NAME OF PERSON/YOU] [WAS/WERE] covered by
a
public assistance medical program.
At any time between [FIRST MONTH OF REFERENCE PERIOD] 1st and the end
of
[FOURTH MONTH OF REFERENCE PERIOD] [WAS/WERE] [NAME OF
PERSON/YOU] covered by any other public assistance program that pays
for medical
care?
(1) Yes
(2) No
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-CAIDNM-
May I see [YOUR/HIS/HER] Medicaid[/OTHER NAME FOR MEDICAID]
card to verify the name of the medical program?
NAMES OF CHILDREN COVERED MAY BE LISTED
ON THE CARD OF THE PRIMARY RECIPIENT.
(N) Card Not Available
(1) Verified to be a Medicaid[/OTHER NAME FOR MEDICAID] card.
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-KIDCOV-
How about [YOUR/HIS/HER] [child/children]
[Were/Was] ***READ NAME(S) LISTED BELOW***
covered by Medicaid[/OTHER NAME FOR MEDICAID]
or some other public assistance medical program at any
time between [FIRST MONTH OF REFERENCE PERIOD] 1st and today?
(1) Yes (2) No
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-CAIDKIDS- PARENT IS [FIRST AND LAST NAME OF PERSON]
Which of [YOUR/HIS/HER] children [WAS/WERE] covered by
Medicaid[/OTHER NAME FOR MEDICAID]?
ENTER "N" FOR NO MORE
___ ___ ___ ___ ___ ___ ___ ___
___ ___ ___ ___ ___ ___ ___
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-CDMNTH-
In which months [WAS/WERE] [NAME OF PERSON/YOU/YOUR] [and
YOUR/HIS/HER] [covered/child covered/children covered]--
READ EACH ANSWER CATEGORY
(1) Yes
(2) No
___ In [MONTH OF INTERVIEW]?
___ In [FOURTH MONTH OF REFERENCE PERIOD]?
___ In [THIRD MONTH OF REFERENCE PERIOD]?
___ In [SECOND MONTH OF REFERENCE PERIOD]?
___ In [FIRST MONTH OF REFERENCE PERIOD]?
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-HIVER-
Earlier I recorded that for some, or all, of the time from [FIRST MONTH
OF
REFERENCE PERIOD] 1st through today [NAME OF PERSON/YOU] [WAS/WERE]
covered by a health insurance plan held in the name of [FIRST AND LAST
NAME OF
PERSON]. Is that correct?
(1) Yes
(2) No
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-H4MNTH-
[Last time I recorded that [NAME OF PERSON/YOU] [WAS/WERE] [covered
by health
insurance/covered by health insurance held in the name of/NOT covered
by health
insurance/covered by Medicare.]
[Other than Medicaid/OTHER NAME FOR MEDICAID/Other than Medicare we
just
talked about/Other than the medical assistance program] [and Medicare
we just talked
about/we just talked about/and Medicare/we just talked about and Medicare]
[ARE/IS]
[YOU/NAME OF PERSON] covered by [any other]
health insurance--READ EACH ANSWER CATEGORY
(1) Yes (2) No (N) NONE OF THESE MONTHS
__ In this month?
__ [WAS/WERE] [YOU/HE/SHE] covered in [FOURTH MONTH OF
REFERENCE PERIOD]?
__ In [THIRD MONTH OF REFERENCE PERIOD]?
__ In [SECOND MONTH OF REFERENCE PERIOD]?
__ In [FIRST MONTH OF REFERENCE PERIOD]?
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-CBHINS-
If I were to call back later would it be possible
for me to get this information?
(1) Yes
(2) No
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-HIOWN-
During any time from [FIRST MONTH OF REFERENCE PERIOD] 1st through today,
did [NAME OF PERSON/YOU] also have health insurance in [YOUR/HIS/HER]
own
name?
(1) Yes
(2) No
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-HIOWNER-
[IS/WAS] [YOUR/HIS/HER] health insurance coverage in [YOUR/HIS/HER]
own name
or [ARE/WERE/WAS] [YOU/HE/SHE] covered as a family member on someone
else's
plan?
(1) Plan in own name
(2) Covered by someone else's plan
(3) Both
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-HIHOLDR-
Who had the health insurance plan that covered [NAME OF PERSON/YOU]?
ENTER THE LINE NUMBER OF THE PERSON
(N) No one currently living here
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-HEMPLY-
[Let's talk about the plan in [YOUR/HIS/HER/that person's] [name/own
name.]
Was the health insurance obtained through--
READ ANSWER CATEGORIES
(1) [YOUR/HIS/HER/that person's] current employer or work
(2) [YOUR/HIS/HER/that person's] former employer
(3) [YOUR/HIS/HER/that person's] union
(4) CHAMPUS
(5) CHAMPVA
(6) Or the Military/VA health care
(7) Privately purchased
(8) Or in some other way
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-HICOST-
[DOES/DID] [that person's/YOUR/HIS/HER] [current employer/former employer/union]
pay all, part, or none of the premium of the plan?
(1) All
(2) Part
(3) None
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-HIPERS-
Other than [NAME OF PERSON/YOU], who else was covered
by this plan?
(ENTER LINE NUMBERS OF PERSONS COVERED)
ENTER "N" AFTER LAST LINE NUMBER IS ENTERED.
(A) All household members
(N) No one in the household/No more
___ ___ ___ ___ ___ ___ ___ ___
___ ___ ___ ___ ___ ___ ___
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-HIOTHR-
During the period from [FIRST MONTH OF REFERENCE PERIOD] 1st through
the end of [LAST MONTH OF REFERENCE PERIOD], did this plan also cover
anyone who did NOT live in this household?
(1) Yes
(2) No
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-HIWHO-
Who, OUTSIDE this household, did the plan cover?
ENTER "1" FOR EACH YES THAT APPLIES.
ENTER "2" FOR EACH NO THAT APPLIES.
___ Spouse/Partner
___ Children 18 years of age or older
___ Children under 18 years old
___ Others
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-H1KDCOV-
Was [FIRST AND LAST NAME OF PERSON] covered by a health insurance plan
[other than Medicaid] at any time between [FIRST MONTH OF REFERENCE
PERIOD]
1st and today?
(1) Yes
(2) No
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-H2KDCOV-
Which children if any were covered by a health insurance plan [other
than Medicaid] at
anytime between [FIRST MONTH OF REFERENCE PERIOD] 1st and today?
READ LIST OF CHILDREN'S NAMES DISPLAYED
ENTER APPROPRIATE LINE NUMBER OF EACH CHILD COVERED.
ENTER "N" FOR NONE OF THESE CHILDREN/NO MORE.
___ ___ ___ ___ ___ ___ ___ ___
___ ___ ___ ___ ___ ___ ___
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-HI1OUT-
Was [NAME OF PERSON] covered by the health insurance plan
of someone who does NOT currently live in the household?
(1) Yes
(2) No
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-HI2OUT-
Which children if any were covered by the health insurance plan of
someone who does NOT currently live in the household?
READ LIST OF CHILDREN'S NAMES DISPLAYED
ENTER APPROPRIATE LINE NUMBER OF EACH CHILD COVERED BY
SOMEONE OUTSIDE. ENTER "N" FOR NONE OF THESE CHILDREN/NO
MORE.
___ ___ ___ ___ ___ ___ ___ ___
___ ___ ___ ___ ___ ___ ___
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-HINONE-
I recorded that [NAME OF PERSON/YOU] [WAS/WERE] NOT covered
by any health insurance plan during the months of [MONTHS OF REFERENCE
PERIOD PERSON NOT COVERED]. Which ONE OR MORE of these reasons
describe why [NAME OF PERSON/YOU] [WAS/WERE] not covered?
(SHOW FLASHCARD I.) ENTER "N" AFTER LAST ENTRY
(01) Too expensive, can't afford health insurance
(02) No health insurance offered by (employer of self, spouse, or parent)
(03) Not working at a job long enough to qualify
(04) Job layoff, job loss, or any reason related to unemployment
(05) Not eligible because working part time or temporary job
(06) Can't obtain insurance because of poor health, illness, age,
or a pre-existing condition
(07) Dissatisfied with previous insurance OR don't believe in insurance
(08) Have been healthy, not much sickness in the family,
haven't needed health insurance
(09) Able to go to VA or military hospital for medical care
(10) Covered by some other health plan, such as Medicaid
(11) No longer covered by parents policy
(12) Other
___ ___ ___ ___ ___ ___
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-HISPEC-
Specify the exact "OTHER" reason not covered by health insurance.
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Page Last Modified: May 12, 2006
