HHID HOUSEHOLD IDENTIFICATION NUMBER
Section: N Level: Respondent Type: Character Width: 6 Decimals: 0
..................................................................................
1501 000002-213399. Household Identifier
PN RESPONDENT PERSON IDENTIFICATION NUMBER
Section: N Level: Respondent Type: Character Width: 3 Decimals: 0
..................................................................................
1047 010. Person Identifier
14 011. Person Identifier
341 020. Person Identifier
2 021. Person Identifier
50 030. Person Identifier
47 040. Person Identifier
SSUBHH 2002 SUB-HOUSEHOLD IDENTIFICATION NUMBER
Section: N Level: Respondent Type: Character Width: 1 Decimals: 0
..................................................................................
1429 3. 1st deceased respondent from a household
72 4. 2nd deceased respondent from a household
GSUBHH 2000 SUB-HOUSEHOLD IDENTIFICATION NUMBER
Section: N Level: Respondent Type: Character Width: 1 Decimals: 0
..................................................................................
1450 0. Original sample household - no split from divorce or separation
of spouses or partners
16 1. Split household - one half of couple from SUBHH 0 and new
spouse or partner, if any
15 2. Split household - one half of couple from SUBHH 0 and new
spouse or partner, if any
17 3. 1st deceased respondent from a household
1 4. 2nd deceased respondent from a household
2 7. Reunited household - respondents from split household reunite
SPN_SP 2002 SPOUSE PERSON IDENTIFICATION NUMBER
Section: N Level: Respondent Type: Character Width: 3 Decimals: 0
..................................................................................
254 010. Person Identifier
27 011. Person Identifier
1 012. Person Identifier
312 020. Person Identifier
2 021. Person Identifier
22 030. Person Identifier
2 031. Person Identifier
38 040. Person Identifier
1 041. Person Identifier
2 810. Person Identifier
1 811. Person Identifier
839 Blank. R not coupled
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
SN001 MEDICARE COVERAGE
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_GovCover.N001_
The next questions are about health insurance, both public and private.
Medicare is a public health insurance program for people 65 or older and for
disabled persons. (Medicaid/STATE NAME FOR MEDICAID) is a public health
insurance program for people with low incomes.
Was [RESPONDENT FIRST NAME] covered by Medicare health insurance at the time
of (her/his) death?
..................................................................................
1339 1. YES
147 5. NO
13 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
2 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); ((N001_ = YES)
AND (piA019_RAge < 65)) OR ((N001_ <> YES) AND ((piA019_RAge > 65) OR
(piA019_RAge = 65)));
SN002M1 WHY NOT MEDICARE COVERED- 1
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
CAI Reference: BN_GovCover.N002_
Why is that?
INTERVIEWER: R WAS AGE ([See Blaise Specifications for fill piA019_RAge]), SO
PROBE WHY R IS (NOT) COVERED BY MEDICARE
..................................................................................
44 1. R is disabled; R is on disability; Spouse on disability; R is
on Social Security disability or SSI
3 2. R has a specific medical problem. (E.g. If R says,'Disabled due
to medical condition,' code it as 02, not 01)
4 3. R has Medicare-NFS
4. R mentions has Part A and Part B of Medicare
5. R mentions has Part A of Medicare; the first half of Medicare
6. R mentions has Part B of Medicare; the second half of Medicare
7. R mentions a Medicare card or the mechanics of using it
8. R receives Medicare through a deceased spouse
9. R mentions his/her age in conjunction with having Medicare; R
has had Medicare since a certain age; R got Medicare 'early'
10. R pays into Medicare, but doesn't use it; R has Medicare, but
chooses not to use it
3 50. R never applied for Medicare or invested in it-NFS
2 51. R didn't work long enough to qualify for Medicare; R didn't
work enough quarters; R's spouse didn't work enough quarters to
qualify
52. R is still working (If R mentions other insurance coverage
through his/her employment, code the appropriate insurance
code only)
3 53. R never qualified for Medicare in his/her employment; R was in
the military/a federal employee/a postal worker etc.; R doesn't
get Social Security or Medicaid
2 54. R used to have Medicare-NFS; R had Medicare, but not now; R
dropped it
1 55. Medicare charges too much; Medicare too expensive for what you
receive
56. R will be on Medicare in the future; R not old enough to
qualify at present; R in the process of getting Medicare
57. R had Medicare through a deceased spouse and R no longer
receives it
58. R's spouse only receives Medicare
59. R is not familiar with Medicare; confusion about eligibility
2 70. R has other medical insurance/coverage-NFS
5 71. R has veteran's coverage or insurance; 'I'm covered by the VA'
1 72. R has federal employee/Postal Service insurance
3 73. R has private insurance; e.g. Cigna, Kaiser, Blue Cross/Blue
Shield
6 74. R is covered by Medicaid
3 75. R's spouse's medical insurance covers R
3 76. R covered under company health plan or health insurance; R
covered under former employer's health plan or health insurance
2 90. R mentions income level/group, home ownership, an economic
factor
1 91. R mentions Social Security; e.g. 'I have Social Security'(Note
that all mentions of SSI or disability go under codes 01 or 02)
2 92. R is not a U.S. citizen; R is an illegal alien; R lives
10 97. Other
6 98. DK (Don’t Know); NA (Not Ascertained)
99. RF (Refused)
1395 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); ((N001_ = YES)
AND (piA019_RAge < 65)) OR ((N001_ <> YES) AND ((piA019_RAge > 65) OR
(piA019_RAge = 65)));
SN002M2 WHY NOT MEDICARE COVERED- 2
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
CAI Reference: BN_GovCover.N002_
Why is that?
INTERVIEWER: R WAS AGE ([See Blaise Specifications for fill piA019_RAge]), SO
PROBE WHY R IS (NOT) COVERED BY MEDICARE
..................................................................................
3 1. R is disabled; R is on disability; Spouse on disability; R is
on Social Security disability or SSI
2. R has a specific medical problem. (E.g. If R says,'Disabled due
to medical condition,' code it as 02, not 01)
3. R has Medicare-NFS
4. R mentions has Part A and Part B of Medicare
5. R mentions has Part A of Medicare; the first half of Medicare
6. R mentions has Part B of Medicare; the second half of Medicare
7. R mentions a Medicare card or the mechanics of using it
8. R receives Medicare through a deceased spouse
9. R mentions his/her age in conjunction with having Medicare; R
has had Medicare since a certain age; R got Medicare 'early'
10. R pays into Medicare, but doesn't use it; R has Medicare, but
chooses not to use it
1 50. R never applied for Medicare or invested in it-NFS
51. R didn't work long enough to qualify for Medicare; R didn't
work enough quarters; R's spouse didn't work enough quarters to
qualify
52. R is still working (If R mentions other insurance coverage
through his/her employment, code the appropriate insurance
code only)
53. R never qualified for Medicare in his/her employment; R was in
the military/a federal employee/a postal worker etc.; R doesn't
get Social Security or Medicaid
54. R used to have Medicare-NFS; R had Medicare, but not now; R
dropped it
55. Medicare charges too much; Medicare too expensive for what you
receive
1 56. R will be on Medicare in the future; R not old enough to
qualify at present; R in the process of getting Medicare
57. R had Medicare through a deceased spouse and R no longer
receives it
58. R's spouse only receives Medicare
59. R is not familiar with Medicare; confusion about eligibility
70. R has other medical insurance/coverage-NFS
71. R has veteran's coverage or insurance; 'I'm covered by the VA'
72. R has federal employee/Postal Service insurance
73. R has private insurance; e.g. Cigna, Kaiser, Blue Cross/Blue
Shield
1 74. R is covered by Medicaid
75. R's spouse's medical insurance covers R
76. R covered under company health plan or health insurance; R
covered under former employer's health plan or health insurance
90. R mentions income level/group, home ownership, an economic
factor
91. R mentions Social Security; e.g. 'I have Social Security'(Note
that all mentions of SSI or disability go under codes 01 or 02)
92. R is not a U.S. citizen; R is an illegal alien; R lives
97. Other
98. DK (Don’t Know); NA (Not Ascertained)
99. RF (Refused)
1495 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); N001_ = YES;
SN004 MEDICARE PART B COVERAGE
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_GovCover.N004_
Part A of Medicare covers most hospital expenses.
Part B covers many doctors' expenses including doctor visits, and the premium
is usually deducted from (her/his) Social Security.
At the time of [RESPONDENT FIRST NAME]'s death, was (she/he) covered by
Medicare Part B?
..................................................................................
1189 1. YES
65 5. NO
83 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
163 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
SN005 MEDICAID COVERAGE SINCE PREV WAVE
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_GovCover.N005_
Was (she/he) covered by health insurance through (Medicaid/STATE NAME FOR
MEDICAID or any other Medicaid program) at any time (between [PREV WAVE IW
MONTH], [PREV WAVE IW YEAR] and when (she/he) died/in the two years before
(her/his) death)?
..................................................................................
376 1. YES
1055 5. NO
68 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
2 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); N005_ = YES;
SN006 CURRENTLY COVERED BY MEDICAID
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_GovCover.N006_
Was (she/he) covered by (Medicaid/STATE NAME FOR MEDICAID) at the time
(she/he) died?
..................................................................................
363 1. YES
11 5. NO
2 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1125 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
SN007 CHAMPUS/CHAMPVA COVERAGE
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_GovCover.N007_
At the time of (her/his) death, was (she/he) covered by TRI-CARE, CHAMPUS,
CHAMP-VA, or any other military health care plan?
DEFINITION: (TRI-CARE is the new name for the military's health insurance
programs. It includes what used to be known as CHAMPUS and CHAMP-VA. CHAMPUS
was a health care program for active or retired military personnel and their
dependents or survivors. CHAMP-VA provided medical care for veterans and their
dependents or survivors of veterans who had a service-connected disability. VA
is not a health insurance program.)
..................................................................................
52 1. YES
1421 5. NO
26 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
2 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); (N001_ <> YES)
AND (N006_ = YES); ((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND
(RVARS.Z145_TypeExit_V <> FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <>
SECREPEATPOST); NOT ((N001_ <> YES) AND (N006_ = YES)); (N001_ = YES) AND
(N006_ = YES); ((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND
(RVARS.Z145_TypeExit_V <> FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <>
SECREPEATPOST); NOT ((N001_ <> YES) AND (N006_ = YES)); NOT ((N001_ = YES) AND
(N006_ = YES));
SN008 BRANCHPNT-MEDICARE/MEDICAID COVERAGE
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_GovCover.N008_
..................................................................................
319 1. R IS COVERED BY MEDICARE OR (MEDICARE AND MEDICAID)
44 2. R IS COVERED BY MEDICAID AND NOT MEDICARE
1136 3. ALL OTHERS
2 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
(piGovCoverN001_ = YES) OR (piGovCoverN006_ = YES);
SN009 MEDICARE/MEDICAID HMO
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_MediCaidCarePlan.N009_
We are interested in how (her/his) (Medicare/Medicare or (Medicaid/STATE NAME
FOR MEDICAID)) health insurance worked for routine care.
Did [RESPONDENT FIRST NAME] receive (her/his) (Medicare /(Medicaid/STATE NAME
FOR MEDICAID)) benefits through an HMO, that is a Health Maintenance
Organization?
DEFINITION: (With an HMO, the cost of the physician visit is typically covered
in full or you pay only a small amount. All of your routine care must be
provided by an HMO physician.)
..................................................................................
210 1. YES
1009 5. NO
163 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
119 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
(piGovCoverN001_ = YES) OR (piGovCoverN006_ = YES); (piGovCoverN001_ = YES) AND
(N009_ = YES);
SN243 HMO NEEDED FOR OTHER BENS
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_MediCaidCarePlan.N243_
Did (she/he) have to join this HMO in order to receive supplemental benefits
from another plan?
..................................................................................
84 1. YES
95 5. NO
28 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1294 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
(piGovCoverN001_ = YES) OR (piGovCoverN006_ = YES); N009_ = YES;
SN010 MEDICARE/MEDICAID HMO- HOW LONG - YRS
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
CAI Reference: BN_MediCaidCarePlan.N010_
At the time of (her/his) death, about how long had (she/he) been receiving
(her/his) (Medicare /(Medicaid/STATE NAME FOR MEDICAID)) benefits through this
HMO?
YEARS:
..................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
157 0 25 9.63 7.48 1298
-----------------------------------------------------------------
46 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
(piGovCoverN001_ = YES) OR (piGovCoverN006_ = YES); N009_ = YES; (N010_ = 0) OR
N010_ = EMPTY;
SN011 MEDICARE/MEDICAID HMO- HOW LONG - MOS
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
CAI Reference: BN_MediCaidCarePlan.N011_
At the time of (her/his) death, about how long had (she/he) been receiving
(her/his) (Medicare /(Medicaid/STATE NAME FOR MEDICAID)) benefits through this
HMO?
MONTHS:
..................................................................................
7 3-18. Actual Value
45 98. DK (Don't Know); NA (Not Ascertained)
1 99. RF (Refused)
1448 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
(piGovCoverN001_ = YES) OR (piGovCoverN006_ = YES); N009_ <> YES;
SN012 MEDICARE/MEDICAID HMO-HAS LIST OF DRS
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_MediCaidCarePlan.N012_HMOListDrs
Did this health insurance plan have a list or book of doctors that one is
encouraged or required to use?
..................................................................................
88 1. YES
952 5. NO
132 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
329 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
(piGovCoverN001_ = YES) OR (piGovCoverN006_ = YES); (N012_HMOListDrs = YES) OR
(N009_ = YES);
SN013 MEDICARE/MEDICAID HMO-PAY DR NOT ON LIST
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_MediCaidCarePlan.N013_HMOPayMore
Did (this health insurance plan/the HMO) plan pay any of the costs of routine
care if one saw a doctor who was not (on this list/in the HMO)?
..................................................................................
71 1. YES
58 2. YES, WITH A REFERRAL
125 5. NO
43 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
1203 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
(piGovCoverN001_ = YES) OR (piGovCoverN006_ = YES); N009_ = YES;
SN014 MEDICARE/MEDICAID HMO-AMT PAY
Section: N Level: Respondent Type: Numeric Width: 3 Decimals: 0
CAI Reference: BN_MediCaidCarePlan.N014_
Not including co-pays or deductions from (her/his) Social Security, how much
did (she/he), (herself/himself), pay in premiums for this plan?
INTERVIEWER: DO NOT PROBE DK/RF
AMOUNT:
..................................................................................
137 0-982. Actual Value
71 998. DK (Don't Know); NA (Not Ascertained)
2 999. RF (Refused)
1291 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
(piGovCoverN001_ = YES) OR (piGovCoverN006_ = YES); N009_ = YES; NOT (((N014_ =
DONTKNOW) OR (N014_ = REFUSAL)) AND N015_ = EMPTY); ((N014_ > 0) AND (N014_ <>
REFUSAL)) AND (N014_ <> DONTKNOW);
SN018 MEDICARE/MEDICAID HMO-AMT PAY - PER
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_MediCaidCarePlan.N018_
Not including co-pays or deductions from (her/his) Social Security, how much
did (she/he), (herself/himself), pay for this plan?
PER:
..................................................................................
46 1. MONTH
3 2. QUARTER (EVERY 3 MONTHS)
3. SEMI-ANNUALLY (EVERY 6 MONTHS/TWICE A YEAR)
2 4. YEAR
7. OTHER (SPECIFY)
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1450 Blank. INAP (Inapplicable)
SN015 MEDICARE/MEDICAID HMO-AMT PAY - MIN
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
CAI Reference: BN_MediCaidCarePlan.N015_
N015_ - N017_ Unfolding Sequence
Did it amount to less than $___, more than $___per month, or what?
BREAKPOINTS: 15, 30, 60, 120
PROCEDURE(S): UNFM_2Up1Down
ENTRY POINT(S): 30
..................................................................................
40 0. Value of Breakpoint
7 16. Value of Breakpoint
4 30. Value of Breakpoint
12 31. Value of Breakpoint
1 60. Value of Breakpoint
9 61. Value of Breakpoint
1428 Blank. INAP (Inapplicable)
SN016 MEDICARE/MEDICAID HMO-AMT PAY - MAX
Section: N Level: Respondent Type: Numeric Width: 4 Decimals: 0
CAI Reference: BN_MediCaidCarePlan.N016_
..................................................................................
1 14. Value of Breakpoint
8 29. Value of Breakpoint
4 30. Value of Breakpoint
8 59. Value of Breakpoint
1 60. Value of Breakpoint
9 119. Value of Breakpoint
42 1200. Value of Breakpoint
1428 Blank. INAP (Inapplicable)
SN017 MEDICARE/MEDICAID HMO-AMT PAY - RESULT
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
CAI Reference: BN_MediCaidCarePlan.N017_
..................................................................................
97. Data Not Available
41 98. DK (Don't Know); NA (Not Ascertained)
2 99. RF (Refused)
1458 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
(piGovCoverN001_ = YES) OR (piGovCoverN006_ = YES); N009_ = YES;
SN020 LEFT MEDICARE HMO LAST TWO YRS
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_MediCaidCarePlan.N020_
At any time (since [PREV WAVE IW MONTH], [PREV WAVE IW YEAR]/since [PREV WAVE
IW YEAR]/in the last two years before (her/his) death), had (she/he) left an
HMO that delivered Medicare services?
..................................................................................
8 1. YES
195 5. NO
7 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1291 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
(piGovCoverN001_ = YES) OR (piGovCoverN006_ = YES); N009_ = YES; N020_ = YES;
SN021M1 WHY LEAVE MEDICARE HMO- 1
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
CAI Reference: BN_MediCaidCarePlan.N021M
Why did (she/he) leave that HMO?
INTERVIEWER: CHOOSE ALL THAT APPLY
..................................................................................
1. OWN PHYSICIAN LEFT PLAN
2 2. HMO DIDN'T PROVIDE NEEDED SERVICES
3. HMO COSTS INCREASED; found cheaper plan
2 4. HMO ENCOURAGED ME TO LEAVE
2 5. Better coverage with new plan
1 6. Too far away from HMO; R moved; HMO not in region
7. OTHER (SPECIFY)
10. Switched to Medicare
11. R retired, left, or changed jobs
12. Less convenient
13. Lost coverage NFS
1 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1493 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
(piGovCoverN001_ = YES) OR (piGovCoverN006_ = YES); N009_ = YES; N020_ = YES;
SN021M2 WHY LEAVE MEDICARE HMO- 2
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
CAI Reference: BN_MediCaidCarePlan.N021M
Why did (she/he) leave that HMO?
INTERVIEWER: CHOOSE ALL THAT APPLY
..................................................................................
1. OWN PHYSICIAN LEFT PLAN
2. HMO DIDN'T PROVIDE NEEDED SERVICES
3. HMO COSTS INCREASED; found cheaper plan
4. HMO ENCOURAGED ME TO LEAVE
5. Better coverage with new plan
6. Too far away from HMO; R moved; HMO not in region
7. OTHER (SPECIFY)
10. Switched to Medicare
11. R retired, left, or changed jobs
12. Less convenient
13. Lost coverage NFS
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1501 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
SN023 NUM PRIVATE HEALTH INS PLANS
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
CAI Reference: BN.N023_
Now, we'd like to ask about the other types of health insurance plans (she/he)
might have, such as insurance through an employer or a business, coverage for
retirees, or health insurance you buy for yourself, including any (Medigap or)
other supplemental coverage.
Do NOT include long-term care insurance. (Other than (her/his) Medicare HMO
you've just told me about, how/, or anything that you have just told me about.
How) many other such plans did (she/he) have at the time of (her/his) death?
INTERVIEWER: ENTER ZERO FOR NONE
NUMBER OF PLANS:
..................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
1442 0 11 0.57 0.61 2
-----------------------------------------------------------------
57 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
(piGovCoverN001_ = YES) AND (CNT = 1);
SN025_1 WHICH IS PRIMARY PLAN-PRIVATE/MEDICARE-1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N025_
Which was (her/his) primary plan, Medicare or ([NAME OF INSURANCE PLAN]) ?
..................................................................................
621 1. MEDICARE
67 2. NAME OF PLAN (W22_1/N024_1)
7 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
806 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N025_ = MEDICARE;
SN026_1 MEDIGAP PLAN LETTER- 1
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
CAI Reference: BN_PlanDetails.puN026_
Many Medicare Supplemental or Medigap Plans are referred to by a Plan Letter.
Do you know the Plan Letter for (her/his) plan?
INTERVIEWER: PROBE: What is it?
IF NO PLAN LETTER ENTER 'Z'
ENTER LETTER (A-J):
..................................................................................
36 1. A
7 2. B
4 3. C
2 4. D
4 5. E
9 6. F
1 7. G
8. H
9. I
2 10. J
168 95. Z
1 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1267 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N025_ = MEDICARE;
SN027_1 MEDIGAP HELP WITH COPAYMTS/DEDUCTIBLES-1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N027_
Tell me how that plan worked with Medicare. Did it provide help with...
copayments and deductibles for hospitalizations?
..................................................................................
558 1. YES
27 5. NO
36 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
880 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N025_ = MEDICARE;
SN028_1 MEDIGAP-HELP WITH SKILLED NURSING CARE-1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N028_
(Did it provide help with...) paying for skilled nursing care?
..................................................................................
369 1. YES
149 5. NO
103 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
880 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N025_ = MEDICARE;
SN029_1 MEDIGAP-HELP PAY HOME HEALTH/HOSPICE- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N029_
(Did it provide help with...) paying for home health or hospice care?
..................................................................................
335 1. YES
171 5. NO
114 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
880 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N025_ = MEDICARE;
SN030_1 MEDIGAP-HELP PAY DR VISITS- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N030_
(Did it provide help with...) paying for doctor visits?
..................................................................................
567 1. YES
31 5. NO
23 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
880 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N025_ = MEDICARE;
SN031_1 MEDIGAP-HELP PAY FOR OUTPATIENT CARE- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N031_
(Did it provide help with...) paying for outpatient care?
..................................................................................
530 1. YES
41 5. NO
50 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
880 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
SN032_1 PRIVATE PLAN 1-3 HELP PAY REGULAR RX- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N032_
(Did it provide help with...) paying for regular prescription drugs?
..................................................................................
500 1. YES
254 5. NO
29 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
718 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
((piSecJWORKSTATUSJ020_WorkforPay = YES) AND ((ACTIVELANGUAGE <> EXTENG) AND
(ACTIVELANGUAGE <> EXTSPN))) OR ((RVARS.Z123_CurWorkng_V = YES) AND
((ACTIVELANGUAGE = EXTENG) OR (ACTIVELANGUAGE = EXTSPN)));
SN033_1 OBTAIN HI THRU CURRNT EMP/OWN BUSINESS-1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N033_HowObtIns
Did (she/he) obtain this health insurance through (her/his) own business or an
employer?
ASK 'WHOSE EMPLOYER?' IF NOT CLEAR
..................................................................................
49 1. YES
41 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1411 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N033_HowObtIns <> YES; N034_ <> YES; (piRespondents1X065ACouplenss = MARRIED)
OR (piRespondents1X065ACouplenss = PARTNERED_VOL);
SN035_1 OBTAIN INS THRU HWP CURRENT EMPLOYER- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N035_
Did (she/he) obtain this health insurance through ( your/his/her) current
employer?
..................................................................................
65 1. YES
308 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1127 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N033_HowObtIns <> YES; N034_ <> YES; (piRespondents1X065ACouplenss = MARRIED)
OR (piRespondents1X065ACouplenss = PARTNERED_VOL); N035_ <> YES;
SN036_1 OBTAIN INS THRU HWP FORMER EMPLOYER- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N036_
Did (she/he) obtain this health insurance through ( your/his/her) former
employer?
..................................................................................
83 1. YES
225 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1192 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N033_HowObtIns <> YES; N034_ <> YES; (N035_ <> YES) AND (N036_ <> YES);
SN037_1 WHERE PURCHASE PRIVATE PLAN INSURANCE- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N037_
Did (she/he) purchase this plan directly from an insurance company, through
(her/his) (or/or (her/his)) (husband/wife/partner)'s/or your) union, through a
group such as AARP, a church, or other organization, or what?
..................................................................................
251 1. INSURANCE COMPANY
47 2. R`S UNION
11 3. SPOUSE`S UNION
79 4. GROUP
20 5. Former or deceased spouse's employer/union
99 6. Includes federal, state or military programs
49 7. OTHER (SPECIFY)
30 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
915 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
SN039_1 PAY ALL/SOME/NONE PRIV PLAN HI COSTS-1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N039_PayHlthInsCost
Including any help from [his/her] family, did [he/she] (or [you/[his/her]
[husband/wife/partner]]) pay all of the costs, some of the costs, or none of
the costs of the premium for this health insurance coverage?
..................................................................................
467 1. ALL
125 2. SOME
159 3. NONE
32 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
718 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N039_PayHlthInsCost <> NONE;
SN040_1 PRIV PLAN HI PAY PER/MONTH- AMT- 1
Section: N Level: Respondent Type: Numeric Width: 3 Decimals: 0
CAI Reference: BN_PlanDetails.N040_
How much did [he/she] (or [you/[his/her] [husband/wife/partner]]) pay every
month in premiums for this plan?
(INTERVIEWER: COUNT ANY PAYROLL DEDUCTIONS, BUT DO NOT INCLUDE ANY AMOUNT PAID
BY THE EMPLOYER)
DO NOT PROBE DK/RF
AMOUNT PER MONTH:
..................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
356 0 600 144.40 98.62 877
-----------------------------------------------------------------
264 998. DK (Don't Know); NA (Not Ascertained)
4 999. RF (Refused)
SN041_1 PRIV PLAN HI PAY PER/MONTH- MIN- 1
Section: N Level: Respondent Type: Numeric Width: 3 Decimals: 0
CAI Reference: BN_PlanDetails.N041_
N041_ - N043_ Unfolding Sequence
Did it amount to less than $____ per month, more than $____ per month, or
what?
BREAKPOINTS: 25, 50, 100, 150
PROCEDURE(S): UNFM_2UP1DOWN
ENTRY POINT(S): 50
..................................................................................
122 0. Value of Breakpoint
4 25. Value of Breakpoint
13 26. Value of Breakpoint
10 50. Value of Breakpoint
37 51. Value of Breakpoint
11 100. Value of Breakpoint
19 101. Value of Breakpoint
12 150. Value of Breakpoint
40 151. Value of Breakpoint
1233 Blank. INAP (Inapplicable)
SN042_1 PRIV PLAN HI PAY PER/MONTH- MAX- 1
Section: N Level: Respondent Type: Numeric Width: 4 Decimals: 0
CAI Reference: BN_PlanDetails.N042_
..................................................................................
4 25. Value of Breakpoint
15 49. Value of Breakpoint
10 50. Value of Breakpoint
25 99. Value of Breakpoint
11 100. Value of Breakpoint
15 149. Value of Breakpoint
12 150. Value of Breakpoint
176 1500. Value of Breakpoint
1233 Blank. INAP (Inapplicable)
SN043_1 PRIV PLAN HI PAY PER/MONTH- RESULT- 1
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
CAI Reference: BN_PlanDetails.N043_
..................................................................................
97. Data Not Available
134 98. DK (Don't Know); NA (Not Ascertained)
4 99. RF (Refused)
1363 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N039_PayHlthInsCost <> NONE; ((piRespondents1X065ACouplenss = MARRIED) OR
(piRespondents1X065ACouplenss = PARTNERED_VOL)) AND ((N035_ = YES) OR (N036_ =
YES)); ((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N039_PayHlthInsCost <> NONE; NOT (((piRespondents1X065ACouplenss = MARRIED) OR
(piRespondents1X065ACouplenss = PARTNERED_VOL)) AND ((N035_ = YES) OR (N036_ =
YES))); N037_ = OTH_SPECIFY; ((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND
(RVARS.Z145_TypeExit_V <> FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <>
SECREPEATPOST); CNT <= N023_; N039_PayHlthInsCost <> NONE; NOT
(((piRespondents1X065ACouplenss = MARRIED) OR (piRespondents1X065ACouplenss =
PARTNERED_VOL)) AND ((N035_ = YES) OR (N036_ = YES))); NOT (N037_ =
OTH_SPECIFY);
SN046_1 BRANCHPNT-SOURCE OF HEALTH INSURANCE- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N046_
..................................................................................
102 1. INS THRU SPOUSE AND R IS MARRIED, DIVORCED, OR SEPARATED
119 2. INS THRU SOMEPLACE ELSE
403 3. INS THRU CURRENT/FORMER EMPLOYER OR UNION
877 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N039_PayHlthInsCost <> NONE; piGovCoverN001_ = YES; ((RVARS.Z145_TypeExit_V <>
NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <> FIRSTREPEATPOST)) AND
(RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_; N039_PayHlthInsCost <>
NONE; NOT (piGovCoverN001_ = YES);
SN047_1 BRANCHPNT-COVERD BY MEDICARE/ALL OTH- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N047_
..................................................................................
555 1. R IS COVERED BY MEDICARE
69 2. ALL OTHERS
877 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
SN052_1 PRIVATE PLAN INSURANCE AN HMO- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N052_Plan1HMO
Was (her/his) plan an HMO, that is, a Health Maintenance Organization?
DEFINITION: (With an HMO, the cost of the physician visit is typically covered
in full or you pay only a small amount. All of your routine care must be
provided by an HMO physician.)
..................................................................................
104 1. YES
626 5. NO
53 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
718 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
SN053_1 NUMBER YEARS IN PLAN- 1
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
CAI Reference: BN_PlanDetails.N053_NumYrPlan
How long had (she/he) been with this plan?
YEARS:
..................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
617 1 50 18.83 13.40 726
-----------------------------------------------------------------
158 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
(N053_NumYrPlan = 0) OR N053_NumYrPlan = EMPTY;
SN054_1 NUMBER MONTHS IN PLAN- 1
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
CAI Reference: BN_PlanDetails.N054_NumMoPlan
How long has (she/he) been with this plan?
MONTHS:
..................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
10 1 12 4.70 3.92 1335
-----------------------------------------------------------------
156 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
SN055_1 PRIV PLAN HI- HAS LIST OF DRS- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N055_ListDoctor
Did this health insurance plan have a list or book of doctors that (she/he)
was encouraged or required to use?
..................................................................................
170 1. YES
548 5. NO
65 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
718 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N055_ListDoctor = YES;
SN056_1 PLAN PAY FOR DOCTORS NOT ON LIST- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N056_DocNotList
Did (this health insurance plan/the HMO) pay any of the costs for routine care
if (she/he) saw a doctor who was not (on this list/in the HMO)?
..................................................................................
61 1. YES
60 2. YES, WITH A REFERRAL
33 5. NO
16 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1331 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
(piA019_RAge < 65) AND (N033_HowObtIns = YES); ((RVARS.Z145_TypeExit_V <>
NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <> FIRSTREPEATPOST)) AND
(RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_; NOT ((piA019_RAge < 65)
AND (N033_HowObtIns = YES)); (piA019_RAge < 65) AND (N034_ = YES);
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
NOT ((piA019_RAge < 65) AND (N033_HowObtIns = YES)); NOT ((piA019_RAge < 65)
AND (N034_ = YES));
SN058_1 PRIV HI FROM CUR/FOR EMP AND LESS 65-1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N058_
..................................................................................
23 1. R HAS HEALTH INS FROM CURRENT EMPLOYER AND R IS LESS THAN 65
2. R HAS HEALTH INS FROM FORMER EMPLOYER AND R IS LESS THAN 65
760 3. ALL OTHERS
718 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
SN066_1 LIMITS ON HI DUE TO PREEXISTING COND- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N066_LimitHlthIns
Were there any limits or restrictions on this health insurance plan due to a
preexisting condition?
..................................................................................
9 1. YES
711 5. NO
62 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
718 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
SN032_2 PRIVATE PLAN 1-3 HELP PAY REGULAR RX- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N032_
(Did it provide help with...) paying for regular prescription drugs?
..................................................................................
11 1. YES
8 5. NO
3 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1479 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
((piSecJWORKSTATUSJ020_WorkforPay = YES) AND ((ACTIVELANGUAGE <> EXTENG) AND
(ACTIVELANGUAGE <> EXTSPN))) OR ((RVARS.Z123_CurWorkng_V = YES) AND
((ACTIVELANGUAGE = EXTENG) OR (ACTIVELANGUAGE = EXTSPN)));
SN033_2 OBTAIN HI THRU CURRNT EMP/OWN BUSINESS-2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N033_HowObtIns
Did (she/he) obtain this health insurance through (her/his) own business or an
employer?
ASK 'WHOSE EMPLOYER?' IF NOT CLEAR
..................................................................................
1 1. YES
5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1499 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N033_HowObtIns <> YES; N034_ <> YES; (piRespondents1X065ACouplenss = MARRIED)
OR (piRespondents1X065ACouplenss = PARTNERED_VOL);
SN035_2 OBTAIN INS THRU HWP CURRENT EMPLOYER- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N035_
Did (she/he) obtain this health insurance through ( your/his/her) current
employer?
..................................................................................
2 1. YES
8 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1490 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N033_HowObtIns <> YES; N034_ <> YES; (piRespondents1X065ACouplenss = MARRIED)
OR (piRespondents1X065ACouplenss = PARTNERED_VOL); N035_ <> YES;
SN036_2 OBTAIN INS THRU HWP FORMER EMPLOYER- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N036_
Did (she/he) obtain this health insurance through ( your/his/her) former
employer?
..................................................................................
2 1. YES
5 5. NO
2 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1492 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N033_HowObtIns <> YES; N034_ <> YES; (N035_ <> YES) AND (N036_ <> YES);
SN037_2 WHERE PURCHASE PRIVATE PLAN INSURANCE- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N037_
Did (she/he) purchase this plan directly from an insurance company, through
(her/his) (or/or (her/his)) (husband/wife/partner)'s/or your) union, through a
group such as AARP, a church, or other organization, or what?
..................................................................................
3 1. INSURANCE COMPANY
2 2. R`S UNION
1 3. SPOUSE`S UNION
5 4. GROUP
5. Former or deceased spouse's employer/union
3 6. Includes federal, state or military programs
1 7. OTHER (SPECIFY)
2 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1484 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
SN039_2 PAY ALL/SOME/NONE PRIV PLAN HI COSTS-2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N039_PayHlthInsCost
Including any help from [his/her] family, did [he/she] (or [you/[his/her]
[husband/wife/partner]]) pay all of the costs, some of the costs, or none of
the costs of the premium for this health insurance coverage?
..................................................................................
12 1. ALL
2 2. SOME
6 3. NONE
2 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1479 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N039_PayHlthInsCost <> NONE;
SN040_2 PRIV PLAN HI PAY PER/MONTH- AMT- 2
Section: N Level: Respondent Type: Numeric Width: 3 Decimals: 0
CAI Reference: BN_PlanDetails.N040_
How much did [he/she] (or [you/[his/her] [husband/wife/partner]]) pay every
month in premiums for this plan?
(INTERVIEWER: COUNT ANY PAYROLL DEDUCTIONS, BUT DO NOT INCLUDE ANY AMOUNT PAID
BY THE EMPLOYER)
DO NOT PROBE DK/RF
AMOUNT PER MONTH:
..................................................................................
4 13-178. Actual Value
12 998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1485 Blank. INAP (Inapplicable)
SN041_2 PRIV PLAN HI PAY PER/MONTH- MIN- 2
Section: N Level: Respondent Type: Numeric Width: 3 Decimals: 0
CAI Reference: BN_PlanDetails.N041_
N041_ - N043_ Unfolding Sequence
Did it amount to less than $____ per month, more than $____ per month, or
what?
BREAKPOINTS: 25, 50, 100, 150
PROCEDURE(S): UNFM_2UP1DOWN
ENTRY POINT(S): 50
..................................................................................
9 0. Value of Breakpoint
1 26. Value of Breakpoint
1 101. Value of Breakpoint
1 150. Value of Breakpoint
1489 Blank. INAP (Inapplicable)
SN042_2 PRIV PLAN HI PAY PER/MONTH- MAX- 2
Section: N Level: Respondent Type: Numeric Width: 4 Decimals: 0
CAI Reference: BN_PlanDetails.N042_
..................................................................................
1 49. Value of Breakpoint
1 150. Value of Breakpoint
10 1500. Value of Breakpoint
1489 Blank. INAP (Inapplicable)
SN043_2 PRIV PLAN HI PAY PER/MONTH- RESULT- 2
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
CAI Reference: BN_PlanDetails.N043_
..................................................................................
97. Data Not Available
10 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1491 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N039_PayHlthInsCost <> NONE; ((piRespondents1X065ACouplenss = MARRIED) OR
(piRespondents1X065ACouplenss = PARTNERED_VOL)) AND ((N035_ = YES) OR (N036_ =
YES)); ((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N039_PayHlthInsCost <> NONE; NOT (((piRespondents1X065ACouplenss = MARRIED) OR
(piRespondents1X065ACouplenss = PARTNERED_VOL)) AND ((N035_ = YES) OR (N036_ =
YES))); N037_ = OTH_SPECIFY; ((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND
(RVARS.Z145_TypeExit_V <> FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <>
SECREPEATPOST); CNT <= N023_; N039_PayHlthInsCost <> NONE; NOT
(((piRespondents1X065ACouplenss = MARRIED) OR (piRespondents1X065ACouplenss =
PARTNERED_VOL)) AND ((N035_ = YES) OR (N036_ = YES))); NOT (N037_ =
OTH_SPECIFY);
SN046_2 BRANCHPNT-SOURCE OF HEALTH INSURANCE- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N046_
..................................................................................
2 1. INS THRU SPOUSE AND R IS MARRIED, DIVORCED, OR SEPARATED
2 2. INS THRU SOMEPLACE ELSE
12 3. INS THRU CURRENT/FORMER EMPLOYER OR UNION
1485 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N039_PayHlthInsCost <> NONE; piGovCoverN001_ = YES; ((RVARS.Z145_TypeExit_V <>
NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <> FIRSTREPEATPOST)) AND
(RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_; N039_PayHlthInsCost <>
NONE; NOT (piGovCoverN001_ = YES);
SN047_2 BRANCHPNT-COVERD BY MEDICARE/ALL OTH- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N047_
..................................................................................
15 1. R IS COVERED BY MEDICARE
1 2. ALL OTHERS
1485 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
SN052_2 PRIVATE PLAN INSURANCE AN HMO- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N052_Plan1HMO
Was (her/his) plan an HMO, that is, a Health Maintenance Organization?
DEFINITION: (With an HMO, the cost of the physician visit is typically covered
in full or you pay only a small amount. All of your routine care must be
provided by an HMO physician.)
..................................................................................
3 1. YES
17 5. NO
2 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1479 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
SN053_2 NUMBER YEARS IN PLAN- 2
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
CAI Reference: BN_PlanDetails.N053_NumYrPlan
How long had (she/he) been with this plan?
YEARS:
..................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
18 3 50 24.11 12.60 1479
-----------------------------------------------------------------
4 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
(N053_NumYrPlan = 0) OR N053_NumYrPlan = EMPTY;
SN054_2 NUMBER MONTHS IN PLAN- 2
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
CAI Reference: BN_PlanDetails.N054_NumMoPlan
How long has (she/he) been with this plan?
MONTHS:
..................................................................................
4 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1497 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
SN055_2 PRIV PLAN HI- HAS LIST OF DRS- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N055_ListDoctor
Did this health insurance plan have a list or book of doctors that (she/he)
was encouraged or required to use?
..................................................................................
3 1. YES
16 5. NO
3 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1479 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N055_ListDoctor = YES;
SN056_2 PLAN PAY FOR DOCTORS NOT ON LIST- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N056_DocNotList
Did (this health insurance plan/the HMO) pay any of the costs for routine care
if (she/he) saw a doctor who was not (on this list/in the HMO)?
..................................................................................
2 1. YES
2. YES, WITH A REFERRAL
1 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1498 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
(piA019_RAge < 65) AND (N033_HowObtIns = YES); ((RVARS.Z145_TypeExit_V <>
NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <> FIRSTREPEATPOST)) AND
(RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_; NOT ((piA019_RAge < 65)
AND (N033_HowObtIns = YES)); (piA019_RAge < 65) AND (N034_ = YES);
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
NOT ((piA019_RAge < 65) AND (N033_HowObtIns = YES)); NOT ((piA019_RAge < 65)
AND (N034_ = YES));
SN058_2 PRIV HI FROM CUR/FOR EMP AND LESS 65- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N058_
..................................................................................
1 1. R HAS HEALTH INS FROM CURRENT EMPLOYER AND R IS LESS THAN 65
2. R HAS HEALTH INS FROM FORMER EMPLOYER AND R IS LESS THAN 65
21 3. ALL OTHERS
1479 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
SN066_2 LIMITS ON HI DUE TO PREEXISTING COND- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N066_LimitHlthIns
Were there any limits or restrictions on this health insurance plan due to a
preexisting condition?
..................................................................................
1. YES
18 5. NO
4 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1479 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
SN032_3 PRIVATE PLAN 1-3 HELP PAY REGULAR RX- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N032_
(Did it provide help with...) paying for regular prescription drugs?
..................................................................................
1. YES
1 5. NO
3 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1497 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
((piSecJWORKSTATUSJ020_WorkforPay = YES) AND ((ACTIVELANGUAGE <> EXTENG) AND
(ACTIVELANGUAGE <> EXTSPN))) OR ((RVARS.Z123_CurWorkng_V = YES) AND
((ACTIVELANGUAGE = EXTENG) OR (ACTIVELANGUAGE = EXTSPN)));
SN033_3 OBTAIN HI THRU CURRNT EMP/OWN BUSINESS-3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N033_HowObtIns
Did (she/he) obtain this health insurance through (her/his) own business or an
employer?
ASK 'WHOSE EMPLOYER?' IF NOT CLEAR
..................................................................................
1 1. YES
5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1499 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N033_HowObtIns <> YES; N034_ <> YES; (piRespondents1X065ACouplenss = MARRIED)
OR (piRespondents1X065ACouplenss = PARTNERED_VOL);
SN035_3 OBTAIN INS THRU HWP CURRENT EMPLOYER- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N035_
Did (she/he) obtain this health insurance through ( your/his/her) current
employer?
..................................................................................
1. YES
1 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1499 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N033_HowObtIns <> YES; N034_ <> YES; (piRespondents1X065ACouplenss = MARRIED)
OR (piRespondents1X065ACouplenss = PARTNERED_VOL); N035_ <> YES;
SN036_3 OBTAIN INS THRU HWP FORMER EMPLOYER- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N036_
Did (she/he) obtain this health insurance through ( your/his/her) former
employer?
..................................................................................
1. YES
1 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1499 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N033_HowObtIns <> YES; N034_ <> YES; (N035_ <> YES) AND (N036_ <> YES);
SN037_3 WHERE PURCHASE PRIVATE PLAN INSURANCE- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N037_
Did (she/he) purchase this plan directly from an insurance company, through
(her/his) (or/or (her/his)) (husband/wife/partner)'s/or your) union, through a
group such as AARP, a church, or other organization, or what?
..................................................................................
1. INSURANCE COMPANY
2. R`S UNION
3. SPOUSE`S UNION
1 4. GROUP
5. Former or deceased spouse's employer/union
6. Includes federal, state or military programs
7. OTHER (SPECIFY)
2 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1498 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
SN039_3 PAY ALL/SOME/NONE PRIV PLAN HI COSTS-3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N039_PayHlthInsCost
Including any help from [his/her] family, did [he/she] (or [you/[his/her]
[husband/wife/partner]]) pay all of the costs, some of the costs, or none of
the costs of the premium for this health insurance coverage?
..................................................................................
1 1. ALL
1 2. SOME
3. NONE
2 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1497 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N039_PayHlthInsCost <> NONE;
SN040_3 PRIV PLAN HI PAY PER/MONTH- AMT- 3
Section: N Level: Respondent Type: Numeric Width: 3 Decimals: 0
CAI Reference: BN_PlanDetails.N040_
How much did [he/she] (or [you/[his/her] [husband/wife/partner]]) pay every
month in premiums for this plan?
(INTERVIEWER: COUNT ANY PAYROLL DEDUCTIONS, BUT DO NOT INCLUDE ANY AMOUNT PAID
BY THE EMPLOYER)
DO NOT PROBE DK/RF
AMOUNT PER MONTH:
..................................................................................
4 998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1497 Blank. INAP (Inapplicable)
SN041_3 PRIV PLAN HI PAY PER/MONTH- MIN- 3
Section: N Level: Respondent Type: Numeric Width: 3 Decimals: 0
CAI Reference: BN_PlanDetails.N041_
N041_ - N043_ Unfolding Sequence
Did it amount to less than $____ per month, more than $____ per month, or
what?
BREAKPOINTS: 25, 50, 100, 150
PROCEDURE(S): UNFM_2UP1DOWN
ENTRY POINT(S): 50
..................................................................................
4 0. Value of Breakpoint
1497 Blank. INAP (Inapplicable)
SN042_3 PRIV PLAN HI PAY PER/MONTH- MAX- 3
Section: N Level: Respondent Type: Numeric Width: 4 Decimals: 0
CAI Reference: BN_PlanDetails.N042_
..................................................................................
4 1500. Value of Breakpoint
1497 Blank. INAP (Inapplicable)
SN043_3 PRIV PLAN HI PAY PER/MONTH- RESULT- 3
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
CAI Reference: BN_PlanDetails.N043_
..................................................................................
97. Data Not Available
4 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1497 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N039_PayHlthInsCost <> NONE; ((piRespondents1X065ACouplenss = MARRIED) OR
(piRespondents1X065ACouplenss = PARTNERED_VOL)) AND ((N035_ = YES) OR (N036_ =
YES)); ((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N039_PayHlthInsCost <> NONE; NOT (((piRespondents1X065ACouplenss = MARRIED) OR
(piRespondents1X065ACouplenss = PARTNERED_VOL)) AND ((N035_ = YES) OR (N036_ =
YES))); N037_ = OTH_SPECIFY; ((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND
(RVARS.Z145_TypeExit_V <> FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <>
SECREPEATPOST); CNT <= N023_; N039_PayHlthInsCost <> NONE; NOT
(((piRespondents1X065ACouplenss = MARRIED) OR (piRespondents1X065ACouplenss =
PARTNERED_VOL)) AND ((N035_ = YES) OR (N036_ = YES))); NOT (N037_ =
OTH_SPECIFY);
SN046_3 BRANCHPNT-SOURCE OF HEALTH INSURANCE- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N046_
..................................................................................
1. INS THRU SPOUSE AND R IS MARRIED, DIVORCED, OR SEPARATED
1 2. INS THRU SOMEPLACE ELSE
3 3. INS THRU CURRENT/FORMER EMPLOYER OR UNION
1497 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N039_PayHlthInsCost <> NONE; piGovCoverN001_ = YES; ((RVARS.Z145_TypeExit_V <>
NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <> FIRSTREPEATPOST)) AND
(RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_; N039_PayHlthInsCost <>
NONE; NOT (piGovCoverN001_ = YES);
SN047_3 BRANCHPNT-COVERD BY MEDICARE/ALL OTH- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N047_
..................................................................................
3 1. R IS COVERED BY MEDICARE
1 2. ALL OTHERS
1497 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
SN052_3 PRIVATE PLAN INSURANCE AN HMO- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N052_Plan1HMO
Was (her/his) plan an HMO, that is, a Health Maintenance Organization?
DEFINITION: (With an HMO, the cost of the physician visit is typically covered
in full or you pay only a small amount. All of your routine care must be
provided by an HMO physician.)
..................................................................................
1 1. YES
1 5. NO
2 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1497 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
SN053_3 NUMBER YEARS IN PLAN- 3
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
CAI Reference: BN_PlanDetails.N053_NumYrPlan
How long had (she/he) been with this plan?
YEARS:
..................................................................................
1 3. Actual Value
3 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1497 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
(N053_NumYrPlan = 0) OR N053_NumYrPlan = EMPTY;
SN054_3 NUMBER MONTHS IN PLAN- 3
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
CAI Reference: BN_PlanDetails.N054_NumMoPlan
How long has (she/he) been with this plan?
MONTHS:
..................................................................................
3 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1498 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
SN055_3 PRIV PLAN HI- HAS LIST OF DRS- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N055_ListDoctor
Did this health insurance plan have a list or book of doctors that (she/he)
was encouraged or required to use?
..................................................................................
1. YES
1 5. NO
3 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1497 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
N055_ListDoctor = YES;
SN056_3 PLAN PAY FOR DOCTORS NOT ON LIST- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N056_DocNotList
Did (this health insurance plan/the HMO) pay any of the costs for routine care
if (she/he) saw a doctor who was not (on this list/in the HMO)?
..................................................................................
1. YES
2. YES, WITH A REFERRAL
5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1501 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
(piA019_RAge < 65) AND (N033_HowObtIns = YES); ((RVARS.Z145_TypeExit_V <>
NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <> FIRSTREPEATPOST)) AND
(RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_; NOT ((piA019_RAge < 65)
AND (N033_HowObtIns = YES)); (piA019_RAge < 65) AND (N034_ = YES);
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
NOT ((piA019_RAge < 65) AND (N033_HowObtIns = YES)); NOT ((piA019_RAge < 65)
AND (N034_ = YES));
SN058_3 PRIV HI FROM CUR/FOR EMP AND LESS 65- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N058_
..................................................................................
1 1. R HAS HEALTH INS FROM CURRENT EMPLOYER AND R IS LESS THAN 65
2. R HAS HEALTH INS FROM FORMER EMPLOYER AND R IS LESS THAN 65
3 3. ALL OTHERS
1497 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); CNT <= N023_;
SN066_3 LIMITS ON HI DUE TO PREEXISTING COND- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_PlanDetails.N066_LimitHlthIns
Were there any limits or restrictions on this health insurance plan due to a
preexisting condition?
..................................................................................
1. YES
1 5. NO
3 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1497 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
SN067 DENTAL COVERAGE
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_DentalPlans.N067_
Did (she/he) have any insurance that covers dental bills?
..................................................................................
262 1. YES
1144 5. NO
93 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
2 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); N067_ = YES;
ptN090_NumOfPlans = 0;
SN068 DENTAL COV - NEW OR PREV MENTION PLAN
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_DentalPlans.N068_DenCovNewPrev
Is that one of the plans you have already described, or a different plan?
..................................................................................
196 1. PREVIOUSLY DESCRIBED PLAN
63 2. DIFFERENT PLAN
3 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1239 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); N067_ = YES;
NOT (ptN090_NumOfPlans = 0); N068_DenCovNewPrev = PREVDESCRPLAN;
SN069 DENTAL COV - WHICH PREV MENTION PLAN
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
CAI Reference: BN_DentalPlans.N069_DenCovWhi
Which plan is that?
..................................................................................
103 1. FIRST PLAN MENTIONED AT SN024
7 2. SECOND PLAN MENTIONED AT SN024
3. THIRD PLAN MENTIONED AT SN024
4. PLAN MENTIONED AT SN070
5. PLAN MENTIONED AT SN074
6. PLAN MENTIONED AT SN105
7. PLAN MENTIONED AT SN113
8. PLAN MENTIONED AT SN242
9. PLAN MENTIONED AT SN138
10. PLAN MENTIONED AT SN146
11. PLAN MENTIONED AT SN155
12. PLAN MENTIONED AT SN163
13. PLAN MENTIONED AT SN167
14. PLAN MENTIONED AT SN174
15. PLAN MENTIONED AT SN179
16. PLAN MENTIONED AT SN187
19 20. MEDICARE
46 21. MEDICAID
6 22. CHAMPUS
14 27. NOT ON LIST
2 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1304 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
SN071 LTC INSURANCE
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_NursingHomeInsurance.N071_LTCIns
Not including government programs, did [RESPONDENT FIRST NAME] have any
insurance which specifically covered nursing home care for a year or more or
any part of personal or medical care in (her/his) home?)
..................................................................................
101 1. YES
1330 5. NO
68 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
2 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); N071_LTCIns =
YES; NOT (ptN090_NumOfPlans = 0);
SN072 LTC COV- NEW OR PRE MENTION PLAN
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_NursingHomeInsurance.N072_LTCCovNHNewPrev
Is that one of the plans you have already described, or a different plan?
..................................................................................
44 1. PREVIOUSLY DESCRIBED PLAN
57 2. DIFFERENT PLAN
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1400 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); N071_LTCIns =
YES; ptN090_NumOfPlans = 0;
SN073 LTC COV- WHICH PREV MENTION PLAN
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
CAI Reference: BN_NursingHomeInsurance.N073_LTCCovNHWhi
Which plan is that?
..................................................................................
21 1. FIRST PLAN MENTIONED AT SN024
2. SECOND PLAN MENTIONED AT SN024
3. THIRD PLAN MENTIONED AT SN024
4. PLAN MENTIONED AT SN070
5. PLAN MENTIONED AT SN074
6. PLAN MENTIONED AT SN105
7. PLAN MENTIONED AT SN113
8. PLAN MENTIONED AT SN242
9. PLAN MENTIONED AT SN138
10. PLAN MENTIONED AT SN146
11. PLAN MENTIONED AT SN155
12. PLAN MENTIONED AT SN163
13. PLAN MENTIONED AT SN167
14. PLAN MENTIONED AT SN174
15. PLAN MENTIONED AT SN179
16. PLAN MENTIONED AT SN187
7 20. MEDICARE
5 21. MEDICAID
2 22. CHAMPUS
7 27. NOT ON LIST
2 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1457 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); N071_LTCIns =
YES;
SN075 COVER NURSING HOME/IN-HOME CARE
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_NursingHomeInsurance.N075_CovNHInHome
Did this plan cover care in a nursing home facility only, personal or long-
term care at home, or both in-home and nursing home care?
..................................................................................
32 1. NURSING HOME CARE ONLY
9 2. IN-HOME CARE ONLY
49 3. BOTH
1 7. OTHER (SPECIFY)
10 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1400 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); N071_LTCIns =
YES;
SN077 RECD BENEFITS UNDER LTC
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_NursingHomeInsurance.N077_RcvBenefLTC
Did [RESPONDENT FIRST NAME] ever receive benefits under (her/his) long-term
care policy?
..................................................................................
42 1. YES
57 5. NO
2 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1400 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); N071_LTCIns =
YES; N072_LTCCovNHNewPrev <> PREVDESCRPLAN;
SN079 AMT PAY FOR LTC
Section: N Level: Respondent Type: Numeric Width: 5 Decimals: 0
CAI Reference: BN_NursingHomeInsurance.N079_AmtPayLTC
How much did (she/he) (or [you/[his/her] [husband/wife/partner]]) pay per
month for this (plan/long term coverage)?
INTERVIEWER: ENTER 0 IF NO PAYMENTS ARE MADE
AMOUNT:
..................................................................................
32 0-25000. Actual Value
25 99998. DK (Don't Know); NA (Not Ascertained)
99999. RF (Refused)
1444 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); N071_LTCIns =
YES; N079_AmtPayLTC > 0;
SN083 AMT PAY FOR LTC PER
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_NursingHomeInsurance.N083_AmtPayLTCPer
About how much was (she/he) paying for this plan before (her/his) death?
PER:
..................................................................................
5 1. YEAR
1 2. QUARTER (EVERY 3 MONTHS)
24 4. MONTH
1 6. Lump sum payment
7. OTHER (SPECIFY)
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1470 Blank. INAP (Inapplicable)
SN080 AMT PAY FOR LTC - MIN
Section: N Level: Respondent Type: Numeric Width: 3 Decimals: 0
CAI Reference: BN_NursingHomeInsurance.N080_
N080_ - N082_ Unfolding Sequence
Did it amount to less than $____ per month, more than $____ per month, or
what?
BREAKPOINTS: 25, 100, 200, 400
PROCEDURE(S): UNFM_2up1down
ENTRY POINT(S): 100
..................................................................................
16 0. Value of Breakpoint
4 26. Value of Breakpoint
2 101. Value of Breakpoint
1 200. Value of Breakpoint
2 201. Value of Breakpoint
1476 Blank. INAP (Inapplicable)
SN081 AMT PAY FOR LTC - MAX
Section: N Level: Respondent Type: Numeric Width: 4 Decimals: 0
CAI Reference: BN_NursingHomeInsurance.N081_
..................................................................................
1 24. Value of Breakpoint
4 99. Value of Breakpoint
1 199. Value of Breakpoint
1 200. Value of Breakpoint
2 399. Value of Breakpoint
16 4000. Value of Breakpoint
1476 Blank. INAP (Inapplicable)
SN082 AMT PAY FOR LTC- RESULT
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
CAI Reference: BN_NursingHomeInsurance.N082_
..................................................................................
97. Data Not Available
16 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1485 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); GovCover.N001_
= YES; ((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); GovCover.N006_
= YES; ((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); GovCover.N007_
= YES;
SN090 NUMBER OF PUBLIC/PRIVATE HI PLANS
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN.N090_NumOfPlans
..................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
1470 1 4 1.84 0.65 31
-----------------------------------------------------------------
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
(N090_NumOfPlans > 0) AND ((ACTIVELANGUAGE <> EXTENG) AND (ACTIVELANGUAGE <>
EXTSPN));
SN091 EVER WITHOUT HI AMONG CURRENTLY INSURED
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN.N091_NoInsurance
Was [RESPONDENT FIRST NAME] ever without health insurance coverage at any time
(since [PREV WAVE IW MONTH], [PREV WAVE IW YEAR]/since [PREV WAVE IW YEAR]/in
the last two years before (her/his) death)?
..................................................................................
1. YES
5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1501 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST); (ACTIVELANGUAGE
<> EXTENG) AND (ACTIVELANGUAGE <> EXTSPN); ((((PlanDetails[1].N032_ = YES) OR
(PlanDetails[2].N032_ = YES)) OR (PlanDetails[3].N032_ = YES)) OR
(((PrescpDrug.N176_MedsCovIns = COMPLETELYCOVRD) OR (PrescpDrug.N176_MedsCovIns
= MOSTLYCOVRD)) OR (PrescpDrug.N176_MedsCovIns = PARTIALLYCOVRD))) OR
(DentalPlans.N067_ = YES); ((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND
(RVARS.Z145_TypeExit_V <> FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <>
SECREPEATPOST); (ACTIVELANGUAGE <> EXTENG) AND (ACTIVELANGUAGE <> EXTSPN); NOT
(((((PlanDetails[1].N032_ = YES) OR (PlanDetails[2].N032_ = YES)) OR
(PlanDetails[3].N032_ = YES)) OR (((PrescpDrug.N176_MedsCovIns =
COMPLETELYCOVRD) OR (PrescpDrug.N176_MedsCovIns = MOSTLYCOVRD)) OR
(PrescpDrug.N176_MedsCovIns = PARTIALLYCOVRD))) OR (DentalPlans.N067_ = YES));
SN098 BRANCHPNT-DENTAL/MEDS COVRGE/ALL OTH
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN.N098_
..................................................................................
1. R`S HEALTH INSURANCE PAYS PART OF PRESCRIPTION AND/OR DENTAL
2. ALL OTHERS
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1501 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
((ACTIVELANGUAGE = EXTENG) OR (ACTIVELANGUAGE = EXTSPN)) AND
(SecA.ContinuInterview.A124_PlaceDied = INHOSPITAL);
SN301 TIME IN HOSPITAL BEFORE DEATH
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
CAI Reference: BN.N301_
The next questions are about health care (she/he) had received. Earlier you
told me that [RESPONDENT FIRST NAME] died while in a hospital. How long had
(she/he) been a patient in that hospital before (her/his) death?
INTERVIEWER ENTER '1 HOUR' IF LESS THAN ONE HOUR
NUMBER:
..................................................................................
614 1-93. Actual Value
12 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
875 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
((ACTIVELANGUAGE = EXTENG) OR (ACTIVELANGUAGE = EXTSPN)) AND
(SecA.ContinuInterview.A124_PlaceDied = INHOSPITAL);
SN302 TIME IN HOSPITAL BEFORE DEATH- UNIT
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN.N302_
The next questions are about health care (she/he) had received. Earlier you
told me that [RESPONDENT FIRST NAME] died while in a hospital. How long had
(she/he) been a patient in that hospital before (her/his) death?
INTERVIEWER ENTER '1 HOUR' IF LESS THAN ONE HOUR
UNIT:
..................................................................................
54 1. HOURS
391 2. DAYS
116 3. WEEKS
53 4. MONTHS
6 5. YEARS
5 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
876 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
((ACTIVELANGUAGE = EXTENG) OR (ACTIVELANGUAGE = EXTSPN)) AND
(SecA.ContinuInterview.A124_PlaceDied = INHOSPITAL);
SN303 REASON IN HOSPITAL
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN.N303_
Why had (she/he) been admitted to the hospital? Was it to have surgery,
receive other treatments, relieve (her/his) symptoms, or what?
..................................................................................
69 1. SURGERY
232 2. OTHER TREATMENTS
296 3. RELIEVE SYMPTOMS
22 7. OTHER (SPECIFY)
6 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
875 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
SN099 OVERNIGHT STAY IN HOSP-SINCE PREV IW/2YR
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_HospitalStay.N099_OverniteHosp
(In addition to that hospital stay,/The next questions are about health care
(she/he) had received ,) (Since [PREV WAVE IW MONTH], [PREV WAVE IW
YEAR]/Since [PREV WAVE IW YEAR]/In the two years before (her/his) death), had
(she/he) been a patient in a hospital overnight?
..................................................................................
947 1. YES
536 5. NO
16 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
2 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
(((ACTIVELANGUAGE = EXTENG) OR (ACTIVELANGUAGE = EXTSPN)) OR (piA124_PlaceDied
= INHOSPITAL)) OR (N099_OverniteHosp = YES); ((ACTIVELANGUAGE <> EXTENG) AND
(ACTIVELANGUAGE <> EXTSPN)) OR (N099_OverniteHosp = YES); (((ACTIVELANGUAGE =
EXTENG) OR (ACTIVELANGUAGE = EXTSPN)) OR (piA124_PlaceDied <> INHOSPITAL)) OR
(N099_OverniteHosp = YES);
SN100 NUM TIMES R STAYED OVERNIGHT IN HOSP
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
CAI Reference: BN_HospitalStay.N100_TimeOverHosp
(Including (her/his) final hospitalization,) How many different times was
(she/he) a patient in a hospital overnight ( (since [PREV WAVE IW MONTH],
[PREV WAVE IW YEAR]/since [PREV WAVE IW YEAR]/in the last two years before
(her/his) death))?
..................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
874 1 90 3.24 4.37 555
-----------------------------------------------------------------
72 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
(((ACTIVELANGUAGE = EXTENG) OR (ACTIVELANGUAGE = EXTSPN)) OR (piA124_PlaceDied
= INHOSPITAL)) OR (N099_OverniteHosp = YES); ((ACTIVELANGUAGE <> EXTENG) AND
(ACTIVELANGUAGE <> EXTSPN)) OR (N099_OverniteHosp = YES); (((ACTIVELANGUAGE =
EXTENG) OR (ACTIVELANGUAGE = EXTSPN)) OR (piA124_PlaceDied <> INHOSPITAL)) OR
(N099_OverniteHosp = YES);
SN101 NUM NIGHTS R SPENT OVERNIGHT IN HOSPITAL
Section: N Level: Respondent Type: Numeric Width: 3 Decimals: 0
CAI Reference: BN_HospitalStay.N101_NiteOverHosp
(Altogether) How many nights was (she/he) a patient in a hospital ( (since
[PREV WAVE IW MONTH], [PREV WAVE IW YEAR]/since [PREV WAVE IW YEAR]/in the
last two years before (her/his) death))?
..................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
810 1 450 24.75 39.86 555
-----------------------------------------------------------------
135 998. DK (Don't Know); NA (Not Ascertained)
1 999. RF (Refused)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
(((ACTIVELANGUAGE = EXTENG) OR (ACTIVELANGUAGE = EXTSPN)) OR (piA124_PlaceDied
= INHOSPITAL)) OR (N099_OverniteHosp = YES); ((ACTIVELANGUAGE <> EXTENG) AND
(ACTIVELANGUAGE <> EXTSPN)) OR (N099_OverniteHosp = YES); (ACTIVELANGUAGE =
EXTENG) OR (ACTIVELANGUAGE = EXTSPN);
SN305 SPEND TIME IN ICU
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_HospitalStay.N305_
(During any of those hospital stays /During (her/his) hospital stay) did
[RESPONDENT FIRST NAME] spend any time in an intensive care unit?
..................................................................................
412 1. YES
516 5. NO
18 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
555 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
(((ACTIVELANGUAGE = EXTENG) OR (ACTIVELANGUAGE = EXTSPN)) OR (piA124_PlaceDied
= INHOSPITAL)) OR (N099_OverniteHosp = YES); ((ACTIVELANGUAGE <> EXTENG) AND
(ACTIVELANGUAGE <> EXTSPN)) OR (N099_OverniteHosp = YES); (ACTIVELANGUAGE =
EXTENG) OR (ACTIVELANGUAGE = EXTSPN);
SN306 USED LIFE SUPPORT
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_HospitalStay.N306_
(During any of those hospital stays /During (her/his) hospital stay) did
(she/he) use life support equipment, such as a respirator?
..................................................................................
244 1. YES
683 5. NO
18 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
555 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
(((ACTIVELANGUAGE = EXTENG) OR (ACTIVELANGUAGE = EXTSPN)) OR (piA124_PlaceDied
= INHOSPITAL)) OR (N099_OverniteHosp = YES); ((ACTIVELANGUAGE <> EXTENG) AND
(ACTIVELANGUAGE <> EXTSPN)) OR (N099_OverniteHosp = YES); (ACTIVELANGUAGE =
EXTENG) OR (ACTIVELANGUAGE = EXTSPN);
SN307 USED KIDNEY DIALYSIS SERVICES
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_HospitalStay.N307_
(During any of those hospital stays /During (her/his) hospital stay)did
(she/he) use kidney dialysis services?
..................................................................................
69 1. YES
869 5. NO
8 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
555 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
(((ACTIVELANGUAGE = EXTENG) OR (ACTIVELANGUAGE = EXTSPN)) OR (piA124_PlaceDied
= INHOSPITAL)) OR (N099_OverniteHosp = YES); ((ACTIVELANGUAGE <> EXTENG) AND
(ACTIVELANGUAGE <> EXTSPN)) OR (N099_OverniteHosp = YES); (ACTIVELANGUAGE =
EXTENG) OR (ACTIVELANGUAGE = EXTSPN);
SN308 RECEIVE ANTIBIOTICS
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_HospitalStay.N308_
(During any of those hospital stays /During (her/his) hospital stay) did
(she/he) receive antibiotics to treat pneumonia or other infection?
..................................................................................
569 1. YES
296 5. NO
80 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
555 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
(((ACTIVELANGUAGE = EXTENG) OR (ACTIVELANGUAGE = EXTSPN)) OR (piA124_PlaceDied
= INHOSPITAL)) OR (N099_OverniteHosp = YES); ((ACTIVELANGUAGE <> EXTENG) AND
(ACTIVELANGUAGE <> EXTSPN)) OR (N099_OverniteHosp = YES);
SN102 HOSPITAL STAYS COVERED BY INS
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
CAI Reference: BN_HospitalStay.N102_HospCovIns
Were the costs for (her/his) hospital stay(s) completely covered by health
insurance, partly covered by insurance, or not covered at all by insurance?
..................................................................................
653 1. COMPLETELY COVERED
167 2. MOSTLY COVERED
75 3. PARTIALLY COVERED
7 5. NOT COVERED AT ALL
14 7. COSTS NOT SETTLED YET
30 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
555 Blank. INAP (Inapplicable)
((RVARS.Z145_TypeExit_V <> NEWPOSTEXIT) AND (RVARS.Z145_TypeExit_V <>
FIRSTREPEATPOST)) AND (RVARS.Z145_TypeExit_V <> SECREPEATPOST);
(((ACTIVELANGUAGE = EXTENG) OR (ACTIVELANGUAGE = EXTSPN)) OR (piA124_PlaceDied
= INHOSPITAL)) OR (N099_OverniteHosp = YES); ((ACTIVELANGUAGE <> EXTENG) AND
(ACTIVELANGUAGE <> EXTSPN)) OR (N099_OverniteHosp = YES); N102_HospCovIns <>
COMPLETELYCOVRD;
SN106 AMT PAID O-O-P HOSPITAL COSTS
Section: N Level: Respondent Type: Numeric Width: 6 Decimals: 0
CAI Reference: BN_HospitalStay.N106_AmtOOPHospCost
About how much did [he/she] pay out-of-pocket for hospital bills [since R's
LAST IW MONTH, YEAR/in the last two years before [his/her] death]?
[IWER: DO NOT PROBE DK/RF]
..................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
97 1 400000 5922.92 40542.26 1208
-----------------------------------------------------------------
16 0. None; includes cost not settled yet
178 999998. DK (Don't Know); NA (Not Ascertained)
2 999999. RF (Refused)
SN107 AMT PAID O-O-P HOSPITAL COSTS - MIN
Section: N Level: Respondent Type: Numeric Width: 5 Decimals: 0
CAI Reference: BN_HospitalStay.N107_
N107_ - N109_ Unfolding Sequence
Did it amount to less than $____ , more than $____ , or what?
BREAKPOINTS: 500 5000 10000 20000 50000
PROCEDURE(S): ENTRY POINT(S):
UNFM_1up3down 20000
UNFM_2up2down 10000
UNFM_3up1down 5000
..................................................................................
65 0. Value of Breakpoint
6 500. Value of Breakpoint
59 501. Value of Breakpoint
5 5000. Value of Breakpoint
13 5001. Value of Breakpoint
2 10000. Value of Breakpoint
23 10001. Value of Breakpoint
4 20001. Value of Breakpoint
3 50001. Value of Breakpoint
1321 Blank. INAP (Inapplicable)
SN108 AMT PAID O-O-P HOSPITAL COSTS - MAX
Section: N Level: Respondent Type: Numeric Width: 6 Decimals: 0
CAI Reference: BN_HospitalStay.N108_
..................................................................................
11 499. Value of Breakpoint
6 500. Value of Breakpoint
64 4999. Value of Breakpoint
5 5000. Value of Breakpoint
16 9999. Value