Description
Extracts include the MAJA-MADE variables if users choose MAMM during the extract process.
Codes and Frequencies
An 'X' indicates the category is available for that sample
Code | Label |
22
|
21
|
20
|
19
|
18
|
17
|
16
|
15
|
14
|
13
|
12
|
11
|
10
|
09
|
08
|
07
|
06
|
05
|
04
|
03
|
02
|
01
|
00
|
99
|
98
|
Code | Label |
97
|
96
|
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
0 | NIU | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | 0 | NIU | X | X |
1 | No | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | 1 | No | X | X |
2 | Yes | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | 2 | Yes | X | X |
Can't find the category you are looking for? Try the Detailed codes
Comparability
No information available.Universe
- 1996-2022: All persons in a reference period that includes October of the current year.
Availability
- 1996-2022
Survey Text
2022 | 2015 | 2008 | 2001 |
2021 | 2014 | 2007 | 2000 |
2020 | 2013 | 2006 | 1999 |
2019 | 2012 | 2005 | 1998 |
2018 | 2011 | 2004 | 1997 |
2017 | 2010 | 2003 | 1996 |
2016 | 2009 | 2002 |
2018
Survey form
view entire document:
text
image
HX10
====
====
====
====
====
====
====
[STR-DT]
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
YES .................................... 1
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
HX11
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
====
[STR-DT]
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
PR07
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
PR08
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
PR09
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
====
[STR-DT]
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
YES ................................... 1
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
PR10
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
2017
Survey form
view entire document:
text
image
HX10
====
====
====
====
====
====
====
[STR-DT]
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
YES .................................... 1
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
HX11
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
====
[STR-DT]
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
PR07
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
PR08
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
PR09
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
====
[STR-DT]
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
YES ................................... 1
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
PR10
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
2016
Survey form
view entire document:
text
image
HX10
====
====
====
====
====
====
====
[STR-DT]
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
YES .................................... 1
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
HX11
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
====
[STR-DT]
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
PR07
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
PR08
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
PR09
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
====
[STR-DT]
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
YES ................................... 1
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
PR10
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
2015
Survey form
view entire document:
text
image
HX10
====
====
====
====
====
====
====
[STR-DT]
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
YES .................................... 1
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
HX11
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
====
[STR-DT]
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
PR07
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
PR08
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
PR09
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
====
[STR-DT]
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
YES ................................... 1
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
PR10
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
2014
Survey form
view entire document:
text
image
HX10
====
====
====
====
====
====
====
[STR-DT]
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
YES .................................... 1
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
HX11
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
====
[STR-DT]
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
PR07
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
PR08
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
PR09
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
====
[STR-DT]
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
YES ................................... 1
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
PR10
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
2013
Survey form
view entire document:
text
image
HX10
====
====
====
====
====
====
====
[STR-DT]
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
YES .................................... 1
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
HX11
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
====
[STR-DT]
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
PR07
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
PR08
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
PR09
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
====
[STR-DT]
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
YES ................................... 1
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
PR10
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
2012
Survey form
view entire document:
text
image
HX10
====
====
====
====
====
====
====
[STR-DT]
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
YES .................................... 1
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
HX11
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
====
[STR-DT]
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
PR07
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
PR08
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
PR09
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
====
[STR-DT]
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
YES ................................... 1
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
PR10
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
2011
Survey form
view entire document:
text
image
HX10
====
====
====
====
====
====
====
[STR-DT]
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
YES .................................... 1
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
HX11
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
====
[STR-DT]
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
PR07
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
PR08
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
PR09
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
====
[STR-DT]
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
YES ................................... 1
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
PR10
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
2010
Survey form
view entire document:
text
image
HX10
====
====
====
====
====
====
====
[STR-DT]
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
YES .................................... 1
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
HX11
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
====
[STR-DT]
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
PR07
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
PR08
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
PR09
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
====
[STR-DT]
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
YES ................................... 1
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
PR10
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
2009
Survey form
view entire document:
text
image
HX10
====
====
====
====
====
====
====
[STR-DT]
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
YES .................................... 1
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
HX11
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
====
[STR-DT]
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
PR07
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
PR08
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
PR09
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
====
[STR-DT]
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
YES ................................... 1
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
PR10
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
2008
Survey form
view entire document:
text
image
HX10
====
====
====
====
====
====
====
[STR-DT]
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
YES .................................... 1
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
HX11
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
====
[STR-DT]
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
PR07
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
PR08
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
PR09
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
====
[STR-DT]
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
YES ................................... 1
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
PR10
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
2007
Survey form
view entire document:
text
image
HX10
====
====
====
====
====
====
====
[STR-DT]
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
YES .................................... 1
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
HX11
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
====
[STR-DT]
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
PR07
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
PR08
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
PR09
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
====
[STR-DT]
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
YES ................................... 1
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
PR10
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
2006
Survey form
view entire document:
text
image
HX10
====
====
====
====
====
====
====
[STR-DT]
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
YES .................................... 1
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
HX11
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
====
[STR-DT]
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
PR07
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
PR08
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
PR09
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
====
[STR-DT]
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
YES ................................... 1
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
PR10
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
2005
Survey form
view entire document:
text
image
HX10
====
====
====
====
====
====
====
[STR-DT]
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
YES .................................... 1
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
HX11
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
====
[STR-DT]
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
PR07
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
PR08
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
PR09
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
====
[STR-DT]
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
YES ................................... 1
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
PR10
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
2004
Survey form
view entire document:
text
image
HX10
====
====
====
====
====
====
====
[STR-DT]
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
YES .................................... 1
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
HX11
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
====
[STR-DT]
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
PR07
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
PR08
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
PR09
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
====
[STR-DT]
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
YES ................................... 1
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
PR10
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
2003
Survey form
view entire document:
text
image
HX10
====
====
====
====
====
====
====
[STR-DT]
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
YES .................................... 1
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
HX11
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
====
[STR-DT]
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
PR07
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
PR08
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
PR09
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
====
[STR-DT]
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
YES ................................... 1
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
PR10
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
2002
Survey form
view entire document:
text
image
HX10
====
====
====
====
====
====
====
[STR-DT]
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
YES .................................... 1
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
HX11
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
====
[STR-DT]
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
PR07
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
PR08
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
PR09
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
====
[STR-DT]
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
YES ................................... 1
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
PR10
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
2001
Survey form
view entire document:
text
image
HX10
====
====
====
====
====
====
====
[STR-DT]
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
YES .................................... 1
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
HX11
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
====
[STR-DT]
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
PR07
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
PR08
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
PR09
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
====
[STR-DT]
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
YES ................................... 1
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
PR10
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
2000
Survey form
view entire document:
text
image
HX10
====
====
====
====
====
====
====
[STR-DT]
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
YES .................................... 1
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
HX11
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
====
[STR-DT]
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
PR07
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
PR08
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
PR09
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
====
[STR-DT]
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
YES ................................... 1
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
PR10
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
1999
Survey form
view entire document:
text
image
HX10
====
====
====
====
====
====
====
[STR-DT]
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
YES .................................... 1
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
HX11
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
====
[STR-DT]
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
PR07
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
PR08
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
PR09
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
====
[STR-DT]
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
YES ................................... 1
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
PR10
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
1998
Survey form
view entire document:
text
image
HX10
====
====
====
====
====
====
====
[STR-DT]
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
YES .................................... 1
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
HX11
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
====
[STR-DT]
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
PR07
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
PR08
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
PR09
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
====
[STR-DT]
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
YES ................................... 1
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
PR10
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
1997
Survey form
view entire document:
text
image
HX10
====
====
====
====
====
====
====
[STR-DT]
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
YES .................................... 1
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
HX11
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
====
[STR-DT]
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
PR07
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
PR08
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
PR09
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
====
[STR-DT]
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
YES ................................... 1
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
PR10
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
1996
Survey form
view entire document:
text
image
HX10
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====
[STR-DT]
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
[Some people are covered by a program called [Medicaid/[STATE NAME FOR MEDICAID]]. This is a state program for persons with low incomes and persons on public assistance. It sometimes covers persons with very large medical bills or those in nursing homes.]
[SHOW CARD HX-3.]
[People covered by [Medicaid/[STATE NAME FOR MEDICAID]] usually have a (piece of paper/card) that looks like this.]
[During the last interview, we recorded that no one in the family was covered by [Medicaid/[STATE NAME FOR MEDICAID]].]
Has anyone in the family been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
YES .................................... 1
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
HX11
NO ..................................... 2 [BOX_14]
REF ................................... -7 [BOX_14]
DK .................................... -8 [BOX-14]
PRESS F1 FOR DEFINITION OF MEDICAID.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('Some .... homes.') ONLY IF ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY SECOND PARAGRAPH (INCLUDING REFERENCE TO SHOW CARD) ONLY IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED ISSUES A CARD OR PIECE OF PAPER TO MEDICAID RECIPIENTS. THIS INCLUDES ALL STATES EXCEPT TENNESSEE. IF THE INTERVIEW IS BEING CONDUCTED IN TENNESSEE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY THIRD PARAGRAPH ('During... MEDICAID]].') ONLY IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AUTOMATICALLY BY CAPI AT HX11 AND GO TO
LOOP_05
----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX11
----------------------------------------------------
====
[STR-DT]
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
PROBE: Who else is covered by [Medicaid/[STATE NAME FOR MEDICAID]]?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
PR07
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
-----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by [Medicaid/[STATE NAME FOR MEDICAID]].
Have all of these people been covered by [Medicaid/[STATE NAME FOR MEDICAID]] at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
PR08
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_05]
DK .................................... -8 [BOX_05]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid' DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' THEN GO TO BOX_03
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, ONLY SOME), CONTINUE WITH PR08
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
PR09
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY MEDICAID AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID DURING CURRENT ROUND.' FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID DURING CURRENT ROUND.'
----------------------------------------------------
====
[STR-DT]
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
Besides the family members we've just talked about, have any additional family members been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
YES ................................... 1
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
PR10
NO .................................... 2
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF MEDICAID.
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
----------------------------------------------------
IF CODED '-2' (NO), '-7' (REFUSED), OR '8' (DON'T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO LOOP_02
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO), '-7' (REFUSED), OR '-8' (DON'T KNOW) AND NO RU MEMBERS ARE FLAGGED AS 'COVERED BY MEDICAID DURING CURRENT ROUND,' GO TO BOX_05
----------------------------------------------------
----------------------------------------------------
OTHERWISE (I.E., IF CODED '1' (YES)), CONTINUE WITH PR10
----------------------------------------------------
====
[STR-DT]
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
PROBE: Who else has been covered by [Medicaid/[STATE NAME FOR MEDICAID]] since (START DATE)?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
-----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'Medicaid'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'Medicaid'. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE, SEE BOX ON HX06.
-----------------------------------------------------
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-MEMBERS-ROSTER WHO MEET EITHER OF THE FOLLOWING CONDITIONS:
- PERSON WAS ADDED TO RU THIS ROUND
OR
- PERSON WAS NOT FLAGGED AS 'COVERED BY MEDICAID' DURING THE PREVIOUS ROUND
-----------------------------------------------------
----------------------------------------------------
FLAG ALL PERSONS SELECTED AS 'COVERED BY MEDICAID' DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS 'NOT COVERED BY MEDICAID' DURING CURRENT ROUND.
----------------------------------------------------
Weights
- 1996-2022 : PERWEIGHT