The questions in this survey are about health insurance. Please include any kind of health insurance as well as government programs like Medicare and Medicaid that provide medical care or help pay medical bills.
H001 (CURRENTLY COVERED BY HEALTHCARE PLAN)
Are you currently covered by any kind of health insurance or some other kind of healthcare plan?
1 (YES) Yes 2 (NO) No
if H001 = YES then
Group of questions presented on the same screen
H002 (INSURANCE TYPE)
Which of the following best describes your current health insurance or healthcare coverage? Please check all that apply.
1 Medicare 2 Medi-Gap 3 Employer or Retiree Insurance (from your own or a spouse’s employer/union or former employer/union) 4 Private insurance that you purchase from an insurer or through your state or federal health insurance marketplace (such as healthcare.gov) 5 Other Government sponsored insurance such as Medicaid, Military health care (TRICARE/VA/CHAMP-VA), or other state insurance plans 6 Other program (please specify) 7 No coverage of any type
H002_other (COVERAGE TYPE--OTHER)
STRING
End of group of questions
End of if
if 1 in H002 or 2 in H002 then
H003 (MEDICARE ADVANTAGE PLAN)
Are you currently enrolled in a Medicare Advantage plan?
1 Yes 2 No 3 I don't know
H004 (MEDICARE PRESCRIPTION COVERAGE)
Are you currently enrolled in Medicare prescription drug coverage (Part D)?
1 Yes 2 No 3 I don't know
Else
Group of questions presented on the same screen
H005_intro (AGE EXPECT TO RECEIVE MEDICARE)
Please provide an answer or click the next button to proceed without answering.
People generally become eligible for Medicare at age 65. At what age do you think you will start receiving Medicare benefits?
Subgroup of questions
H005 (AGE EXPECT TO RECEIVE MEDICARE)
RANGE 50..110
H005_options (AGE EXPECT TO RECEIVE MEDICARE)
1 I don't plan on receiving Medicare benefits 2 I don't know
End of subgroup of questions
H005scripts
End of group of questions
if H005 = response then
H006 (WILL ENROLL IN MEDICARE DRUG COVERAGE)
When you do start receiving Medicare benefits, do you think that you will also enroll in Medicare prescription drug coverage (Part D)?
1 Yes 2 No 3 I don't know
End of if
End of if
H007 (PRESCRIBED MEDICINE BY PROVIDER)
In the past twelve months, have you been prescribed any medicine by a healthcare provider?
1 Yes 2 No 3 I don't know
if H007 = 1 then
H008 (DIFFICULTY PAYING FOR PRESCRIPTION)
In the past twelve months, have you had difficulty paying a bill for prescription medicine?
1 Yes 2 No 3 I don't know
H009 (COST OF PRESCRIPTION CAUSED STOP TAKING MEDICINE)
In the past twelve months, has the cost of a prescription medicine caused you to not take that medicine, take less than you were supposed to, or stop taking it earlier than you should have?
1 Yes 2 No 3 I don't know
End of if
Group of questions presented on the same screen
H010_intro (NAMES OF PEOPLE INTERACTED WITH ON REGULAR BASIS)
You did not enter names or initials in any of the boxes. Your responses are very important to us. Please enter the names or initials of adults you know and interact with on a regular basis OR click on 'I prefer not to do this' to skip the question.
The next several questions ask about specific people you know and talk to regularly, who are at least 65 years old. Please list the first name or initials of 10 adults that you know and interact with on a regular basis.
Subgroup of questions
Loop from 1 to 10
H010 (NAMES OF PEOPLE INTERACTED WITH ON REGULAR BASIS)
STRING
End of loop
End of subgroup of questions
H010_skip (SKIP H010 LIST)
1 I prefer not to do this
H010scripts
End of group of questions
check := 0
Loop from 1 to 10
if H010[cnt1] = response then
check := check + 1
End of if
End of loop
if check > 0 then
tables_intro
For each of the following questions about the people you know, please answer to the best of your knowledge.
Group of questions presented on the same screen
H011_intro (RELATIONSHIP TO PERSON)
For each person listed below, please indicate your primary relationship with that person.
Subgroup of questions
Loop from 1 to 10
if H010[cnt1] = response then
H011 (RELATIONSHIP TO PERSON)
[NAMES OF PEOPLE INTERACTED WITH ON REGULAR BASIS[]]
1 Spouse or partner 2 Family member 3 Friend 4 Coworker 5 Other
End of if
End of loop
End of subgroup of questions
End of group of questions
Group of questions presented on the same screen
H012_intro (PERSONS APPROXIMATE AGE)
For each person listed below, please indicate their approximate age.
Subgroup of questions
Loop from 1 to 10
if H010[cnt2] = response then
H012 (PERSONS APPROXIMATE AGE)
[NAMES OF PEOPLE INTERACTED WITH ON REGULAR BASIS[]]
For each person below, have you talked with them in the past about prescriptions, insurance for prescriptions, or Medicare prescription drug coverage (Part D)?
Subgroup of questions
Loop from 1 to 10
if H010[cnt3] = response then
H013 (TALKED TO PERSONS ABOUT COVERAGE)
[NAMES OF PEOPLE INTERACTED WITH ON REGULAR BASIS[]]
1 Yes 2 No 3 I don't remember
End of if
End of loop
End of subgroup of questions
End of group of questions
check2 := 0
Loop from 1 to 10
if H013[cnt1] = 1 then
check2 := check2 + 1
End of if
End of loop
if check2 > 0 then
Group of questions presented on the same screen
H014_intro (PERSONS ENROLLED IN MEDICARE DRUG COVERAGE)
Do you think this person is currently enrolled in Medicare prescription drug coverage (Part D)?
Subgroup of questions
Loop from 1 to 10
if H013[cnt4] = 1 then
H014 (PERSONS ENROLLED IN MEDICARE DRUG COVERAGE)
[NAMES OF PEOPLE INTERACTED WITH ON REGULAR BASIS[]]
1 Definitely yes 2 I think yes 3 I don't know 4 I think no 5 Definitely no
End of if
End of loop
End of subgroup of questions
End of group of questions
Group of questions presented on the same screen
H015_intro (PERSONS HAD DIFFICULTY PAYING FOR PRESCRIPTION)
Do you think this person had difficulty paying a bill for prescription medicine in the past?
Subgroup of questions
Loop from 1 to 10
if H013[cnt5] = 1 then
H015 (PERSONS HAD DIFFICULTY PAYING FOR PRESCRIPTION)
[NAMES OF PEOPLE INTERACTED WITH ON REGULAR BASIS[]]
1 Definitely yes 2 I think yes 3 I don't know 4 I think no 5 Definitely no
End of if
End of loop
End of subgroup of questions
End of group of questions
Group of questions presented on the same screen
H016_intro (PRESCRIPTION COST CAUSED PERSONS TO STOP TAKING MEDICINE)
Do you think the cost of a prescription medicine caused that person to not take that medicine as prescribed in the past?
Subgroup of questions
Loop from 1 to 10
if H013[cnt6] = 1 then
H016 (PRESCRIPTION COST CAUSED PERSONS TO STOP TAKING MEDICINE)
[NAMES OF PEOPLE INTERACTED WITH ON REGULAR BASIS[]]
1 Definitely yes 2 I think yes 3 I don't know 4 I think no 5 Definitely no
End of if
End of loop
End of subgroup of questions
End of group of questions
End of if
End of if
CS_001 (HOW PLEASANT INTERVIEW)
Could you tell us how interesting or uninteresting you found the questions in this interview?
1 Very interesting 2 Interesting 3 Neither interesting nor uninteresting 4 Uninteresting 5 Very uninteresting
CS_003 (comments)
Do you have any other comments on the interview? Please type these in the box below.(If you have no comments, please click next to complete this survey.)