Questionnaire Text

ASEC 2023 ASEC 2019 ASEC 2015 ASEC 2011
ASEC 2022 ASEC 2018 ASEC 2014 ASEC 2010
ASEC 2021 ASEC 2017 ASEC 2013 ASEC 2009
ASEC 2020 ASEC 2016 ASEC 2012
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ASEC 2023

No questionnaire text is available for this sample.


No questionnaire text is available for this sample.


No questionnaire text is available for this sample.


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ASEC 2022

No questionnaire text is available for this sample.


No questionnaire text is available for this sample.


No questionnaire text is available for this sample.


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ASEC 2021

No questionnaire text is available for this sample.


No questionnaire text is available for this sample.


No questionnaire text is available for this sample.


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ASEC 2020

No questionnaire text is available for this sample.


No questionnaire text is available for this sample.


No questionnaire text is available for this sample.


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ASEC 2019

No questionnaire text is available for this sample.


No questionnaire text is available for this sample.


No questionnaire text is available for this sample.


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ASEC 2018
Questionnaire form view entire document:  text  image
SRCEGEN
? [F1]
ASK OR VERIFY
For the coverage (name/you) (have/has/had) NOW, (do/does/did) (you/he/she) get it through a job, the government or state, or some other way?
JOB GOVERNMENT OR STATE OTHER
Military (TRICARE, VA, etc.) Medical Assistance Privately purchased
Former job/Retiree Medicaid Parent or spouse
Union Medicare (Parts A+B; Part C) School
Spouse/parent's job Medicare Advantage Exchange plan/Marketplace
Job with the government State-provided health coverage Group or association
COBRA Indian Health Service Medicare Supplements
IF RESPONDENT CHOOSES MORE THAN ONE: Let's talk about one plan at a time. Which would you like to tell me about first? [ If respondent is not covered, go back to VERIFY and select "Yes"]
1 Job (current or former)
2 Government or State
3 Some other way

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ASEC 2017
Questionnaire form view entire document:  text  image
SRCEGEN
? [F1]
ASK OR VERIFY
For the coverage (name/you) (have/has/had) NOW, (do/does/did) (you/he/she) get it through a job, the government or state, or some other way?
JOB GOVERNMENT OR STATE OTHER
Military (TRICARE, VA, etc.) Medical Assistance Privately purchased
Former job/Retiree Medicaid Parent or spouse
Union Medicare (Parts A+B; Part C) School
Spouse/parent's job Medicare Advantage Exchange plan/Marketplace
Job with the government State-provided health coverage Group or association
COBRA Indian Health Service Medicare Supplements
IF RESPONDENT CHOOSES MORE THAN ONE: Let's talk about one plan at a time. Which would you like to tell me about first? [ If respondent is not covered, go back to VERIFY and select "Yes"]
1 Job (current or former)
2 Government or State
3 Some other way

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ASEC 2016
Questionnaire form view entire document:  text  image
SRCEGEN
? [F1]
ASK OR VERIFY
For the coverage (name/you) (have/has/had) NOW, (do/does/did) (you/he/she) get it through a job, the government or state, or some other way?
JOB GOVERNMENT OR STATE OTHER
Military (TRICARE, VA, etc.) Medical Assistance Privately purchased
Former job/Retiree Medicaid Parent or spouse
Union Medicare (Parts A+B; Part C) School
Spouse/parent's job Medicare Advantage Exchange plan/Marketplace
Job with the government State-provided health coverage Group or association
COBRA Indian Health Service Medicare Supplements
IF RESPONDENT CHOOSES MORE THAN ONE: Let's talk about one plan at a time. Which would you like to tell me about first? [ If respondent is not covered, go back to VERIFY and select "Yes"]
1 Job (current or former)
2 Government or State
3 Some other way

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ASEC 2015
Questionnaire form view entire document:  text  image
SRCEGEN
? [F1]
ASK OR VERIFY
For the coverage (name/you) (have/has/had) NOW, (do/does/did) (you/he/she) get it through a job, the government or state, or some other way?
JOB GOVERNMENT OR STATE OTHER
Military (TRICARE, VA, etc.) Medical Assistance Privately purchased
Former job/Retiree Medicaid Parent or spouse
Union Medicare (Parts A+B; Part C) School
Spouse/parent's job Medicare Advantage Exchange plan/Marketplace
Job with the government State-provided health coverage Group or association
COBRA Indian Health Service Medicare Supplements
IF RESPONDENT CHOOSES MORE THAN ONE: Let's talk about one plan at a time. Which would you like to tell me about first? [ If respondent is not covered, go back to VERIFY and select "Yes"]
1 Job (current or former)
2 Government or State
3 Some other way

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ASEC 2014

No questionnaire text is available for this sample.


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ASEC 2013
Questionnaire form view entire document:  text  image
SHI18
At any time in, 2012 (was/were) (you/ anyone in this household) covered by TRICARE, CHAMPVA, VA, military health care, or Indian Health Service? NOTE: CHAMPVA is the Civilian Health And Medical Program of the Department of Veteran's Affairs.
1 Yes
2 No

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ASEC 2012
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SHI18
At any time in, 2011 (was/were) (you/ anyone in this household) covered by TRICARE, CHAMPVA, VA, military health care, or Indian Health Service? NOTE: CHAMPVA is the Civilian Health And Medical Program of the Department of Veteran's Affairs.
1 Yes
2 No

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ASEC 2011
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SHI18
At any time in, 2010 (was/were) (you/ anyone in this household) covered by TRICARE, CHAMPVA, VA, military health care, or Indian Health Service?
NOTE: CHAMPVA is the Civilian Health and Medical Program of the Department of Veterans Affairs.
(1) Yes
(2) No

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ASEC 2010
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SHI18
At any time in, 2009 (was/were) (you/ anyone in this household) covered by TRICARE, CHAMPUS, CHAMPVA, VA, military health care, or Indian Health Service?
NOTE: CHAMPVA IS THE CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE DEPARTMENT OF VETERAN'S AFFAIRS.
(1) Yes
(2) No

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ASEC 2009
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SHI18
At any time in, 2008 (was/were) (you/ anyone in this household) covered by TRICARE, CHAMPUS, CHAMPVA, VA, military health care, or Indian Health Service?
NOTE: CHAMPVA IS THE CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE DEPARTMENT OF VETERAN'S AFFAIRS.
(1) Yes
(2) No