Attachment C - Demographic and Other Self-reported Question Items

ATTACHMENT C

Demographic and Other Self-reported
Question Items

MILITARY RETIRED SURVEY
Did you retire as:
⃝ Enlisted
⃝ Officer or Warrant Officer
Family Status:
⃝ Single with Child(ren)
⃝ Single without Child(ren)
⃝ Married with Child(ren)
⃝ Married without Child(ren)
What is your current employment status?
⃝ Employed full time (at least 50 weeks per year and 35 hours per week)
⃝ Employed part-time (less than 50 weeks per year and 35 hours per week)
⃝ Not employed, but seeking work
⃝ Not employed, and not seeking work
What retirement plans do you participate in? (Check all that apply)
⃝ I participate in the military retirement plan
⃝ I have a current or former employer-provided retirement plan
⃝ I have a personal retirement account(s), such as an IRA, TSP or 401k.
What is your current health insurance status? (Check all that apply)
⃝ TRICARE Prime assigned to military facility
⃝ TRICARE Prime assigned to civilian provider
⃝ TRICARE Standard
⃝ TRICARE Extra
⃝ Receive health insurance through civilian employment
⃝ Receive health insurance through spouse’s employer
⃝ Have access to civilian health insurance but do not use.

On average, how long does it take you to get to the closest in-patient military or VA hospital?
⃝ Under 15 minutes
⃝ 15-30 minutes
⃝ 31-60 minutes
⃝ More than 60 minutes
On average how long does it take you to get to the closest in-patient civilian hospital?
⃝ Under 15 minutes
⃝ 15-30 minutes
⃝ 31-60 minutes
⃝ More than 60 minutes
On average, how long does it take you and/or your dependent(s) to get to the nearest military facility
for support services (for example, commissary or exchange).
⃝ Under 15 minutes
⃝ 15-30 minutes
⃝ 31-60 minutes
⃝ More than 60 minutes