Attachment 14 – HC Showcards

14-HC Showcards.docx

Medical Expenditure Panel Survey Household Component and Medical Provider Component (MEPS-HC and MEPS-MPC)

Attachment 14 – HC Showcards

OMB: 0935-0118

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MEDICAL EXPENDITURE PANEL SURVEY



HOUSEHOLD COMPONENT

MAIN STUDY



BLAISE/WVS


SHOW CARDS




Panels 19, 20, and 21






January 2016

Shape2 Shape1


TABLE OF CONTENTS

ROUNDS 1-5


Card Number

Topic

Round(s) Used


RE-1

Ethnic Background

1, 2, 3, 4, 5

RE-2

Racial Background

1, 2, 3, 4, 5

PE-1

Types of Cancer

1, 2, 3, 4, 5

HE-1

Level of Difficulty Categories

1, 3, 5

CS-2

Scale for Child Health Supplement

2, 4

CS-3

Scale for Child Health Supplement

2, 4

CS-4

Number of Times Went to Doctor’s Office or Clinic

2, 4

CS-5

Scale for Child Health Supplement

2, 4

PP-1

Types of Health Care Providers and Facilities

1, 2, 3, 4, 5

PP-2

Types of Hospital Services/Long Term Care Facilities

1, 2, 3, 4, 5

PP-3

Types of Home Care Services

1, 2, 3, 4, 5

PP-3A

Types of Long Term Care Facilities

1, 2, 3, 4, 5

PP-4

Types of Medical Supplies/Expenses

1, 2, 3, 4 ,5

PP-5

Types of Additional Medical Supplies/Expenses

3, 5

PP-6

Types of Dental Care Providers

1, 2, 3, 4, 5

PP-7

Types of Medical Providers

1, 2, 3, 4, 5

PP-8

Types of Hospital Services

1, 2, 3, 4, 5

PP-9

Types of Other Medical Providers

1, 2, 3, 4, 5

PP-10

Types of Home Care Services

1, 2, 3, 4, 5

PP-11

Types of Long Term Care Facilities

1, 2, 3, 4, 5

PP-12

Types of Medical Supplies/Expenses

1, 2, 3, 4, 5

PP-13

Types of Additional Medical Supplies/Expenses

3, 5

EV-1A

Examples of Where Care Received (Event Typing)

1, 2, 4

EV-1B

Examples of Where Care Received (Event Typing)

3, 5

HS-1

Reasons for Entering the Hospital

1, 2, 3, 4, 5

ER-1

Care Received During ER Visit

1, 2, 3, 4, 5

ER-2

Services Received During ER Visit

1, 2, 3, 4, 5

OP-1

Care Received During Outpatient Visit

1, 2, 3, 4, 5

OP-2

Services Received During Outpatient Visit

1, 2, 3, 4, 5

Table of Contents Continued on the Following Page

TABLE OF CONTENTS (Cont.)


Card Number

Topic

Round(s) Used


MV-1

Care Received During Medical Provider Visit

1, 2, 3, 4, 5

MV-2

Services Received During Medical Provider Visit

1, 2, 3, 4, 5

DN-1

Types of Dental Care Providers

1, 2, 3, 4, 5

DN-2

Care Received During Dental Visit

1, 2, 3, 4, 5

HH-1

Types of Home Health Care Workers

1, 2, 3, 4, 5

HH-2

Examples of Home Health Care Received

1, 2, 3, 4, 5

HH-3

Examples of Help With Daily Activities or Personal Care

1, 2, 3, 4, 5

CP-1

Reasons for Not Receiving Anything in Writing

1, 2, 3, 4, 5

PC-1

Last Use of Peak Flow Meter

3, 5

AP-1

Weight Ranges

3, 5

AC-1

Difficulty Scale

2, 4

AC-2

Provider’s Race

2, 4

AC-3

Frequency Scale

2, 4

AC-4

Reasons for Problems

2, 4

HX-1

Ways in Which Health Insurance is Purchased (for STATE)

1, 2, 3, 4, 5

HX-2

Sample Medicare Card

1, 2, 3, 4, 5

HX-3

Sample Medicaid Card for STATE

1, 2, 3, 4, 5

HX-4

Source of Health Insurance (for STATE)

1, 2, 3, 4, 5

HX-6

Medicare HMO Premium Ranges

1, 3

HX-7

Medicare Part D Premium Ranges

1, 3

HX-9

Types of Health Insurance Coverage

1, 2, 3, 4, 5

HX-11

Types of Other State Programs

2, 3, 4, 5

IN-1

Yearly Income Ranges

3, 5

IN-2

Yearly Income Ranges

3, 5

IN-3

Monthly Income Ranges

3, 5

IN-4

Other Sources of Income Categories

3, 5

AS-1

Asset Ranges

5

AS-2

Asset Ranges

5

AS-3

Asset Ranges

5

AS-4

Other Financial Assets

5

AS-5

Other Property and Assets

5


CARD RE-1

RE-1


Shape3

One or more categories may be selected.




-- Mexican


-- Mexican-American/Chicano


-- Puerto Rican


-- Cuban/Cuban American


-- Dominican


-- Central or South American


CARD RE-2

Shape4

One or more categories may be selected.

RE-2







-- White

-- Black or African American

-- American Indian or Alaska Native

-- Asian Indian

-- Chinese

-- Filipino

-- Japanese

-- Korean

-- Vietnamese

-- Other Asian

-- Native Hawaiian

-- Guamanian or Chamorro

-- Samoan

-- Other Pacific Islander

CARD PE-1



PE-1

-- Bladder

-- Blood

-- Bone

-- Brain

-- Breast

-- Cervix

-- Colon

-- Esophagus

-- Gallbladder

-- Kidney

-- Larynx-Windpipe

-- Leukemia

-- Liver

-- Lung

-- Lymphoma

-- Melanoma

-- Mouth/Tongue/Lip

-- Ovary

-- Pancreas

-- Prostate

-- Rectum

-- Skin – Non-Melanoma

-- Skin (unknown type)

-- Soft tissue muscle or fat

-- Stomach

-- Testis

-- Throat-Pharynx

-- Thyroid

-- Uterus

-- Other

CARD HE-1

HE-1



-- No Difficulty


-- Some Difficulty

-- A Lot of Difficulty


-- Completely Unable To Do It




CARD CS-2

CS-2





  1. No Problem

2 Some Problem

3

4 A Very Big Problem



CARD CS-3

CS-3




-- Never

-- Sometimes

-- Usually

-- Always



CARD CS-4

CS-4




None

1

2

3

4

5-9

10 or more

CARD CS-5

CS-5




  1. Worst Health Care Possible

2

3

4

5

6

7

8

9

10 Best Health Care Possible



CARD PP-1

TYPES OF HEALTH CARE PROVIDERS AND FACILITIES



Medical Professionals and Practitioners:


Medical Doctor

Nurse or Nurse Practitioner

Paramedic

Health Aide

Physician’s Assistant

Midwife/Nurse Midwife

Optometrist/Ophthalmologist

Podiatrist (Foot Doctor)

Chiropractor

Acupuncturist

Therapist - Physical, Speech,
Occupational

Audiologist

Physiatrist

Physical Therapy or
Rehabilitation Services



Mental Health Professionals:


Psychiatrist

Psychologist

Psychiatric Social Worker

PP-1

Mental Health Therapist


Medical Facility or Clinic:


Health Clinic

Walk-in Surgi-Clinic

Company or school Clinic

Infirmary

Neighborhood Health Clinic

Family Planning Center

Mental Health Facility

Retail Clinic (e.g., Pharmacy/ Grocery Store Clinic)




Dental Care:


Dentist

Dental or Oral Surgeon

Orthodontist

Dental Hygienist

Dental Technical

Dental Assistant


CARD PP-2


PP-2


TYPES OF HOSPITAL SERVICES



Hospital Stay


Emergency Room Visit


Outpatient Department Visit



CARD PP-3

PP-3



TYPES OF HOME CARE SERVICES


Skilled Medical Care


Home care from a nurse, any type of therapist, a doctor, a

social worker, or anyone else providing nursing or medical

care.



Personal Care


Home care services including bathing, dressing, help

getting around the house, or help with getting medication,

either paid or unpaid.



Household Chore Services


Help in the home with services like cooking or cleaning

either paid or unpaid.



Companionship


Services such as reading, talking, or going for a walk, a

drive, or to a restaurant either paid or unpaid.


Any Other Type of Home Care

CARD PP-3A

PP-3A



TYPES OF LONG TERM CARE FACILITIES


Inpatient Rehabilitation Facility or Convalescent Home


Nursing Home


Residential Mental Health Treatment Center


Residential Eating Disorder Treatment Center


Residential Drug and Alcohol Treatment Center


Residential Addiction Treatment Center


Residential Hospice Care


Residential Respite Care

CARD PP-4

PP-4



TYPES OF OTHER MEDICAL SUPPLIES/EXPENSES



Eyeglasses or Contact Lenses …


Bought

Replaced

Paid for Repairing



Diabetic Equipment or Supplies …


Insulin

Syringes

Test Paper

Other Diabetic Equipment or Supplies



CARD PP-5




Ambulance Services


Orthopedic Items

-- Corrective shoes or inserts

-- Braces

-- Crutches

-- Canes

-- Walkers

-- Wheelchairs

-- Scooters


Hearing Devices

-- Hearing aids

-- Amplifiers for a telephone

-- Adaptive speech equipment

-- Speech synthesizer


Prostheses

-- Artificial limbs


Bathroom Aids

-- Portable commodes

-- Raised toilet seats

-- Portable tub seats

-- Handrails

-- Other bathing equipment

PP-5



Medical Equipment

-- Hospital beds

-- Lifts

-- Monitors

-- Special chairs

-- Oxygen

-- Bed pans

-- Adaptive feeding equipment

-- Vaporizer or nebulizer

-- Blood pressure monitor


Disposable Supplies

-- Ostomy supplies

-- Bandages

-- Dressings

-- Tape

-- Adult disposable diapers

-- Catheters

-- Syringes not prescribed by a

physician

-- IV supplies


Alterations/Modifications

-- Ramps

-- Handrails

-- Elevators

-- Automobile modifications


Other

CARD PP-6

PP-6



TYPES OF DENTAL CARE PROVIDERS




Dentist


Dental or Oral Surgeon


Orthodontist


Dental Hygienist


Dental Technician


Dental Assistant


CARD PP-7

PP-7


TYPES OF MEDICAL PROVIDERS



Medical Professionals:


Medical Doctor Physician’s Assistant

Nurse Optometrist/Ophthalmologist Nurse Practitioner Podiatrist (Foot Doctor)

Midwife/Nurse Midwife Chiropractor

Physiatrist Acupuncturist

Paramedic Audiologist

Health Aide

Physical Therapy or Rehabilitation Services

Therapist-Physical, Speech, Occupational



Mental Health Professionals:


Psychiatrist

Psychologist

Psychiatric Social Worker

Mental Health Therapist

CARD PP-8

PP-8



TYPES OF HOSPITAL SERVICES



Hospital Stay



Emergency Room Visit



Outpatient Department Visit


CARD PP-9

PP-9


TYPES OF OTHER MEDICAL PROVIDERS


Medical Professionals and Practitioners:


Paramedic

Health Aide

Physician’s Assistant

Midwife

Optometrist/Ophthalmologist

Podiatrist (Foot Doctor)

Chiropractor

Acupuncturist

Therapist - Physical, Speech, Occupational

Audiologist

Physical Therapy or Rehabilitation Services


Medical Facility or Clinic:


Health Clinic

Walk-in Surgi-Clinic

Company or School Clinic

Infirmary

Neighborhood Health Clinic

Family Planning Center

Mental Health Facility

Retail Clinic (e.g., Pharmacy/Grocery Store Clinic)


Mental Health Professionals:


Psychiatric Social Worker

Mental Health Therapist

CARD PP-10

PP-10



TYPES OF HOME CARE SERVICES


Skilled Medical Care


Home care from a nurse, any type of therapist, a doctor, a

social worker, or anyone else providing nursing or medical

care.



Personal Care


Home care services including bathing, dressing, help

getting around the house, or help with getting medication, either paid or unpaid.



Household Chore Services


Help in the home with services like cooking or cleaning

either paid or unpaid.



Companionship


Services such as reading, talking, or going for a walk, a

drive, or to a restaurant either paid or unpaid.


Any Other Type of Home Care

CARD PP-11

PP-11



TYPES OF LONG TERM CARE FACILITIES


Inpatient Rehabilitation Facility or Convalescent Home


Nursing Home


Residential Mental Health Treatment Center


Residential Eating Disorder Treatment Center


Residential Drug and Alcohol Treatment Center


Residential Addiction Treatment Center


Residential Hospice Care


Residential Respite Care


CARD PP-12

PP-12



TYPES OF OTHER MEDICAL SUPPLIES/EXPENSES



Eyeglasses or Contact Lenses …


Bought

Replaced

Paid for Repairing



Diabetic Equipment or Supplies …


Insulin

Syringes

Test Paper

Other Diabetic Equipment or Supplies


CARD PP-13




Ambulance Services


Orthopedic Items

-- Corrective shoes or inserts

-- Braces

-- Crutches

-- Canes

-- Walkers

-- Wheelchairs

-- Scooters


Hearing Devices

-- Hearing aids

-- Amplifiers for a telephone

-- Adaptive speech equipment

-- Speech synthesizer


Prostheses

-- Artificial limbs


Bathroom Aids

-- Portable commodes

-- Raised toilet seats

-- Portable tub seats

-- Handrails

-- Other bathing equipment

PP-13



Medical Equipment

-- Hospital beds

-- Lifts

-- Monitors

-- Special chairs

-- Oxygen

-- Bed pans

-- Adaptive feeding equipment

-- Vaporizer or nebulizer

-- Blood pressure monitor


Disposable Supplies

-- Ostomy supplies

-- Bandages

-- Dressings

-- Tape

-- Adult disposable diapers

-- Catheters

-- Syringes not prescribed by a

physician

-- IV supplies


Alterations/Modifications

-- Ramps

-- Handrails

-- Elevators

-- Automobile modifications


Other

CARD EV-1A (Rounds 1, 2 and 4)

EV-1A



-- Hospital Stay

-- Hospital Emergency Room

-- Hospital Outpatient Department

-- Medical Provider

  • e.g., Doctor’s Office, Group Practice, Clinic, HMO, Lab, Mental Health Care, Alternative Care

-- Dental Office/Dental Clinic

-- At Home

-- Other Medical Expenses

  • Eyeglasses or Contact Lenses

  • Insulin, Other Diabetic Equipment/Supplies

-- Institutional/Long Term Care Stay

  • e.g., Nursing Home, Rehabilitation Facility, Drug Treatment, Psychiatric Facility

CARD EV-1B (Rounds 3 and 5)

EV-1B


-- Hospital Stay

-- Hospital Emergency Room

-- Hospital Outpatient Department

-- Medical Provider

  • e.g., Doctor’s Office, Group Practice, Clinic, HMO, Lab, Mental Health Care, Alternative Care

-- Dental Office/Dental Clinic

-- At Home

-- Other Medical Expenses

  • Eyeglasses or Contact Lenses

  • Insulin, Other Diabetic Equipment/Supplies

  • Ambulance, Orthopedic Items, Hearing Devices, Prostheses, Bathroom Aids, Medical Equipment, Disposable Supplies, Alterations/Modifications

-- Institutional/Long Term Care Stay

  • e.g., Nursing Home, Rehabilitation Facility, Drug Treatment, Psychiatric Facility

CARD HS-1

HS-1



-- Operation or Surgical Procedure


-- Treatment or Therapy, Not Including Surgery


-- Diagnostic Tests Only


-- Give Birth to a Baby - Normal or

Caesarean Section (Mother)


-- To Be Born (Baby)


-- Pregnancy-Related Complications




CARD ER-1

ER-1



-- Diagnosis or Treatment


-- Emergency (e.g., Accident or Injury)


-- Psychotherapy or Mental Health

Counseling


-- Follow-up or Post-Operative Visit


-- Immunization or Shots


-- Pregnancy-Related

(Including Prenatal Care and Delivery)


CARD ER-2

ER-2



-- Laboratory Tests


-- Throat Swab


-- Sonogram or Ultrasound


-- X-Rays


-- Mammogram


-- MRI or CAT Scan


-- EKG or ECG


-- EEG


-- Vaccination


-- Anesthesia


CARD OP-1

OP-1



-- General Checkup


-- Diagnosis or Treatment


-- Emergency (e.g., Accident or Injury)


-- Psychotherapy or Mental Health Counseling


-- Follow-up or Post-Operative Visit


-- Immunizations or Shots


-- Vision Exam


-- Pregnancy-Related

(Including Prenatal Care and Delivery)


-- Well Child Exam


-- Laser Eye Surgery

CARD OP-2

OP-2



-- Laboratory Tests


-- Throat Swab


-- Sonogram or Ultrasound


-- X-Rays


-- Mammogram


-- MRI or CAT Scan


-- EKG or ECG


-- EEG


-- Vaccination


-- Anesthesia

CARD MV-1

MV-1



-- General Checkup


-- Diagnosis or Treatment


-- Emergency (e.g., Accident or Injury)


-- Psychotherapy or Mental Health Counseling


-- Follow-up or Post-Operative Visit


-- Immunizations or Shots


-- Vision Exam


-- Pregnancy-Related

(Including Prenatal Care and Delivery)


-- Well Child Exam

-- Laser Eye Surgery

CARD MV-2



-- Laboratory Tests


-- Throat Swab


-- Sonogram or Ultrasound


-- X-Rays


-- Mammogram


MV-2

-- MRI or CAT Scan


-- EKG or ECG


-- EEG


-- Vaccination


-- Anesthesia


CARD DN-1

DN-1



-- General Dentist


-- Hygienist (Dental)


-- Technician (Dental)


-- Dental Surgeon


-- Orthodontist


-- Endodontist


-- Periodontist


-- Other


CARD DN-2

DN-2



* DIAGNOSTIC OR PREVENTATIVE

-- General Exam, Checkup or Consultation

-- Cleaning, Prophylaxis, or Polishing

-- X-Rays, Radiographs, or Bitewings

-- Fluoride Treatment

-- Sealant (Plastic Coatings on Back Teeth)


* RESTORATIVE OR ENDODONTIC

-- Fillings

-- Inlays

-- Crowns or Caps

-- Root Canal


* PERIODONTIC (GUM TREATMENT)

-- Periodontal Scaling, Root Planing, or Gum Surgery

-- Periodontal Recall Visit (Periodic or Regular)


* ORAL SURGERY

-- Extraction, Tooth Pulled

-- Implants

-- Abscess or Infection Treatment

-- Other Oral Surgery


* PROSTHETICS

-- Fixed Bridges

-- Dentures or Removable Partial Dentures

-- Relining or Repair of Bridges or Dentures


* ORTHODONTICS

-- Orthodontia, Braces, or Retainers

* ADDITIONAL PROCEDURES

-- Bonding, Whitening, or Bleaching

-- Treatment for TMD or TMJ

CARD HH-1


-- Certified Nursing Assistant (CNA)

-- Companion

-- Dietitian/Nutritionist

-- Home Health/Home Care Aide

-- Hospice Worker

-- Homemaker

-- I.V. or Infusion Therapist

-- Medical Doctor

-- Nurse/Nurse Practitioner

-- Nurse’s Aide

HH-1

-- Occupational Therapist

-- Personal Care Attendant

-- Physical Therapist

-- Respiratory Therapist

-- Social Worker

-- Speech Therapist

CARD HH-2

HH-2


Medical Treatments


Changing bandages, wound care, giving medication, taking blood pressure, giving shots or injections, any type of therapy, other medical treatments




Help Using Medical Equipment or Assistive Device (Examples)


Oxygen tank, wheelchair, walker, hospital bed, tub seat, special railing, special commode, other medical equipment or assistive device



Help With Daily Activities or Personal Care

(Examples)


Using the telephone, paying bills, shopping, driving, housework, preparing meals, bathing, dressing, using the toilet, getting in or out of a bed or chair, walking, eating, other daily activities or personal care

CARD HH-3

HH-3



Help With Daily

Activities or Personal Care

(Examples)



Using the telephone, paying bills, shopping, driving, housework, preparing meals, bathing, dressing, using the toilet, getting in or out of a bed or chair, walking, eating, other daily activities or personal care


CARD CP-1

CP-1


-- Paid at Time of Visit

-- Made a Co-payment

-- Bill Sent Directly to Other Source

-- Bill Has Not Arrived


-- No Bill Sent:

-- HMO Plan

-- VA (Veterans Administration)/CHAMPVA

-- Military Facility

-- Public Assistance/Medicaid/SCHIP

-- Indian Health Service (IHS)

-- Worker’s Compensation

-- School, Employer, or Other Private Health

Center/Clinic

-- Public Clinic/Health Center or Private

Charity (Include Community and Migrant

Health Center, Federally Qualified

Health Center)


-- No Charge: Telephone Call

-- Free From Provider

(Professional Courtesy/Free Sample)


-- Government-Financed Research And

Clinical Trials

CARD PC-1



PC-1


-- Within the last 7 days


-- More than 7 days ago, but within last 30 days


-- More than 30 days ago


CARD AP-1

AP-1



-- 99 pounds or less

-- 100 to 149 pounds

-- 150 to 199 pounds

-- 200 to 249 pounds

-- 250 to 299 pounds

-- 300 pounds or more

CARD AC-1

AC-1



-- Very Difficult

-- Somewhat Difficult

-- Not Too Difficult

-- Not At All Difficult

CARD AC-2

AC-2



-- White

-- Black/African American

-- Asian

-- Indian/Native American Alaska Native

-- Other Pacific Islander

-- Some Other Race

CARD AC-3



-- Never

-- Sometimes

-- Usually

-- Always

AC-3

CARD AC-4

AC-4


-- Couldn’t Afford Care

-- Insurance Company Wouldn’t Approve, Cover Or Pay For Care

-- Doctor Refused To Accept Family’s Insurance Plan

-- Problems Getting to Doctor’s Office

-- Different Language

-- Couldn’t Get Time Off Work

-- Didn’t Know Where To Go To Get Care

-- Was Refused Services

-- Couldn’t Get Child Care

-- Didn’t Have Time Or Took Too Long

CARD HX-1

HX-1



-- From a Professional Association


-- From a Small Business Group


-- From a Union


-- Directly From an Insurance Agent


-- Directly From Insurance Company


-- Directly From an HMO


-- Directly From a High Risk Pool


-- From a Previous Employer


-- From a Previous Employer (COBRA)


-- Directly From the Health Insurance Marketplace

CARD HX-2

HX-2



Sample Medicare Card








CARD HX-3

HX-3



Sample Medicaid Card

[State Name Here]


(One for Each State)


CARD HX-4

HX-4



-- From a Group or Association


-- Directly Through a School


-- Directly From an Insurance Agent


-- Directly From Insurance Company


-- Directly From an HMO


-- Directly From an High Risk Pool


-- From a Union


-- From Anyone’s Previous Employer (COBRA)


-- From Anyone’s Previous Employer

(Not COBRA)


-- From Spouse’s/Deceased Spouse’s Previous

Employer


-- From Some Other Employer


-- Under Plan of Someone Not Living Here


-- Directly From the Health Insurance Marketplace

CARD HX-6

HX-6




-- 1 - 50


-- 51 - 100


-- 101 - 200


-- 201 - 300


-- 301 or more



CARD HX-7

HX-7




-- 1 - 30


-- 31 - 60


-- 61 - 90


-- 91 - 120


-- 121 or more




CARD HX-9

HX-9



-- Hospital and Physician Benefits, Including

Coverage Through an HMO


-- Dental


-- Prescription Drugs


-- Vision


-- Medicare Supplement or Medigap


-- Long-Term Care in a Nursing Home


-- Extra Cash for Hospital Stays


-- Serious Disease or Dread Disease


CARD HX-11

HX-11



-- TANF (Temporary Aid for Needy Families)


-- SSI (Supplemental Security Income)


-- WIC (Women, Infants and Children)


-- IHS (Indian Health Service)


-- Public Health Clinic


-- VA (Veterans Administration)/CHAMPVA



CARD IN-1

IN-1




-- 1 - 5,000


-- 5,001 - 10,000


-- 10,001 - 15,000


-- 15,001 - 25,000


-- 25,001 - 50,000


-- 50,001 - 100,000


-- 100,001 or more




CARD IN-2




-- 1 - 100


-- 101 - 500


-- 501 - 1,000


-- 1,001 - 5,000


-- 5,001 - 15,000


-- 15,001 or more




IN-2

CARD IN-3

IN-3




-- 1 - 250


-- 251 - 500


-- 501 - 750


-- 751 - 1,000


-- 1,001 or more


CARD IN-4




-- Wages and salary


-- Farm income (or loss)


-- Business income (or loss)


-- Social Security/Railroad Retirement

IN-4


-- Private, military, or government pensions


-- Interest


-- Dividends


-- Rental income (or loss)


-- Other source


CARD AS-1




-- 0 - 10,000


-- 10,001 - 25,000


-- 25,001 - 50,000


-- 50,001 - 100,000


-- 100,001 - 250,000

AS-1


-- 250,001 - 500,000


-- 500,001 - 1,000,000


-- 1,000,001 or more

CARD AS-2




-- 0 - 100


-- 101 - 500


-- 501 - 1,000


-- 1,001 - 5,000


-- 5,001 - 10,000


-- 10,001 - 25,000


-- 25,001 - 50,000


-- 50,001 - 100,000


-- 100,001 or more



AS-2


CARD AS-3

AS-3




-- 0 - 1,000


-- 1,001 - 5,000


-- 5,001 - 10,000


-- 10,001 - 25,000


-- 25,001 - 50,000


-- 50,001 - 100,000


-- 100,001 - 250,000


-- 250,001 - 500,000


-- 500,001 or more


CARD AS-4

AS-4



-- Certificates of Deposit (CDs)


-- Government savings bonds


-- Individual development accounts


-- Treasury bills


-- Bonds


-- Bond mutual funds


-- Shares of stock


-- Stock mutual funds


-- Education savings accounts


-- Annuities


-- Trusts


-- Other financial assets

CARD AS-5



-- Second homes


-- Rental real estate


-- Business or Farm


-- Money owed to you by persons
outside of the family


-- Boats or other recreational vehicles


-- Other significant assets such as jewelry, art work or antiques

AS-5




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File TitleMEDICAL EXPENDITURE PANEL SURVEY
AuthorLinda Allers
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File Created2021-01-13

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