Person 1 (continued)
16. Is this person currently covered by any of the following types of health insurance or health coverage plans?
Mark yes or no for each type of coverage in items a - h.
a. Insurance through a current or former employer or union (of this person or another family member)
[] Yes
[] No
b. Insurance purchased directly from an insurance company (by this person or another family member)
[] Yes
[] No
c. Medicare, for people 65 and older, or people with certain disabilities
[] Yes
[] No
d. Medicaid, Medical assistance, or any kind of government-assistance plan for those with low incomes or a disability
[] Yes
[] No
e. Tricare or other military health care
[] Yes
[] No
f. VA (including those who have ever used or enrolled for VA health care)
[] Yes
[] No
g. Indian health service
[] Yes
[] No
h. Any other type of health insurance or health coverage plan - specify
[] Yes
[] No
________
Questions 7-48 are a continuation of the questions for each person. Questions 7-48 are a continuation of the questions for each person. (Questions 1-6 appear on pages 2, 3, and 4 of the questionnaire.)
16. Mark the "yes" or "no" box for each part of question 16.
If the person reports any other type of coverage plan in 16h, specify the type of coverage or name of the plan in the write-in box. Do not include plans that cover only one type of health care (such as dental plans) or plans that only cover a person in case of an accident or disability.