Section 14, Part C - Hospitalization and Health Insurance - Medicare, Medicaid, and Other Health Insurance Plans Not
Directly Paid For By The Consumer Unit
Section 14, Part C covers participation in health insurance plans for which the consumer unit does not pay directly, such as Medicare, Medicaid, and military health care plans.
For definitions Information Booklet »
Last time you said that a CU member was/CU
members were enrolled in Medicare. Has the number of CU members
enrolled in Medicare changed?
- Yes
-
No
Are you or any members of your CU presently enrolled in Medicare or have
you or any members of your CU been enrolled since the first of the reference month?
Medicare is the Federal Health Insurance Plan.
- Yes
- No
Are you/How many members of your CU are covered by Medicare?
[enter value] ______________
Last time you said that a CU member was/CU
members were enrolled in Medicaid. Has the number of members
enrolled in Medicaid changed?
- Yes
- No
Are you or any members of your CU enrolled in Medicaid or have
you or any members of your CU been enrolled since the first of the reference month?
- Yes
- No
Are you/How many members of your CU are covered by Medicaid?
[enter value] ______________
Are any members of your CU still covered by a plan other than
Medicare or Medicaid TRICARE, CHAMPUS, or military health
care?
- Yes
- No
Are you or any member of your CU covered by any plan other than Medicare or
Medicaid which provides free health care such as TRICARE, CHAMPUS or
military health care?
-
1. Yes
-
2. No
End of Section 14C
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Screening Questions for Payments »
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Last Modified Date: October 11, 2005