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Section 15, Part A collects out-of-pocket medical payments, including payments for medical services, prescription drug purchases, and rentals or purchases of medical supplies and equipment. IMPORTANT: The Census Bureau does not release to the Bureau of Labor Statistics any confidential information such as names and addresses. This information is only used during the course of the interview.
By payments I mean any expenses paid by any members of your CU directly to a medical provider by cash, check, or credit card for a medical service or item. Include all payments, even those for persons who are outside of your CU.
For definitions Information Booklet »
Since the first of the reference month, have you or any members of your CU made any payments for the following?
* Read each item on list
Describe the care/service/item.[enter text] _______________
Who was/were the "care/service/item" for?
* Enter name of person: [enter text] _____________
In what month was(were) the payment(s) made? [enter text] _____________
* Enter 13 for a continuous expense
What was the total amount paid? [enter value] _____________
* For continuous payments, do not include expenses for the current month
* Enter 'C' for a combined expense
What is the "care/service/item" combined with?
* * Enter all that apply
Did you or any members of your CU make any other payments for the "care/service/item"?
Go to Section 15 Part B - Screening Questions for Reimbursements »
Go to CE CAPI Survey Instrument Home Page »
Last Modified Date: October 11, 2005