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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.
Now I am going to ask you some questions about medical payments and reimbursements. I will begin with your payments.
By payments I mean any expenses paid by any members of your CU directly to a medical provider by cash, check, credit card, or automatically deducted from your account 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] _______________
Was/were the care/service/item for a member of your CU or someone outside of your CU?
In what month was(were) the payment(s) made? [enter text] _____________
* Enter 13 for same amount each month of the reference period
What was the total amount paid in the above month?/ What is your monthly expense? [enter value] _____________
* 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: April 16, 2009