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Section 15, Part B - Medical and Health Expenditures - Screening Questions for Reimbursements
Section 15, Part B covers reimbursements received by the consumer unit for medical services,
prescription drugs, and medical supplies or 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 your reimbursements.
By reimbursements I mean any money received for any members of your
CU from an insurance company, medical care provider or non-CU
member for medical expenses which you previously paid or will pay.
- Enter 1 to continue
For definitions Information Booklet »
Since the first of the reference month, have you or any members of
your CU received any medical reimbursements?
* IF YES - What did you get reimbursed for?
- Eye examinations, treatment, or surgery
- Purchase of eye glasses or contact lenses
- Dental care
- Inpatient hospital room
- Inpatient hospital services
- Services by medical professionals other than physicians
- Physician services
- Lab tests or x-rays
- Care in convalescent or nursing homes
- Other medical care
- Hearing aids
- Prescribed medicines or prescribed drugs
- Rental of supportive or convalescent equipment
- Purchase of supportive or convalescent equipment
- Rental of medical or surgical equipment for general use
- Purchase of medical or surgical equipment for general use
- None/No more
* Ask if not apparent
Describe the care/service/item. [enter text] _____________
* Ask if not apparent
Who was/were the "care/service/item" for?
- Active member CU "number"
- Non-CU member
* Enter name of person: [enter text] _____________
In what month was(were) the reimbursement(s) received?
[enter text] _____________
What was the total amount received? [enter value] _____________
* Enter 'C' for a combined reimbursement
- C
- Not combined expense
What other medical reimbursement is the "care/service/item" combined with?
* Enter all that apply
- Eye examinations, treatment, or surgery
- Purchase of eye glasses or contact lenses
- Dental care
- Inpatient hospital room
- Inpatient hospital services
- Services by medical professionals other than physicians
- Physician services
- Lab tests or x-rays
- Care in convalescent or nursing homes
- Other medical care
- Hearing aids
- Prescribed medicines or prescribed drugs
- Rental of supportive or convalescent equipment
- Purchase of supportive or convalescent equipment
- Rental of medical or surgical equipment for general use
- Purchase of medical or surgical equipment for general use
- Misc. combined (unable to specify/DK)
Did you or any members of your CU receive any other reimbursements for
the "care/service/item"?
- Yes
- No
End of Section 15B
Go to Section 16 - Educational Expenses »
Go to CE CAPI Survey Instrument Home Page »
Last Modified Date: October 11, 2005
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