Variable Format    Q#/Freq            Description/Label
 
BASEID   $BSIDFMT                      Unique SP Identification Number          
                         68,388        LOW-HIGH          BASEID Count                            
 
SURVEYYR SVYRFMT                       Survey Year                              
                         68,388                    2019  2019                                    
 
VERSION  VERSFMT                       Version Number                           
                         68,388                       1  Version 1                               
 
PLANNUM  RNDFKFMT                      Unique Plan Number                       
                         57,244                       .  Inapplicable                            
                         11,144        Range of values   Unique Plan Id                          
                 First available in 2015
 
PLANTYPE PLAN3FMT                      Plan Type                                
                         15,807                       1  Medicare A                              
                         15,305                       2  Medicare B                              
                          7,503                       3  Medicare C/Medicare Advantage           
                         13,068                       4  Medicare D/Part D/MAPD                  
                          4,726                       5  Medicaid                                
                            829                       6  Other Public Plan                       
                          2,948                      20  Employer-sponsored insurance (ESI)      
                          2,042                      21  Employer-sponsored (ESI) Specialty Plan 
                          3,423                      30  Self-purchased Private Plan             
                          1,121                      31  Self-purchased Specialty Plan           
                             76                      40  Veterans Affairs Plan                  
                            808                      50  Tricare plan                            
                            442                      60  Retiree Drug Subsidy Plan               
                            290                      70  Other Insurance Plan Type Unknown       
 
BEGDATE  MMDDYYn8                      Coverage Begin Date for Year(MMDDYYYY)   
                         68,388        MMDDYYYY          Date as MMDDYYYY                        
 
ENDDATE  MMDDYYn8                      Coverage End Date for Year(MMDDYYYY)     
                            116                       .  Inapplicable                            
                         68,272        MMDDYYYY          Date as MMDDYYYY                        
 
SRCCOV01 COV2FMT                       Coverage Source Jan                      
                          1,914                       0  No Entitlement                          
                         12,694                       1  Survey Data Only                        
                         39,621                       2  CMS Administrative Data Only            
                         14,159                       3  Both Survey and Admin Data              
 
SRCCOV02 COV2FMT                       Coverage Source Feb                      
                          1,934                       0  No Entitlement                          
                         12,679                       1  Survey Data Only                        
                         39,577                       2  CMS Administrative Data Only            
                         14,198                       3  Both Survey and Admin Data              
 
SRCCOV03 COV2FMT                       Coverage Source Mar                      
                          2,011                       0  No Entitlement                          
                         12,692                       1  Survey Data Only                        
                         39,439                       2  CMS Administrative Data Only            
                         14,246                       3  Both Survey and Admin Data              
 
SRCCOV04 COV2FMT                       Coverage Source Apr                      
                          2,069                       0  No Entitlement                          
                         12,678                       1  Survey Data Only                        
                         39,368                       2  CMS Administrative Data Only            
                         14,273                       3  Both Survey and Admin Data              
 
SRCCOV05 COV2FMT                       Coverage Source May                      
                          2,056                       0  No Entitlement                          
                         12,688                       1  Survey Data Only                        
                         39,288                       2  CMS Administrative Data Only            
                         14,356                       3  Both Survey and Admin Data              
 
SRCCOV06 COV2FMT                       Coverage Source June                     
                          2,125                       0  No Entitlement                          
                         12,677                       1  Survey Data Only                        
                         39,244                       2  CMS Administrative Data Only            
                         14,342                       3  Both Survey and Admin Data              
 
SRCCOV07 COV2FMT                       Coverage Source July                     
                          2,123                       0  No Entitlement                          
                         12,671                       1  Survey Data Only                        
                         39,187                       2  CMS Administrative Data Only            
                         14,407                       3  Both Survey and Admin Data              
 
SRCCOV08 COV2FMT                       Coverage Source Aug                      
                          2,121                       0  No Entitlement                          
                         12,720                       1  Survey Data Only                        
                         39,148                       2  CMS Administrative Data Only            
                         14,399                       3  Both Survey and Admin Data              
 
SRCCOV09 COV2FMT                       Coverage Source Sep                      
                          2,143                       0  No Entitlement                          
                         12,717                       1  Survey Data Only                        
                         39,546                       2  CMS Administrative Data Only            
                         13,982                       3  Both Survey and Admin Data              
 
SRCCOV10 COV2FMT                       Coverage Source Oct                      
                          2,215                       0  No Entitlement                          
                         12,736                       1  Survey Data Only                        
                         39,843                       2  CMS Administrative Data Only            
                         13,594                       3  Both Survey and Admin Data              
 
SRCCOV11 COV2FMT                       Coverage Source Nov                      
                          2,336                       0  No Entitlement                          
                         12,714                       1  Survey Data Only                        
                         40,380                       2  CMS Administrative Data Only            
                         12,958                       3  Both Survey and Admin Data              
 
SRCCOV12 COV2FMT                       Coverage Source Dec                      
                          2,556                       0  No Entitlement                          
                         12,637                       1  Survey Data Only                        
                         41,222                       2  CMS Administrative Data Only            
                         11,973                       3  Both Survey and Admin Data              
 
COV01    ELIGCOVF                      Monthly Eligibility Jan                  
                          3,547                       0  Ineligible / Not covered                
                         64,841                       1  Eligible / Covered                      
 
COV02    ELIGCOVF                      Monthly Eligibility Feb                  
                          3,550                       0  Ineligible / Not covered                
                         64,838                       1  Eligible / Covered                      
 
COV03    ELIGCOVF                      Monthly Eligibility Mar                  
                          3,565                       0  Ineligible / Not covered                
                         64,823                       1  Eligible / Covered                      
 
COV04    ELIGCOVF                      Monthly Eligibility Apr                  
                          3,594                       0  Ineligible / Not covered                
                         64,794                       1  Eligible / Covered                      
 
COV05    ELIGCOVF                      Monthly Eligibility May                  
                          3,533                       0  Ineligible / Not covered                
                         64,855                       1  Eligible / Covered                      
 
COV06    ELIGCOVF                      Monthly Eligibility June                 
                          3,462                       0  Ineligible / Not covered                
                         64,926                       1  Eligible / Covered                      
 
COV07    ELIGCOVF                      Monthly Eligibility July                 
                          3,309                       0  Ineligible / Not covered                
                         65,079                       1  Eligible / Covered                      
 
COV08    ELIGCOVF                      Monthly Eligibility Aug                  
                          3,335                       0  Ineligible / Not covered                
                         65,053                       1  Eligible / Covered                      
 
COV09    ELIGCOVF                      Monthly Eligibility Sep                  
                          3,722                       0  Ineligible / Not covered                
                         64,666                       1  Eligible / Covered                      
 
COV10    ELIGCOVF                      Monthly Eligibility Oct                  
                          4,059                       0  Ineligible / Not covered                
                         64,329                       1  Eligible / Covered                      
 
COV11    ELIGCOVF                      Monthly Eligibility Nov                  
                          4,764                       0  Ineligible / Not covered                
                         63,624                       1  Eligible / Covered                      
 
COV12    ELIGCOVF                      Monthly Eligibility Dec                  
                          5,773                       0  Ineligible / Not covered                
                         62,615                       1  Eligible / Covered                      
 
S_DVH    DVHFMT                        Dental Vision or Hearing Plan            
                         65,805                       .  Inapplicable                            
                          1,903                       1  Dental only plan                        
                            606                       2  Vision only plan                        
                             55                       3  Dental and vision plan                  
                             19                       4  Other dental vision or hearing          
 
S_OTHPLN OTPLNFMT                      Other plan type                          
                         67,425                       .  Inapplicable                            
                            155                       1  Long term care plan                     
                            683                       2  Prescription drug only plan             
                             27                       3  Life insurance plan                     
                             98                       4  Cancer / dread disease plan             
 
S_HMOPPO YESNO_HI                      Is Plan an HMO/PPO                       
                            883                       D  Don't know                              
                         58,564                       .  Inapplicable                            
                            317                       N  Not ascertained                         
                             96                       R  Refused                                 
                          2,376                       1  Yes                                     
                          6,152                       2  No                                      
                 First available in 2015
 
S_PHREL  REL2FMT                       Policyholder relationship                
                         58,564                       .  Inapplicable                            
                            375                       N  Not ascertained                         
                          7,811                       1  Sample person                           
                          1,555                       2  Spouse                                  
                             34                      30  Father                                  
                             42                      40  Mother                                  
                              7                      56  Partner                                 
                 First available in 2015
 
S_COVNM  PEOPLE                        Total number of people covered by Plan   
                              3                       D  Don't know                              
                         58,564                       .  Inapplicable                            
                            539                       N  Not ascertained                         
                              2                       R  Refused                                 
                          5,675                       1  One person                              
                          3,304                       2  Two people                              
                            165                       3  Three people                            
                             88                       4  Four people                             
                             21                       5  Five people                             
                             15                       6  Six people                              
                              8                       7  Seven people                            
                              4                      8+  Eight or more people                    
                 First available in 2015
 
S_OBTNP  MIPFMT                        How did MIP obtain Plan                  
                         58,564                       .  Inapplicable                            
                            526                       N  Not ascertained                         
                          3,841                       1  Directly                                
                          1,170                       2  Main insured person's current employer  
                          3,217                       3  Main insured person's prior employer    
                            329                       4  Union                                   
                             32                       5  Family business                         
                            333                       6  AARP                                    
                            295                       7  Deceased spouse's employer              
                             41                       8  Deceased spouse's union                 
                             40                       9  Fraternal/professional organization     
                 First available in 2015
 
S_MSCOV  YESNO_HI                      Does Plan cover doctor visits / lab work 
                            243                       D  Don't know                              
                         58,564                       .  Inapplicable                            
                            448                       N  Not ascertained                         
                              1                       R  Refused                                 
                          6,199                       1  Yes                                     
                          2,933                       2  No                                      
                 First available in 2015
 
S_IP     YESNO_HI                      Does Plan cover inpatient stay           
                            370                       D  Don't know                              
                         58,564                       .  Inapplicable                            
                            542                       N  Not ascertained                         
                              2                       R  Refused                                 
                          5,562                       1  Yes                                     
                          3,348                       2  No                                      
                 First available in 2015
 
S_DNTAL  YESNO_HI                      Does Plan cover dental services          
                            167                       D  Don't know                              
                         58,564                       .  Inapplicable                            
                            463                       N  Not ascertained                         
                              1                       R  Refused                                 
                          3,329                       1  Yes                                     
                          5,864                       2  No                                      
                 First available in 2015
 
S_COVNH  YESNO_HI                      Does Plan cover stay in nursing home     
                          1,975                       D  Don't know                              
                         58,564                       .  Inapplicable                            
                            463                       N  Not ascertained                         
                              3                       R  Refused                                 
                          1,396                       1  Yes                                     
                          5,987                       2  No                                      
                 First available in 2015
 
D_COVRX  RXPLFMT                       Drug coverage for Plan                   
                         57,217                       .  Inapplicable                            
                            631                       N  Not ascertained                         
                          4,535                       1  Plan covers prescription drugs          
                          6,005                       2  Plan does not cover prescription drugs  
                 First available in 2015
 
S_TRIRX  TRIRXFMT                      Where Tricare Member obtains medicine    
                              7                       D  Don't know                              
                         67,580                       .  Inapplicable                            
                            150                       N  Not ascertained                         
                            306                       1  Tricare mail order pharmacy             
                             57                       2  Tricare retail network pharmacy         
                            189                       3  Military Treatment Facility             
                             76                       4  Non-network retail pharmacy             
                             23                      91  Other                                   
                 First available in 2015
 
S_PAYSP  YESNO_HI                      MIP pay any premium for Plan             
                            247                       D  Don't know                              
                         58,564                       .  Inapplicable                            
                            543                       N  Not ascertained                         
                              1                       R  Refused                                 
                          7,620                       1  Yes                                     
                          1,413                       2  No                                      
                 First available in 2015
 
S_PREM   PREMAFMT                      Premium MIP pays for Plan                
                          1,790                       D  Don't know                              
                         60,768                       .  Inapplicable                            
                              2                       N  Not ascertained                         
                             21                       R  Refused                                 
                          5,807        Range of values   Premium Amount                          
                 First available in 2015
 
D_ANNPRM PREMAFMT                      Annualized premium MIP pays for Plan     
                          1,790                       D  Don't know                              
                         60,768                       .  Inapplicable                            
                             20                       N  Not ascertained                         
                             21                       R  Refused                                 
                          5,789        Range of values   Premium Amount                          
                 First available in 2015
 
S_PAYUNT PAYUNITF                      Unit of premium MIP pays for Plan        
                            218                       D  Don't know                              
                         60,768                       .  Inapplicable                            
                              2                       N  Not ascertained                         
                              3                       R  Refused                                 
                            658                       1  Per year                                
                            219                       2  Quarterly / Every 3 months              
                             54                       3  Every 2 months                          
                          6,061                       4  Per month                               
                            108                       5  Per week                                
                             44                       6  Every 6 months                          
                            105                       7  Every 2 weeks                           
                            148                      91  Other                                   
                 First available in 2015
 
S_PAYOTH YESNO_HI                      Anyone else pays a portion of Plan cost  
                            449                       D  Don't know                              
                         58,564                       .  Inapplicable                            
                            547                       N  Not ascertained                         
                              4                       R  Refused                                 
                          3,000                       1  Yes                                     
                          5,824                       2  No                                      
                 First available in 2015
 
S_PAYWHO PAYWHOF                       Who pays a portion of Plan cost          
                             16                       D  Don't know                              
                         65,388                       .  Inapplicable                            
                            723                       1  Sample person's current employer        
                          1,724                       2  Sample person's prior employer          
                            235                       3  Sample person's union                   
                             14                       4  Spouse's current employer               
                            214                       5  Spouse's former employer                
                              7                       6  Fraternal / professional organization   
                             19                       7  Medicaid / Medical assistance           
                             48                      91  Other                                   
                 First available in 2015
 
D_FCLTYF FACILTYF                      Plan information obtained from Facility  
                         56,851                       .  Inapplicable                            
                         11,144                       0  Plan not reported by a facility         
                            393                       1  Plan reported by a facility             
                 First available in 2015
 
