Household Reports of HMOs Sample Clauses

Household Reports of HMOs. The variable UPRHMO identifies records for HMO coverage when the household respondent reported that the insurance was purchased through an HMO, reported the insurance company was an HMO, or described the plan as an HMO. In all cases the respondent answered a question using the term “HMO.” UPRHMO is set to “yes” if any of the three following conditions are met: 1. If the respondent reported insurance purchased directly through an HMO (HX03, HX23) 2. If the respondent identified the type of insurance company as an HMO (HX49, HX51) 3. If the respondent answered yes to the following question (MC01): {Is/Was} (POLICYHOLDER)’s {NAME OF INSURER BEING LOOPED ON} an HMO {as of (END DATE)}? {When answering this question, do not consider (POLICYHOLDER)’s insurance through Medicare.} [With an HMO, you must generally receive care from HMO physicians. For other doctors, the expense is not covered unless you were referred by the HMO or there was a medical emergency.] UPRHMO is set to “no” when the plan was not an HMO. UPRHMO is set to “inapplicable” when the plan was not hospital/physician or Medicare supplemental coverage.

Household Reports of HMOs. ‌ The variable UPRHMO_M23 identifies records for HMO coverage when the household respondent reported the insurance company was an HMO. Note that plan source categories at HX200/HX300/HP40 were collapsed so respondents can no longer specify that the insurance was purchased directly through an HMO. The HMO question is asked of all private coverage records, even if the person also reports Medicaid or another government-sponsored plan with hospital/physician coverage in the round. UPRHMO_M23 is set to Yes (1) if the respondent answered Yes (1) to the following question (MC10): {Is/Was} {your/{POLICYHOLDER}’s } {NAME OF INSURER} an HMO {as of (END DATE)}? {When answering this question, do not consider {your/his/her} insurance through Medicare.} [With an HMO, you must generally receive care from HMO physicians. For other doctors, the expense is not covered unless you were referred by the HMO or there was a medical emergency.] UPRHMO_M23 is set to No (2) when the plan was not an HMO. UPRHMO_M23 is set to Inapplicable (-1) when the plan was not hospital/physician or Medicare supplemental coverage. If respondents did not know or refused to indicate whether the plan includes hospital/physician and Medicaid coverage, MC10 is not asked. In those cases, UPRHMO_M23 is set to Cannot Be Computed (-15).

Household Reports of HMOs. ‌ The variable UPRHMO identifies records for HMO coverage when the household respondent reported that the insurance was purchased through an HMO, reported the insurance company was an HMO, or described the plan as an HMO. In all cases the respondent answered a question using the term “HMO.” The HMO question is asked of all private coverage records, even if the person also reports Medicaid or another government-sponsored plan with hospital/physician coverage in the round. UPRHMO is set to 1 YES if either of the following conditions are met: 1. If the respondent reported insurance purchased directly through an HMO (HX200, HX300, HP40) 2. If the respondent answered 1 YES to the following question (MC10): {Is/Was} {your/{POLICYHOLDER}’s } {NAME OF INSURER} an HMO {as of (END DATE)}? {When answering this question, do not consider {your/his/her} insurance through Medicare.} [With an HMO, you must generally receive care from HMO physicians. For other doctors, the expense is not covered unless you were referred by the HMO or there was a medical emergency.] UPRHMO is set to 2 NO when the plan was not an HMO. UPRHMO is set to -1 INAPPLICABLE when the plan was not hospital/physician or Medicare supplemental coverage.