Recommendations for Monitoring Access to Care among Medicaid Beneficiaries at the State-level. Appendix C. BRFSS Module on Health Care Access for 2013



1 Do you have Medicare?


1            Yes

2            No

7            Don't know/Not sure

9 Refused

Note: Medicare is a coverage plan for people age 65 or over and for certain disabled people.


2 Are you CURRENTLY covered by any of the following types of health insurance or health

coverage plans?


(Select all that apply)

Please Read:

01 Your employer

02 Someone else's employer

03 A plan that you or someone else buys on your own

04 Medicaid or Medical Assistance [or substitute state program name]

05 The military, CHAMPUS, or the VA [or CHAMP-VA]

06 The Indian Health Service [or the Alaska Native Health Service]

07 Some other source

88 None

77 Don't know/Not sure

99 Refused

CATI Note: If PPHF State go to core 3.2


3 Other than cost, there are many other reasons people delay getting needed medical care.

Have you delayed getting needed medical care for any of the following reasons in the past 12 months? Select the most important reason.


Please read

1 You couldn't get through on the telephone.

2 You couldn't get an appointment soon enough.

3 Once you got there, you had to wait too long to see the doctor.

4 The (clinic/doctor's) office wasn't open when you got there.

5 You didn't have transportation.

Do not read:


6 Other ____________


8 No, I did not delay getting medical care/did not need medical care

7 Don't know/Not sure

9 Refused

CATI Note: If PPHF State, go to core 3.4

CATI Note: If Q3.1 = 1 (Yes) continue, else go to Q4b


4a In the PAST 12 MONTHS was there any time when you did NOT have ANY health

insurance or coverage?


1 Yes [Go to Q5]

2 No [Go to Q5]

7 Don't know/Not sure [Go to Q5]

9 Refused [Go to Q5]

CATI Note: If Q3.1 = 2, 7, or 9 continue, else go to next question (Q5)


4b About how long has it been since you last had health care coverage?


1 6 months or less

2 More than 6 months, but not more than 1 year ago

3 More than 1 year, but not more than 3 years ago

4 More than 3 years

5 Never

7 Don't know/Not sure

9 Refused

5 How many times have you been to a doctor, nurse, or other health professional in the past 12 months?


_ _ Number of times

8 8 None

7 7 Don't know/Not sure

9 9 Refused

6 Was there a time in the past 12 months when you did not take your medication as prescribed because of cost? Do not include over-the-counter (OTC) medication.


1 Yes

2 No

Do not read:

3 No medication was prescribed.

7 Don't know/Not sure

9 Refused

7 In general, how satisfied are you with the health care you received? Would you say—


1 Very satisfied

2 Somewhat satisfied

3 Not at all satisfied

Do not read

8 Not applicable

7 Don't know/Not sure

9 Refused


8 Do you currently have any medical bills that are being paid off over time?



This could include medical bills being paid off with a credit card, through personal loans, or bill paying arrangements with hospitals or other providers. The bills can be from earlier years as well as this year.

1 Yes

2 No

7 Don't know/Not sure

9 Refused

CATI Note: If PPHF state, Go to core section 4.


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