MEDICAL EXPENDITURE PANEL SURVEY
HOUSEHOLD COMPONENT MAIN STUDY
SHOW CARDS
Panels 26, 25, 24, and 23
January 2021
TABLE OF CONTENTS
Card Number |
Topic |
RE-1 |
Periods of Active Duty Service |
RE-2 |
Ethnic Background |
RE-3 |
Racial Background |
PE-1 |
Types of Heart Conditions |
PE-2 |
Types of Cancer |
PE-3 |
Frequency Scale |
HE-1 |
Level of Difficulty Categories |
PP-1 |
Types of Hospital Visits |
PP-2 |
Types of Emergency Room Services |
PP-3 |
Types of Outpatient Care |
PP-4 |
Types of Primary Care |
PP-5 |
Types of Medical Specialists |
PP-6 |
Types of Dental Care Providers |
PP-7 |
Types of Mental Health Professionals |
PP-8 |
Types of Other Medical Professionals |
PP-9 |
Types of Clinics |
PP-10 |
Types of Laboratories |
PP-11 |
Types of Therapists |
PP-12 |
Types of Vision Care Providers |
PP-13 |
Types of Alternative Care |
PP-14 |
Types of Home Care Services |
PP-15 |
Types of Residential Care |
PP-16 |
Records Job Aid – Examples of Health Care |
EV-1A |
Examples of Where Care Received (Event Typing) |
EV-1B |
Examples of Where Care Received (Event Typing) |
HS-1 |
Reasons for Entering the Hospital |
ER-1 |
Care Received During ER Visit |
ER-2 |
Services Received During ER Visit |
OP-1 |
Type of Medical Doctor Seen During Outpatient Visit |
OP-2 |
Type of Provider Seen During Outpatient Visit |
OP-3 |
Care Received During Outpatient Visit |
OP-4 |
Services Received During Outpatient Visit |
MV-1 |
Type of Medical Doctor Seen During Medical Provider Visit |
MV-2 |
Type of Provider Seen During Medical Provider Visit |
MV-3 |
Care Received During Medical Provider Visit |
MV-4 |
Services Received During Medical Provider Visit |
TH-1 |
Type of Medical Doctor Contacted During Telehealth Visit |
TH-2 |
Type of Provider Contacted During Telehealth Visit |
TH-3 |
Care Received During Telehealth Visit |
DN-1 |
Types of Dental Care Providers |
DN-2 |
Care Received During Dental Visit |
HH-1 |
Types of Home Health Care Workers |
HH-2 |
Types of Home Health Care Workers |
IC-1 |
Types of Residential Care Facilities |
OM-1 |
Types of Disposable Medical Supplies |
OM-2 |
Types of Other Medical Equipment |
CP-1 |
Reasons for Not Receiving Anything in Writing |
CP-2 |
Total Charges for Disposable Supplies |
CS-1 |
Scale for Child Health Supplement |
CS-2 |
Scale for Child Health Supplement |
CS-3 |
Number of Times Went to Doctor’s Office or Clinic |
CS-4 |
Scale for Child Health Supplement |
AC-1 |
Provider’s Race |
AC-2 |
Difficulty Scale |
AC-3 |
Frequency Scale |
HX-1 |
Sample Medicare Card |
HX-2 |
Sample Medicaid Card (for STATE) |
HX-3 |
Source of Health Insurance (for STATE) |
HX-4 |
Types of Public Insurance |
HX-5 |
Medicare HMO Premium Ranges |
HX-6 |
Medicare Part D Premium Ranges |
HX-7 |
Types of Health Insurance Coverage |
HX-8 |
State Sources of Health Insurance for Self-Employed Jobs |
IN-1 |
Yearly Income Ranges |
IN-2 |
Yearly Income Ranges |
IN-3 |
Monthly Income Ranges |
IN-4 |
Other Sources of Income Categories |
AS-1 |
Asset Ranges |
AS-2 |
Asset Ranges |
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One or more categories may be selected.
- – September 2001 or later
- – August 1990 to August 2001, including the Persian Gulf War
- – May 1975 to July 1990
- – Vietnam era, August 1964 to April 1975
- – February 1955 to July 1964
- – Korean War, July 1950 to January 1955
- – January 1947 to June 1950
- – World War II, December 1941 to December 1946
- – November 1941 or earlier
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One or more categories may be selected.
- – Mexican
- – Mexican-American/Chicano
- – Puerto Rican
- – Cuban/Cuban American
- – Dominican
- – Central or South American
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One or more categories may be selected.
- – White
- – Black or African American
- – American Indian or Alaska Native
- – Asian Indian
- – Chinese
- – Filipino
- – Japanese
- – Korean
- – Vietnamese
- – Other Asian
- – Native Hawaiian
- – Guamanian or Chamorro
- – Samoan
- – Other Pacific Islander
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- – Heart murmur
- – Heart arrhythmia/irregular heartbeat
- – Blocked or clogged artery
- – Congestive heart failure
- – Atrial fibrillation
- – Mitral valve prolapse
- – Enlarged heart
- – Heart valve problems (e.g., leaky, blocked, collapsed)
- – Tachycardia/Rapid heart rate
- – Bradycardia/Slow heart rate
- – Other
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- – Bladder
- – Blood
- – Bone
- – Brain
- – Breast
- – Cervical
- – Colon
- – Esophagus
- – Gallbladder
- – Kidney/Renal
- – Larynx-Windpipe
- – Leukemia
- – Liver
- – Lung
- – Lymphoma (Non-Hodgkin’s)
- – Mouth/Tongue/Lip
- – Ovarian
- – Pancreas
- – Prostate
- – Rectum
- – Skin � Melanoma
- – Skin � Non-Melanoma
- – Skin (unknown type)
- – Soft tissue muscle or fat
- – Stomach
- – Testicular
- – Throat or Pharynx
- – Thyroid
- – Uterine
- – Other
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- – Within the last 7 days
- – More than 7 days ago, but within last 30 days
- – More than 30 days ago
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- – No difficulty
- – Some difficulty
- – A Lot of difficulty
- – Completely unable to do it
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- – Admitted to the hospital for one or more nights
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- – Any type of care received in a hospital emergency room
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Same-day care received at a hospital outpatient department such as...
- – Surgery centers
- – Cancer treatment centers
- – Physical therapy and rehabilitation centers
- – Cardiology centers
- – Obesity treatment centers
- – Radiology and imaging centers
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Primary care doctor such as...
- – General practitioner
- – Internist
- – Pediatrician
- – Family medicine provider
- – Medical doctor
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Such as...
- – Orthopedist
- – Cardiologist
- – Dermatologist
- – Oncologist
- – Neurologist
- – Gynecologist
- – Allergist
- – Gastroenterologist
- – Surgeon
- – Kidney specialist (Nephrologist)
- – Radiologist
- – Ear, nose and throat specialist (Otorhinolaryngologist)
- – Urologist
- – Podiatrist
- – Audiologist
- – Any other type of medical specialist
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Such as...
- – Dentists
- – Oral surgeons
- – Orthodontists
- – Dental assistants
- – Dental hygienists
- – Pediatric dentists
- – Endodontists
- – Periodontists
- – Dental technicians
- – Other type of dental care providers
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Such as...
- – Psychiatrist
- – Psychologist
- – Licensed clinical social worker
- – Mental health therapist
- – Counselor
- – Psychiatric social worker
- – Other mental health professional
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Such as...
- – Nurse (RN, LPN, PHN, BSN)
- – Nurse practitioner
- – Nurse’s aide
- – Physician’s assistant (PA)
- – Midwife
- – Health aide
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Such as...
- – Walk-in urgent care
- – Retail clinic � in a pharmacy
- – Retail clinic � in a grocery store
- – Family planning center
- – College or university clinic
- – Employer clinic
- – Free clinic
- – Infirmary
- – Other type of health clinic
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Such as...
- – Independent medical lab
- – Testing facility lab
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Such as...
- – Physical therapists
- – Occupational therapist
- – Speech therapist
- – Chiropractor
- – Physiatrist
- – Behavioral therapist
- – Other type of therapist
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Such as...
- – Optometrist
- – Ophthalmologist
- – Vision technician
- – Optician
- – Orthoptist
- – Other eye care professional
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Such as...
- – Acupuncture
- – Homeopathic care
- – Massage therapy
- – Hypnosis
- – Naturopathic care
- – Herbalist
- – Other alternative care professional
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Care received from someone who visited your home, such as...
- Skilled medical care from -
- – a home care nurse,
- – any type of therapist,
- – a social worker,
- – anyone else providing nursing or medical care
- Personal care services such as help with -
- – bathing,
- – dressing,
- – taking medication
- Household chore services
- – help with cooking
- – help with cleaning
- Companionship services such as -
- – reading,
- – talking,
- – going for a walk or drive
- Any other type of home care
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Residential or long-term care received at places such as...
- – Nursing home for rehabilitation services
- – Inpatient rehabilitation facility or convalescent home
- – Hospice care
- – Respite care
- – Mental health treatment center
- – Drug and alcohol treatment center
- – Addiction treatment center
- – Eating disorder treatment center
- – Other treatment center
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MEPS counts many things you might not think of as health care:
- Preventive and Diagnostic Care
- – Diagnostic tests such as blood work, X-rays, mammograms, MRI or CAT scans
- – Vaccinations for children and adults, flu shots and allergy shots
- – Blood pressure checks and other types of heart health monitoring
- – All types of preventive care, including well visits
- Acute Illness Care
- – Hospital stays, even if just part of a day or longer
- – Care received at the Emergency Room or Urgent Care Centers
- – Care at walk-in clinics such as clinics at work, or in a pharmacy (Minute Clinics)
- – Sick visits to a doctor, nurse or physician assistant
- Continuing Medical Treatment
- – Care received at home by visiting nurses or other home health aides
- – Cancer treatments including chemotherapy and radiation
- – Dialysis
- – Counseling and other care from psychologists or mental health specialists
- – Physical, speech or occupational therapy
- – Chiropractic care, acupuncture, homeopathic or other alternative care
- Other Types of Care
- – Pre-natal care, and all other obstetrician/gynecological care
- – Pre-op care before surgery, the surgery and the follow-up care
- – Eye exams and prescription glasses or contact lenses
- – Prescription medicines including birth control, insulin and diabetic supplies
- – Phone calls to medical providers or labs to check test results
- – Dental check-ups and orthodontic care (braces)
- – Oral surgery
- And much more – ask your interviewer if you are not sure what to include!
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- – Hospital � Inpatient Stay
- – Hospital Emergency Room
- – Hospital Outpatient Department
- – Dental Office
- – Medical Provider Office or Clinic
- – Telehealth
- – Care Received at Home
- – Residential or Long Term Care Facility
- e.g., Nursing home, rehabilitation facility, drug treatment, psychiatric facility
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- – Hospital – Inpatient Stay
- – Hospital Emergency Room
- – Hospital Outpatient Department
- – Dental Office
- – Medical Provider Office or Clinic
- – Telehealth
- – Care Received at Home
- – Residential or Long Term Care Facility
- e.g., Nursing home, rehabilitation facility, drug treatment, psychiatric facility
- – Glasses/Contact Lenses
- – Other Medical Expenses
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- – Operation or surgical procedure
- – Treatment or therapy, not including surgery
- – Diagnostic tests only
- – Give birth to a baby - Normal or Caesarean section (Mother)
- – To be born (Baby)
- – Pregnancy-Related complications
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- – Diagnosis or treatment
- – Emergency (e.g., accident or injury)
- – Psychotherapy or mental health counseling
- – Follow-up or post-operative visit
- – Immunization or shots
- – Pregnancy-Related (Including prenatal care and delivery)
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- – Laboratory tests
- – Sonogram or ultrasound
- – X-Rays
- – Mammogram
- – MRI or CAT scan
- – EKG, ECG, or EEG
- – Vaccination
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- – Cardiology (Heart)
- – Endocrinology/Metabolism (Diabetes, Thyroid)
- – Family practice
- – Gastroenterology
- – General practice
- – General surgery
- – Gynecology/Obstetrics
- – Internal Medicine (Internist)
- – Nephrology (Kidneys)
- – Neurology
- – Oncology (Tumors, Cancer)
- – Ophthalmology (Eyes)
- – Orthopedics
- – Otorhinolaryngology (Ear, Nose, Throat)
- – Pediatrician
- – Physical medicine/Rehab
- – Psychiatry/Psychiatrist
- – Radiology
- – Urology
- – Other specialty
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- – Acupuncturist
- – Chiropractor
- – Dentist/Dental care person
- – Homeopathic/Naturopathic/Herbalist/Other alternative/Complementary care provider
- – Massage therapist
- – Mental health counselor/Marital or family therapist
- – Midwife
- – Nurse/Nurse practitioner
- – Optometrist
- – Physical/Occupational therapist
- – Physician�s assistant
- – Podiatrist
- – Psychologist
- – Social worker
- – Technician
- – Other
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- – General checkup
- – Diagnosis or treatment
- – Emergency (e.g., accident or injury)
- – Psychotherapy or mental health counseling
- – Follow-up or post-operative visit
- – Immunizations or shots
- – Vision exam
- – Pregnancy-Related (Including prenatal care and delivery)
- – Well child exam
- – Laser eye surgery
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- – Laboratory tests
- – Sonogram or ultrasound
- – X-rays
- – Mammogram
- – MRI or CAT scan
- – EKG, ECG, or EEG
- – Vaccination
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- – Allergy/Immunology
- – Cardiology (Heart)
- – Dermatology (Skin)
- – Endocrinology/Metabolism (Diabetes, Thyroid)
- – Family practice
- – Gastroenterology
- – General practice
- – General surgery
- – Gynecology/Obstetrics
- – Internal medicine (Internist)
- – Nephrology (Kidneys)
- – Neurology
- – Oncology (Tumors, Cancer)
- – Ophthalmology (Eyes)
- – Orthopedics
- – Otorhinolaryngology (Ear, nose, throat)
- – Pediatrician
- – Psychiatry/Psychiatrist
- – Urology
- – Other
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- – Acupuncturist
- – Chiropractor
- – Dentist/Dental care person
- – Homeopathic/Naturopathic/Herbalist/Other alternative/Complementary care provider
- – Massage therapist
- – Mental health counselor/Marital or family therapist
- – Midwife
- – Nurse/Nurse practitioner
- – Optometrist
- – Physical/Occupational therapist
- – Physician�s assistant
- – Podiatrist
- – Psychologist
- – Social worker
- – Technician
- – Other
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- – General checkup
- – Diagnosis or treatment
- – Emergency (e.g., accident or injury)
- – Psychotherapy or mental health counseling
- – Follow-up or post-operative visit
- – Immunizations or shots
- – Vision exam
- – Pregnancy-Related (Including prenatal care and delivery)
- – Well child exam
- – Laser eye surgery
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- – Laboratory tests
- – Sonogram or ultrasound
- – X-rays
- – Mammogram
- – MRI or CAT scan
- – EKG, ECG, or EEG
- – Vaccination
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- – Allergy/Immunology
- – Cardiology (Heart)
- – Dermatology (Skin)
- – Endocrinology/Metabolism (Diabetes, Thyroid)
- – Family practice
- – Gastroenterology
- – General practice
- – General surgery
- – Gynecology/Obstetrics
- – Internal medicine (Internist)
- – Nephrology (Kidneys)
- – Neurology
- – Oncology (Tumors, Cancer)
- – Ophthalmology (Eyes)
- – Orthopedics
- – Otorhinolaryngology (Ear, nose, throat)
- – Pediatrician
- – Psychiatry/Psychiatrist
- – Urology
- – Other
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- – Acupuncturist
- – Chiropractor
- – Dentist/Dental care person
- – Homeopathic/Naturopathic/Herbalist/Other alternative/Complementary care provider
- – Massage therapist
- – Mental health counselor/Marital or family therapist
- – Midwife
- – Nurse/Nurse practitioner
- – Optometrist
- – Physical/Occupational therapist
- – Physician�s assistant
- – Podiatrist
- – Psychologist
- – Social worker
- – Technician
- – Other
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- – General checkup
- – Diagnosis or treatment
- – Emergency (e.g., accident or injury)
- – Psychotherapy or mental health counseling
- – Follow-up or post-operative visit
- – Immunizations or shots
- – Vision exam
- – Pregnancy-Related (Including prenatal care and delivery)
- – Well child exam
- – Laser eye surgery
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- – General dentist
- – Pediatric dentist
- – Dental specialist (e.g., Orthodontist, Endodontist, Periodontist)
- – Dental hygienist
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- Diagnostic or Preventive
- – General exam, check-up, or consultation
- – Cleaning, prophylaxis, polishing, or periodontal recall visit (Periodic or regular)
- – X-Rays, radiographs, or bitewings
- – Fluoride treatment
- – Sealant (Plastic coatings on back teeth)
- Restorative or Endodontic
- – Fillings, inlays, crowns or caps
- – Root canal
- Periodontic (Gum Treatment)
- – Periodontal scaling, root planing, or gum surgery
- Oral Surgery
- – Extraction, tooth pulled, or other oral surgery
- – Implants
- Prosthetics
- – Fixed bridges, dentures or removable partial dentures, relining or repair of bridges or dentures
- Orthodontics
- – Orthodontia, braces, or retainers
- Additional Procedures
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- – Certified Nursing Assistant (CNA)
- – Dietitian/Nutritionist
- – I.V. or infusion therapist
- – Medical doctor
- – Nurse/Nurse practitioner
- – Occupational Therapist
- – Physical therapist
- – Respiratory therapist
- – Social worker
- – Speech therapist
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- – Companion
- – Homemaker or house cleaner
- – Home health aide or home care aide
- – Hospice worker
- – Nurse’s aide
- – Personal care attendant
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- – Inpatient rehabilitation facility or convalescent home
- – Nursing home
- – Residential mental health treatment center
- – Residential eating disorder treatment center
- – Residential drug and alcohol or addiction treatment center
- – Residential hospice care
- – Residential respite care
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Disposable Supplies such as...
- – Ostomy supplies
- – Bandages and dressings
- – Tape
- – Adult disposable diapers
- – Catheters
- – Syringes not prescribed by a physician
- – IV supplies
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Medical Equipment such as...
- Mobility aids
- – Walker
- – Scooter
- – Wheelchair
- – Braces
- Equipment used in the home
- – Hospital bed
- – Monitor
- – Bed pan
- – Lift
- – Special chair
- – Adaptive feeding equipment
- Home and automobile modifications
- – Ramp
- – Elevator
- – Handrails
- – Automobile modification
- Hearing and speech assistance
- – Hearing aid
- – Amplifier for a telephone
- – Adaptive speech equipment
- Other
- – Blood pressure monitor
- – Oxygen
- – Vaporizer or nebulizer
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- – Paid at time of visit
- – Made a co-payment
- – Bill sent directly to other source
- – Bill has not arrived
- – No Bill Sent:
- – HMO plan
- – VA (Veterans Administration)/CHAMPVA
- – Military facility
- – Public Assistance/Medicaid/SCHIP
- – Indian Health Service (IHS)
- – Worker’s Compensation
- – Private health center/Clinic
- – Public clinic/Health center or private charity
- – Telephone call – No charge
- – Free from provider
- – Government-Financed research and clinical trials
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- – 0
- – 1 - 10
- – 11 - 30
- – 31 - 100
- – 101 or More
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- 0 No problem
- 1
- 2 Some problem
- 3
- 4 A very big problem
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- – Never
- – Sometimes
- – Usually
- – Always
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- None
- 1 time
- 2 times
- 3 times
- 4 times
- 5 to 9 times
- 10 or more times
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- 0 Worst health care possible
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10 Best health care possible
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- – White
- – Black/African American
- – Asian
- – Indian/Native American Alaska Native
- – Other Pacific Islander
- – Some other race
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- – Very difficult
- – Somewhat difficult
- – Not too difficult
- – Not at all difficult
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- – Never
- – Sometimes
- – Usually
- – Always
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Medicare Card Sample
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Sample Medicaid Card
[State Name Here]
(One for Each State)
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- – From a group or association
- – Directly through a school
- – Directly from an insurance agent
- – Directly from an insurance company
- – Directly from an HMO
- – From a union
- – From anyone�s previous employer
- – From spouse�s/Deceased spouse�s previous employer
- – From some other employer
- – Under a plan of someone not living here
- – Directly from the Health Insurance Marketplace
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- – Medicare
- – Medicaid
- – SCHIP
- – TRICARE
- – CHAMPVA
- – VA
- – Other government program providing hospital and physician benefits
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- – 1 - 50
- – 51 - 100
- – 101 - 200
- – 201 - 300
- – 301 or more
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- – 1 - 30
- – 31 - 60
- – 61 - 90
- – 91 - 120
- – 121 or more
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- – Hospital and physician benefits, including coverage through an HMO
- – Dental
- – Prescription drugs
- – Vision
- – Medicare supplement/Medigap
- – Long-Term care in a nursing home
- – Extra cash for hospital stays
- – Serious disease or dread disease
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- – From a professional association
- – From a small business group
- – From a union
- – Directly from an insurance agent
- – Directly from an insurance company
- – Directly from an HMO
- – From a previous employer
- – Directly from the Health Insurance Marketplace
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- – 1 - 5,000
- – 5,001 - 10,000
- – 10,001 - 15,000
- – 15,001 - 25,000
- – 25,001 - 50,000
- – 50,001 - 100,000
- – 100,001 or more
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- – 1 - 100
- – 101 - 500
- – 501 - 1,000
- – 1,001 - 5,000
- – 5,001 - 15,000
- – 15,001 or more
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- – 1 - 250
- – 251 - 500
- – 501 - 750
- – 751 - 1,000
- – 1,001 or more
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- – Wages and salary
- – Farm income (or loss)
- – Business income (or loss)
- – Social Security/Railroad Retirement
- – Private, military, or government pensions
- – Interest
- – Dividends
- – Rental income (or loss)
- – Other source
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- – 0 - 10,000
- – 10,001 - 25,000
- – 25,001 - 50,000
- – 50,001 - 100,000
- – 100,001 - 250,000
- – 250,001 - 500,000
- – 500,001 - 1,000,000
- – 1,000,001 or more
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- – 0 - 1,000
- – 1,001 - 5,000
- – 5,001 - 10,000
- – 10,001 - 25,000
- – 25,001 - 50,000
- – 50,001 - 100,000
- – 100,001 - 250,000
- – 250,001 - 500,000
- – 500,001 or more
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