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Covid-19

MEPS Show Cards Spring 2022

 

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CARD AC-1


  • White
  • Black / African American
  • Asian
  • Indian/Native American/Alaska Native
  • Other Pacific Islander
  • Some other race

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CARD AC-2


  • Very difficult
  • Somewhat difficult
  • Not too difficult
  • Not at all difficult

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CARD AC-3


  • Never
  • Sometimes
  • Usually
  • Always

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CARD AS-1


  • 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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CARD AS-2


  • 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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CARD CP-1


  • 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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CARD CP-2


  • 0
  • 1 - 10
  • 11 - 30
  • 31 - 100
  • 101 or More

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CARD CS-1


  • 0 No problem
  • 1
  • 2 Some problem
  • 3
  • 4 A very big problem

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CARD CS-2


  • Never
  • Sometimes
  • Usually
  • Always

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CARD CS-3


  • None
  • 1 time
  • 2 times
  • 3 times
  • 4 times
  • 5 to 9 times
  • 10 or more times

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CARD CS-4


  • 0 Worst health care possible
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10 Best health care possible

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CARD DN-1


  • General dentist
  • Pediatric dentist
  • Dental specialist (e.g., Orthodontist, Endodontist, Periodontist)
  • Dental hygienist

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CARD DN-2


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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CARD ER-1


  • 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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CARD ER-2


  • Laboratory tests
  • Sonogram or ultrasound
  • X-rays
  • Mammogram
  • MRI or CAT scan
  • EKG, ECG, or EEG
  • Vaccination

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CARD EV-1A


  • 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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CARD EV-1B


  • 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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CARD HE-1


  • No difficulty
  • Some difficulty
  • A lot of difficulty
  • Completely unable to do it

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CARD HH-1


  • 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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CARD HH-2


  • Companion
  • Homemaker or house cleaner
  • Home health aide or home care aide
  • Hospice worker
  • Nurse's aide
  • Personal care attendant

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CARD HS-1


  • 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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CARD HX-1


New Medicare Card Sample Identification card.


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CARD HX-2


  • From a group or association
  • Directly through a school
  • Directly from an insurance agent
  • Directly from 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 plan of someone not living here
  • Directly from the Health Insurance Marketplace

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CARD HX-3


  • Medicare
  • Medicaid
  • SCHIP
  • TRICARE
  • CHAMPVA
  • VA
  • Other government program providing hospital and physician benefits

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CARD HX-4


  • 1 - 50
  • 51 - 100
  • 101 - 200
  • 201 - 300
  • 301 or more

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CARD HX-5


  • 1 - 30
  • 31 - 60
  • 61 - 90
  • 91 - 120
  • 121 or more

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CARD HX-6


  • 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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CARD HX-7


  • 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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CARD IC-1


  • 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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CARD IN-1


  • 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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CARD IN-2


  • 1 - 100
  • 101 - 500
  • 501 - 1,000
  • 1,001 - 5,000
  • 5,001 - 15,000
  • 15,001 or more

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CARD IN-3


  • 1 - 250
  • 251 - 500
  • 501 - 750
  • 751 - 1,000
  • 1,001 or more

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CARD IN-4


  • 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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CARD MV-1

  • 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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CARD MV-2


  • 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 assistant
  • Podiatrist
  • Psychologist
  • Social worker
  • Technician
  • Other

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CARD MV-3


  • 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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CARD MV-4


  • Laboratory tests
  • Sonogram or ultrasound
  • X-rays
  • Mammogram
  • MRI or CAT scan
  • EKG, ECG, or EEG
  • Vaccination

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CARD OM-1


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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CARD OM-2


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 modifications

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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CARD OP-1


  • 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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CARD OP-2


  • 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 assistant
  • Podiatrist
  • Psychologist
  • Social worker
  • Technician
  • Other

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CARD OP-3


  • 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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CARD OP-4


  • Laboratory tests
  • Sonogram or ultrasound
  • X-Rays
  • Mammogram
  • MRI or CAT scan
  • EKG, ECG, or EEG
  • Vaccination

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CARD PE-1


  • 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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CARD PE-2


  • 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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CARD PE-3


  • Within the last 7 days
  • More than 7 days ago, but within last 30 days
  • More than 30 days ago

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CARD PP-1


  • Admitted to the hospital for one or more nights

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CARD PP-2


  • Any type of care received in a hospital emergency room

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CARD PP-3


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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CARD PP-4


Primary care doctor such as...

  • General practitioner
  • Internist
  • Pediatrician
  • Family medicine provider
  • Medical doctor

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CARD PP-5


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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CARD PP-6


Such as...

  • Dentists
  • Oral surgeons
  • Orthodontists
  • Dental assistants
  • Dental hygienists
  • Pediatric dentists
  • Endodontists
  • Periodontists
  • Dental technicians
  • Other type of dental care provider

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CARD PP-7


Such as...

  • Psychiatrist
  • Psychologist
  • Licensed clinical social worker
  • Mental health therapist
  • Counselor
  • Psychiatric social worker
  • Other mental health professional

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CARD PP-8


Such as...

  • Nurse (RN, LPN, PHN, BSN)
  • Nurse practitioner
  • Nurse aide
  • Physician assistant (PA)
  • Midwife
  • Health aide

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CARD PP-9


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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CARD PP-10


Such as...

  • Independent medical lab
  • Testing facility lab

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CARD PP-11


Such as...

  • Physical therapist
  • Occupational therapist
  • Speech therapist
  • Chiropractor
  • Physiatrist
  • Behavioral therapist
  • Other type of therapist

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CARD PP-12


Such as...

  • Optometrist
  • Ophthalmologist
  • Vision technician
  • Optician
  • Orthoptist
  • Other eye care professional

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CARD PP-13


Such as...

  • Acupuncture
  • Homeopathic care
  • Massage therapy
  • Hypnosis
  • Naturopathic care
  • Herbalist
  • Other alternative care professional

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CARD PP-14


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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CARD PP-15


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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CARD PP-16

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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CARD RE-1


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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CARD RE-2


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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CARD RE-3


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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CARD TH-1


  • 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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CARD TH-2


  • 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 assistant
  • Podiatrist
  • Psychologist
  • Social worker
  • Technician
  • Other

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CARD TH-3


  • 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

Return to Table of Contents



If you have any questions, contact your field interviewer or call Alex Scott, a study representative at 1-800-945-MEPS (6377).