Information on the health status of Americans, health insurance coverage, and access, use, and cost of health services.

Due to the COVID-19 pandemic, additional procedures for developing weights for the 2020 MEPS data were designed to correct for potential biases in the data due to changes in data collection and response bias. However, evaluations of MEPS data quality in 2020 – corroborated in analyses of other Federal surveys fielded in 2020 – suggest that users of the MEPS 2020 data should exercise caution when interpreting estimates based on these data, including the comparison of such estimates with those of other years.

2018 Design Change – Impact on Use and Expenditures: Starting with interviews conducted in 2018, the MEPS Household Component questionnaire was revised to improve respondents’ reporting of health care use. These improvements likely contribute to observed increases (and may dampen any actual decreases) in events and expenditures from 2016 to 2018, particularly from 2017 to 2018.

Utilization: For event-based estimates (mean events per person, mean expenditure per event, and total number of events), events include all dental visits, prescribed medicine purchases (including refills), office-based and outpatient visits, emergency room visits, inpatient stays, and home health events. A home health event is defined as one month during which home health service was received. Office-based visits and Outpatient events that are phone calls, and informal Home Health care are not included in utilization estimates. Expenditures for these events are not collected, and are denoted on the event files as “-1 Inapplicable”. Other medical equipment and services are not included in utilization estimates because information for these events is collected per interview or per year for each person, rather than on a per-purchase basis.

Expenditures: Expenditures include payments for medical events reported during the calendar year. Expenditures in MEPS are defined as the sum of direct payments for care provided during the year, including out-of-pocket payments and payments by private insurance, Medicaid, Medicare, and other sources. Payments for over-the-counter drugs and phone contacts with medical providers are not included in MEPS total expenditure estimates. Indirect payments not related to specific medical events, such as Medicaid Disproportionate Share and Medicare Direct Medical Education subsidies, also are not included. Any charges associated with uncollected liability, bad debt, and charitable care (unless provided by a public clinic or hospital) are not counted as expenditures.

Expenditures shown over time are not adjusted for inflation.

Respondents were asked to report the age of each family member as of the date of each interview for each round of data collection. The age variable used to create these estimates is based on the sample person’s age as of the end of the year. If data were not collected during a round because the sample person was out of scope (e.g., deceased or institutionalized), then age at the time of the previous round was used.

The census region variable is based on the location of the household at the end of the year. If missing, the most recent location available is used.

Northeast: Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, New York, New Jersey, and Pennsylvania.

Midwest: Ohio, Indiana, Illinois, Michigan, Wisconsin, Minnesota, Iowa, Missouri, North Dakota, South Dakota, Nebraska, and Kansas.

South: Delaware, Maryland, District of Columbia, Virginia, West Virginia, North Carolina, South Carolina, Georgia, Florida, Kentucky, Tennessee, Alabama, Mississippi, Arkansas, Louisiana, Oklahoma, and Texas.

West: Montana, Idaho, Wyoming, Colorado, New Mexico, Arizona, Utah, Nevada, Washington, Oregon, California, Alaska, and Hawaii.

Education for each person is based on the highest education level completed when entering MEPS. A small percentage of persons (< 2 percent) had a missing response for education.

Employment status is based on the person’s employment status at the end of the year. If missing, the most recent non-missing employment status variable is used. A small percentage of persons (< 2 percent) had a missing response for employment status.

Office-based physician visits are a sub-category of Office-based events, and Outpatient physician visits are a sub-category of Outpatient events.

A home health event is defined as one month during which home health service was received.

For prescription medicines, an event is defined as a purchase or refill.

Other medical equipment and services are expenses for medical equipment such as eyeglasses, hearing aids, or wheelchairs. Starting in Panel 21 Round 5 and Panel 22 Round 3 (the last half of 2017), questions about Other Medical expenses are asked in every round (previously only questions about glasses/contact lenses were asked every round). The increased frequency of questions and reduced length of reference periods likely led to more reporting due to improved recall. goes to if he/she is sick or needs advice about his/her health.

Uninsured: Individuals who did not have health insurance coverage for the entire calendar year were classified as uninsured. The uninsured were defined as people not covered by Medicaid, Medicare, TRICARE (Armed Forces-related coverage), other public hospital/physician programs, private hospital/physician insurance (including Medigap coverage) or insurance purchased through health insurance Marketplaces. People covered only by non-comprehensive State-specific programs (e.g., Maryland Kidney Disease Program) or private single service plans such as coverage for dental or vision care only, or coverage for accidents or specific diseases, were considered uninsured.

Any private: Individuals classified as having any private health insurance coverage had private insurance that provided coverage for hospital and physician care (including Medigap coverage and TRICARE) at some point during the year.

Public only: Individuals are considered to have public only health insurance coverage if they were not covered by private insurance or TRICARE and they were covered by Medicare, Medicaid, or other public hospital and physician coverage at some point during the year.

65+, No Medicare: Individuals classified as 65+, No Medicare either had private coverage at some point during the year that is not identified as Medigap coverage or were uninsured throughout the year.

Marital status is based on the person’s marital status at the end of the year. If missing, the most recent non-missing marital status variable is used. A small percentage of persons (< 2 percent) had a missing value for marital status.

The MEPS respondent was asked to rate the health of each person in the family at the time of the interview according to the following categories: excellent, very good, good, fair, and poor. For persons with missing health status in a round, the response for health status at the previous round was used, if available. A small percentage of persons (< 2 percent) had a missing response for perceived health status.

The MEPS respondent was asked to rate the mental health of each person in the family at the time of the interview according to the following categories: excellent, very good, good, fair, and poor. For persons with missing mental health status in a round, the response for mental health status at the previous round was used, if available. A small percentage of persons (< 2 percent) had a missing response for perceived mental health status.

Each sample person was classified according to the total annual income of his or her family. Possible sources of income included annual earnings from wages, salaries, bonuses, tips, and commissions; business and farm gains and losses; unemployment and Worker’s Compensation; interest and dividends; alimony, child support, and other private cash transfers; private pensions, individual retirement account (IRA) withdrawals, Social Security, and Department of Veterans Affairs payments; Supplemental Security Income and cash welfare payments from public assistance, Aid to Families with Dependent Children and Aid to Dependent Children; gains or losses from estates, trusts, partnerships, S corporations, rent, and royalties; and a small amount of ‘other’ income. Poverty status is the ratio of family income to the corresponding federal poverty thresholds, which control for family size and age of the head of family. Categories are defined as follows:

Negative or Poor: Household income below the Federal poverty line.

Near poor: Household income over the poverty line through 125 percent of the poverty line.

Low income: Household income 125 percent through 200 percent of the poverty line.

Middle income: over 200 percent to 400 percent of the poverty line.

High income: over 400 percent of the poverty line.

Classification by race and ethnicity is based on information reported for each family member. Starting in 2002, specifications changed so that individuals could report multiple races. Respondents were asked if the race of the sample person was best described as American Indian, Alaska Native, Asian or Pacific Islander, black, white, or other. Prior to 2002, race categories in the tables for American Indian, Alaska Native, Asian or Pacific Islander, multiple races, white, and other are collapsed into the single category of White and other.

For all years, respondents were asked if the sample person’s main national origin or ancestry was Puerto Rican; Cuban; Mexican, Mexicano, Mexican American, or Chicano; other Latin American; or other Spanish. All persons whose main national origin or ancestry was reported in one of these Hispanic groups, regardless of racial background, are classified as Hispanic. Since the Hispanic grouping can include black Hispanic, white Hispanic, and other Hispanic, the race categories of black, white, and other do not include Hispanic people.

Private: Includes payments made by insurance plans covering hospital and medical care (excluding payments from Medicare, Medicaid, and other public sources). Payments from Medigap plans or TRICARE (Armed-Forces-related coverage) are included.

Medicare: A federally financed health insurance plan for the elderly, persons receiving Social Security disability payments, and most persons with end-stage renal disease. Medicare Part A, which provides hospital insurance, is automatically given to those who are eligible for Social Security. Medicare Part B provides supplementary medical insurance that pays for medical expenses and can be purchased for a monthly premium.

Medicaid: A means-tested government program jointly financed by federal and state funds that provides health care to those who are eligible. Program eligibility criteria vary significantly by state, but the program is designed to provide health coverage to families and individuals who are unable to afford necessary medical care.

Other: Includes payments from the Department of Veterans Affairs (excluding TRICARE); other federal sources (Indian Health Service, military treatment facilities, and other care provided by the Federal Government); various state and local sources (community and neighborhood clinics, State and local health departments, and State programs other than Medicaid); payments from Workers’ Compensation; and, other unclassified sources (e.g., automobile, homeowner’s, or liability insurance, and other miscellaneous or unknown sources). It also includes private insurance payments reported for persons without private health insurance coverage during the year, as defined in MEPS, and Medicaid payments reported for persons who were not enrolled in the Medicaid program at any time during the year.

Due to the COVID-19 pandemic, additional procedures for developing weights for the 2020 MEPS data were designed to correct for potential biases in the data due to changes in data collection and response bias. However, evaluations of MEPS data quality in 2020 – corroborated in analyses of other Federal surveys fielded in 2020 – suggest that users of the MEPS 2020 data should exercise caution when interpreting estimates based on these data, including the comparison of such estimates with those of other years.

Respondents were asked to report the age of each family member as of the date of each interview for each round of data collection. The age variable used to create these estimates is based on the sample person’s age as of the end of the year. If data were not collected during a round because the sample person was out of scope (e.g., deceased or institutionalized), then age at the time of the previous round was used.

The census region variable is based on the location of the household at the end of the year. If missing, the most recent location available is used.

Northeast: Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, New York, New Jersey, and Pennsylvania.

Midwest: Ohio, Indiana, Illinois, Michigan, Wisconsin, Minnesota, Iowa, Missouri, North Dakota, South Dakota, Nebraska, and Kansas.

South: Delaware, Maryland, District of Columbia, Virginia, West Virginia, North Carolina, South Carolina, Georgia, Florida, Kentucky, Tennessee, Alabama, Mississippi, Arkansas, Louisiana, Oklahoma, and Texas.

West: Montana, Idaho, Wyoming, Colorado, New Mexico, Arizona, Utah, Nevada, Washington, Oregon, California, Alaska, and Hawaii.

Education for each person is based on the highest education level completed when entering MEPS. A small percentage of persons (< 2 percent) had a missing response for education.

Employment status is based on the person’s employment status at the end of the year. If missing, the most recent non-missing employment status variable is used. A small percentage of persons (< 2 percent) had a missing response for employment status.

Uninsured: Individuals who did not have health insurance coverage for the entire calendar year were classified as uninsured. The uninsured were defined as people not covered by Medicaid, Medicare, TRICARE (Armed Forces-related coverage), other public hospital/physician programs, private hospital/physician insurance (including Medigap coverage) or insurance purchased through health insurance Marketplaces. People covered only by non-comprehensive State-specific programs (e.g., Maryland Kidney Disease Program) or private single service plans such as coverage for dental or vision care only, or coverage for accidents or specific diseases, were considered uninsured.

Any private: Individuals classified as having any private health insurance coverage had private insurance that provided coverage for hospital and physician care (including Medigap coverage and TRICARE) at some point during the year.

Public only: Individuals are considered to have public only health insurance coverage if they were not covered by private insurance or TRICARE and they were covered by Medicare, Medicaid, or other public hospital and physician coverage at some point during the year.

65+, No Medicare: Individuals classified as 65+, No Medicare either had private coverage at some point during the year that is not identified as Medigap coverage or were uninsured throughout the year.

Marital status is based on the person’s marital status at the end of the year. If missing, the most recent non-missing marital status variable is used. A small percentage of persons (< 2 percent) had a missing value for marital status.

The MEPS respondent was asked to rate the health of each person in the family at the time of the interview according to the following categories: excellent, very good, good, fair, and poor. For persons with missing health status in a round, the response for health status at the previous round was used, if available. A small percentage of persons (< 2 percent) had a missing response for perceived health status.

The MEPS respondent was asked to rate the mental health of each person in the family at the time of the interview according to the following categories: excellent, very good, good, fair, and poor. For persons with missing mental health status in a round, the response for mental health status at the previous round was used, if available. A small percentage of persons (< 2 percent) had a missing response for perceived mental health status.

Each sample person was classified according to the total annual income of his or her family. Possible sources of income included annual earnings from wages, salaries, bonuses, tips, and commissions; business and farm gains and losses; unemployment and Worker’s Compensation; interest and dividends; alimony, child support, and other private cash transfers; private pensions, individual retirement account (IRA) withdrawals, Social Security, and Department of Veterans Affairs payments; Supplemental Security Income and cash welfare payments from public assistance, Aid to Families with Dependent Children and Aid to Dependent Children; gains or losses from estates, trusts, partnerships, S corporations, rent, and royalties; and a small amount of ‘other’ income. Poverty status is the ratio of family income to the corresponding federal poverty thresholds, which control for family size and age of the head of family. Categories are defined as follows:

Negative or Poor: Household income below the Federal poverty line.

Near poor: Household income over the poverty line through 125 percent of the poverty line.

Low income: Household income 125 percent through 200 percent of the poverty line.

Middle income: over 200 percent to 400 percent of the poverty line.

High income: over 400 percent of the poverty line.

Classification by race and ethnicity is based on information reported for each family member. Starting in 2002, specifications changed so that individuals could report multiple races. Respondents were asked if the race of the sample person was best described as American Indian, Alaska Native, Asian or Pacific Islander, black, white, or other. Prior to 2002, race categories in the tables for American Indian, Alaska Native, Asian or Pacific Islander, multiple races, white, and other are collapsed into the single category of White and other.

For all years, respondents were asked if the sample person’s main national origin or ancestry was Puerto Rican; Cuban; Mexican, Mexicano, Mexican American, or Chicano; other Latin American; or other Spanish. All persons whose main national origin or ancestry was reported in one of these Hispanic groups, regardless of racial background, are classified as Hispanic. Since the Hispanic grouping can include black Hispanic, white Hispanic, and other Hispanic, the race categories of black, white, and other do not include Hispanic people.

Due to the COVID-19 pandemic, additional procedures for developing weights for the 2020 MEPS data were designed to correct for potential biases in the data due to changes in data collection and response bias. However, evaluations of MEPS data quality in 2020 – corroborated in analyses of other Federal surveys fielded in 2020 – suggest that users of the MEPS 2020 data should exercise caution when interpreting estimates based on these data, including the comparison of such estimates with those of other years.

Respondents were asked to report the age of each family member as of the date of each interview for each round of data collection. The age variable used to create these estimates is based on the sample person’s age as of the end of the year. If data were not collected during a round because the sample person was out of scope (e.g., deceased or institutionalized), then age at the time of the previous round was used.

The census region variable is based on the location of the household at the end of the year. If missing, the most recent location available is used.

Northeast: Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, New York, New Jersey, and Pennsylvania.

Midwest: Ohio, Indiana, Illinois, Michigan, Wisconsin, Minnesota, Iowa, Missouri, North Dakota, South Dakota, Nebraska, and Kansas.

South: Delaware, Maryland, District of Columbia, Virginia, West Virginia, North Carolina, South Carolina, Georgia, Florida, Kentucky, Tennessee, Alabama, Mississippi, Arkansas, Louisiana, Oklahoma, and Texas.

West: Montana, Idaho, Wyoming, Colorado, New Mexico, Arizona, Utah, Nevada, Washington, Oregon, California, Alaska, and Hawaii.

Difficulty categories are not mutually exclusive. For instance, a person can have difficulty obtaining both medical and dental care.

Education for each person is based on the highest education level completed when entering MEPS. A small percentage of persons (< 2 percent) had a missing response for education.

Employment status is based on the person’s employment status at the end of the year. If missing, the most recent non-missing employment status variable is used. A small percentage of persons (< 2 percent) had a missing response for employment status.

Uninsured: Individuals who did not have health insurance coverage for the entire calendar year were classified as uninsured. The uninsured were defined as people not covered by Medicaid, Medicare, TRICARE (Armed Forces-related coverage), other public hospital/physician programs, private hospital/physician insurance (including Medigap coverage) or insurance purchased through health insurance Marketplaces. People covered only by non-comprehensive State-specific programs (e.g., Maryland Kidney Disease Program) or private single service plans such as coverage for dental or vision care only, or coverage for accidents or specific diseases, were considered uninsured.

Any private: Individuals classified as having any private health insurance coverage had private insurance that provided coverage for hospital and physician care (including Medigap coverage and TRICARE) at some point during the year.

Public only: Individuals are considered to have public only health insurance coverage if they were not covered by private insurance or TRICARE and they were covered by Medicare, Medicaid, or other public hospital and physician coverage at some point during the year.

65+, No Medicare: Individuals classified as 65+, No Medicare either had private coverage at some point during the year that is not identified as Medigap coverage or were uninsured throughout the year.

Marital status is based on the person’s marital status at the end of the year. If missing, the most recent non-missing marital status variable is used. A small percentage of persons (< 2 percent) had a missing value for marital status.

The MEPS respondent was asked to rate the health of each person in the family at the time of the interview according to the following categories: excellent, very good, good, fair, and poor. For persons with missing health status in a round, the response for health status at the previous round was used, if available. A small percentage of persons (< 2 percent) had a missing response for perceived health status.

The MEPS respondent was asked to rate the mental health of each person in the family at the time of the interview according to the following categories: excellent, very good, good, fair, and poor. For persons with missing mental health status in a round, the response for mental health status at the previous round was used, if available. A small percentage of persons (< 2 percent) had a missing response for perceived mental health status.

Percentages may not sum to 100 due to rounding.

Each sample person was classified according to the total annual income of his or her family. Possible sources of income included annual earnings from wages, salaries, bonuses, tips, and commissions; business and farm gains and losses; unemployment and Worker’s Compensation; interest and dividends; alimony, child support, and other private cash transfers; private pensions, individual retirement account (IRA) withdrawals, Social Security, and Department of Veterans Affairs payments; Supplemental Security Income and cash welfare payments from public assistance, Aid to Families with Dependent Children and Aid to Dependent Children; gains or losses from estates, trusts, partnerships, S corporations, rent, and royalties; and a small amount of ‘other’ income. Poverty status is the ratio of family income to the corresponding federal poverty thresholds, which control for family size and age of the head of family. Categories are defined as follows:

Negative or Poor: Household income below the Federal poverty line.

Near poor: Household income over the poverty line through 125 percent of the poverty line.

Low income: Household income 125 percent through 200 percent of the poverty line.

Middle income: over 200 percent to 400 percent of the poverty line.

High income: over 400 percent of the poverty line.

Classification by race and ethnicity is based on information reported for each family member. Starting in 2002, specifications changed so that individuals could report multiple races. Respondents were asked if the race of the sample person was best described as American Indian, Alaska Native, Asian or Pacific Islander, black, white, or other. Prior to 2002, race categories in the tables for American Indian, Alaska Native, Asian or Pacific Islander, multiple races, white, and other are collapsed into the single category of White and other.

For all years, respondents were asked if the sample person’s main national origin or ancestry was Puerto Rican; Cuban; Mexican, Mexicano, Mexican American, or Chicano; other Latin American; or other Spanish. All persons whose main national origin or ancestry was reported in one of these Hispanic groups, regardless of racial background, are classified as Hispanic. Since the Hispanic grouping can include black Hispanic, white Hispanic, and other Hispanic, the race categories of black, white, and other do not include Hispanic people.

Reasons for difficulty are not mutually exclusive. For instance, a person can have difficulty due to insurance-related issues as well as affordability.

For each individual family member, the respondent is asked whether there is a particular doctor’s office, clinic, health center, or other place that the individual usually goes to if he/she is sick or needs advice about his/her health.

Due to the COVID-19 pandemic, additional procedures for developing weights for the 2020 MEPS data were designed to correct for potential biases in the data due to changes in data collection and response bias. However, evaluations of MEPS data quality in 2020 – corroborated in analyses of other Federal surveys fielded in 2020 – suggest that users of the MEPS 2020 data should exercise caution when interpreting estimates based on these data, including the comparison of such estimates with those of other years.

Respondents were asked to report the age of each family member as of the date of each interview for each round of data collection. The age variable used to create these estimates is based on the sample person’s age as of the end of the year. If data were not collected during a round because the sample person was out of scope (e.g., deceased or institutionalized), then age at the time of the previous round was used.

The census region variable is based on the location of the household at the end of the year. If missing, the most recent location available is used.

Northeast: Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, New York, New Jersey, and Pennsylvania.

Midwest: Ohio, Indiana, Illinois, Michigan, Wisconsin, Minnesota, Iowa, Missouri, North Dakota, South Dakota, Nebraska, and Kansas.

South: Delaware, Maryland, District of Columbia, Virginia, West Virginia, North Carolina, South Carolina, Georgia, Florida, Kentucky, Tennessee, Alabama, Mississippi, Arkansas, Louisiana, Oklahoma, and Texas.

West: Montana, Idaho, Wyoming, Colorado, New Mexico, Arizona, Utah, Nevada, Washington, Oregon, California, Alaska, and Hawaii.

Education for each person is based on the highest education level completed when entering MEPS. A small percentage of persons (< 2 percent) had a missing response for education.

Employment status is based on the person’s employment status at the end of the year. If missing, the most recent non-missing employment status variable is used. A small percentage of persons (< 2 percent) had a missing response for employment status.

A small percentage of persons (< 0.1 percent) had a missing or invalid response for eye exam.

Starting in 2008, the questionnaire for foot care changed slightly, splitting No exam in past year into exam More than 1 year ago and Never had feet checked.

Uninsured: Individuals who did not have health insurance coverage for the entire calendar year were classified as uninsured. The uninsured were defined as people not covered by Medicaid, Medicare, TRICARE (Armed Forces-related coverage), other public hospital/physician programs, private hospital/physician insurance (including Medigap coverage) or insurance purchased through health insurance Marketplaces. People covered only by non-comprehensive State-specific programs (e.g., Maryland Kidney Disease Program) or private single service plans such as coverage for dental or vision care only, or coverage for accidents or specific diseases, were considered uninsured.

Any private: Individuals classified as having any private health insurance coverage had private insurance that provided coverage for hospital and physician care (including Medigap coverage and TRICARE) at some point during the year.

Public only: Individuals are considered to have public only health insurance coverage if they were not covered by private insurance or TRICARE and they were covered by Medicare, Medicaid, or other public hospital and physician coverage at some point during the year.

65+, No Medicare: Individuals classified as 65+, No Medicare either had private coverage at some point during the year that is not identified as Medigap coverage or were uninsured throughout the year.

Marital status is based on the person’s marital status at the end of the year. If missing, the most recent non-missing marital status variable is used. A small percentage of persons (< 2 percent) had a missing value for marital status.

The MEPS respondent was asked to rate the health of each person in the family at the time of the interview according to the following categories: excellent, very good, good, fair, and poor. For persons with missing health status in a round, the response for health status at the previous round was used, if available. A small percentage of persons (< 2 percent) had a missing response for perceived health status.

The MEPS respondent was asked to rate the mental health of each person in the family at the time of the interview according to the following categories: excellent, very good, good, fair, and poor. For persons with missing mental health status in a round, the response for mental health status at the previous round was used, if available. A small percentage of persons (< 2 percent) had a missing response for perceived mental health status.

Percentages may not sum to 100 due to rounding.

Each sample person was classified according to the total annual income of his or her family. Possible sources of income included annual earnings from wages, salaries, bonuses, tips, and commissions; business and farm gains and losses; unemployment and Worker’s Compensation; interest and dividends; alimony, child support, and other private cash transfers; private pensions, individual retirement account (IRA) withdrawals, Social Security, and Department of Veterans Affairs payments; Supplemental Security Income and cash welfare payments from public assistance, Aid to Families with Dependent Children and Aid to Dependent Children; gains or losses from estates, trusts, partnerships, S corporations, rent, and royalties; and a small amount of ‘other’ income. Poverty status is the ratio of family income to the corresponding federal poverty thresholds, which control for family size and age of the head of family. Categories are defined as follows:

Negative or Poor: Household income below the Federal poverty line.

Near poor: Household income over the poverty line through 125 percent of the poverty line.

Low income: Household income 125 percent through 200 percent of the poverty line.

Middle income: over 200 percent to 400 percent of the poverty line.

High income: over 400 percent of the poverty line.

Classification by race and ethnicity is based on information reported for each family member. Starting in 2002, specifications changed so that individuals could report multiple races. Respondents were asked if the race of the sample person was best described as American Indian, Alaska Native, Asian or Pacific Islander, black, white, or other. Prior to 2002, race categories in the tables for American Indian, Alaska Native, Asian or Pacific Islander, multiple races, white, and other are collapsed into the single category of White and other.

For all years, respondents were asked if the sample person’s main national origin or ancestry was Puerto Rican; Cuban; Mexican, Mexicano, Mexican American, or Chicano; other Latin American; or other Spanish. All persons whose main national origin or ancestry was reported in one of these Hispanic groups, regardless of racial background, are classified as Hispanic. Since the Hispanic grouping can include black Hispanic, white Hispanic, and other Hispanic, the race categories of black, white, and other do not include Hispanic people.

Respondents were asked to report the age of each family member as of the date of each interview for each round of data collection. The age variable used to create these estimates is based on the sample person’s age as of the end of the year. If data were not collected during a round because the sample person was out of scope (e.g., deceased or institutionalized), then age at the time of the previous round was used.

The census region variable is based on the location of the household at the end of the year. If missing, the most recent location available is used.

Northeast: Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, New York, New Jersey, and Pennsylvania.

Midwest: Ohio, Indiana, Illinois, Michigan, Wisconsin, Minnesota, Iowa, Missouri, North Dakota, South Dakota, Nebraska, and Kansas.

South: Delaware, Maryland, District of Columbia, Virginia, West Virginia, North Carolina, South Carolina, Georgia, Florida, Kentucky, Tennessee, Alabama, Mississippi, Arkansas, Louisiana, Oklahoma, and Texas.

West: Montana, Idaho, Wyoming, Colorado, New Mexico, Arizona, Utah, Nevada, Washington, Oregon, California, Alaska, and Hawaii.

Education for each person is based on the highest education level completed when entering MEPS. A small percentage of persons (< 2 percent) had a missing response for education.

Employment status is based on the person’s employment status at the end of the year. If missing, the most recent non-missing employment status variable is used. A small percentage of persons (< 2 percent) had a missing response for employment status.

Uninsured: Individuals who did not have health insurance coverage for the entire calendar year were classified as uninsured. The uninsured were defined as people not covered by Medicaid, Medicare, TRICARE (Armed Forces-related coverage), other public hospital/physician programs, private hospital/physician insurance (including Medigap coverage) or insurance purchased through health insurance Marketplaces. People covered only by non-comprehensive State-specific programs (e.g., Maryland Kidney Disease Program) or private single service plans such as coverage for dental or vision care only, or coverage for accidents or specific diseases, were considered uninsured.

Any private: Individuals classified as having any private health insurance coverage had private insurance that provided coverage for hospital and physician care (including Medigap coverage and TRICARE) at some point during the year.

Public only: Individuals are considered to have public only health insurance coverage if they were not covered by private insurance or TRICARE and they were covered by Medicare, Medicaid, or other public hospital and physician coverage at some point during the year.

65+, No Medicare: Individuals classified as 65+, No Medicare either had private coverage at some point during the year that is not identified as Medigap coverage or were uninsured throughout the year.

Marital status is based on the person’s marital status at the end of the year. If missing, the most recent non-missing marital status variable is used. A small percentage of persons (< 2 percent) had a missing value for marital status.

The MEPS respondent was asked to rate the health of each person in the family at the time of the interview according to the following categories: excellent, very good, good, fair, and poor. For persons with missing health status in a round, the response for health status at the previous round was used, if available. A small percentage of persons (< 2 percent) had a missing response for perceived health status.

The MEPS respondent was asked to rate the mental health of each person in the family at the time of the interview according to the following categories: excellent, very good, good, fair, and poor. For persons with missing mental health status in a round, the response for mental health status at the previous round was used, if available. A small percentage of persons (< 2 percent) had a missing response for perceived mental health status.

Percentages may not sum to 100 due to rounding.

Each sample person was classified according to the total annual income of his or her family. Possible sources of income included annual earnings from wages, salaries, bonuses, tips, and commissions; business and farm gains and losses; unemployment and Worker’s Compensation; interest and dividends; alimony, child support, and other private cash transfers; private pensions, individual retirement account (IRA) withdrawals, Social Security, and Department of Veterans Affairs payments; Supplemental Security Income and cash welfare payments from public assistance, Aid to Families with Dependent Children and Aid to Dependent Children; gains or losses from estates, trusts, partnerships, S corporations, rent, and royalties; and a small amount of ‘other’ income. Poverty status is the ratio of family income to the corresponding federal poverty thresholds, which control for family size and age of the head of family. Categories are defined as follows:

Negative or Poor: Household income below the Federal poverty line.

Near poor: Household income over the poverty line through 125 percent of the poverty line.

Low income: Household income 125 percent through 200 percent of the poverty line.

Middle income: over 200 percent to 400 percent of the poverty line.

High income: over 400 percent of the poverty line.

Classification by race and ethnicity is based on information reported for each family member. Starting in 2002, specifications changed so that individuals could report multiple races. Respondents were asked if the race of the sample person was best described as American Indian, Alaska Native, Asian or Pacific Islander, black, white, or other. Prior to 2002, race categories in the tables for American Indian, Alaska Native, Asian or Pacific Islander, multiple races, white, and other are collapsed into the single category of White and other.

For all years, respondents were asked if the sample person’s main national origin or ancestry was Puerto Rican; Cuban; Mexican, Mexicano, Mexican American, or Chicano; other Latin American; or other Spanish. All persons whose main national origin or ancestry was reported in one of these Hispanic groups, regardless of racial background, are classified as Hispanic. Since the Hispanic grouping can include black Hispanic, white Hispanic, and other Hispanic, the race categories of black, white, and other do not include Hispanic people.

Due to the COVID-19 pandemic, additional procedures for developing weights for the 2020 MEPS data were designed to correct for potential biases in the data due to changes in data collection and response bias. However, evaluations of MEPS data quality in 2020 – corroborated in analyses of other Federal surveys fielded in 2020 – suggest that users of the MEPS 2020 data should exercise caution when interpreting estimates based on these data, including the comparison of such estimates with those of other years.

2018 Design Change – Impact on Use and Expenditures: Starting with interviews conducted in 2018, the MEPS Household Component questionnaire was revised to improve respondents’ reporting of health care use. These improvements likely contribute to observed increases (and may dampen any actual decreases) in events and expenditures from 2016 to 2018, particularly from 2017 to 2018.

Utilization: For event-based estimates (mean events per person, mean expenditure per event, and total number of events), events include all dental visits, prescribed medicine purchases (including refills), office-based and outpatient visits, emergency room visits, inpatient stays, and home health events. A home health event is defined as one month during which home health service was received. Office-based visits and Outpatient events that are phone calls, and informal Home Health care are not included in utilization estimates. Expenditures for these events are not collected, and are denoted on the event files as “-1 Inapplicable”. Other medical equipment and services are not included in utilization estimates because information for these events is collected per interview or per year for each person, rather than on a per-purchase basis.

Expenditures: Expenditures include payments for medical events reported during the calendar year. Expenditures in MEPS are defined as the sum of direct payments for care provided during the year, including out-of-pocket payments and payments by private insurance, Medicaid, Medicare, and other sources. Payments for over-the-counter drugs and phone contacts with medical providers are not included in MEPS total expenditure estimates. Indirect payments not related to specific medical events, such as Medicaid Disproportionate Share and Medicare Direct Medical Education subsidies, also are not included. Any charges associated with uncollected liability, bad debt, and charitable care (unless provided by a public clinic or hospital) are not counted as expenditures.

Expenditures shown over time are not adjusted for inflation.

Conditions

Medical conditions are based on conditions for which treatment was received, where treatment includes emergency room visits, home health care, inpatient stays, office-based visits, outpatient visits, and prescription medicine purchases.

All conditions are reported by household respondents and are not verified by medical professionals. Conditions are not mutually exclusive, since multiple conditions can be reported for the same medical event. The Number of people with care reflects treated prevalence, defined as the number of people with a medical event or prescribed medicine purchase for a particular condition. Total expenditures comprise the sum of direct payments for care, including out-of-pocket payments, insurance payments, and payments from other sources. Mean expenditures per person include events with $0 expenditures. Number of events include ER visits, home health, inpatient stays, office-based and outpatient visits, and prescribed medicine purchases associated with a particular condition. Other medical equipment and services and dental visits are not included in these tables since medical conditions are not collected for these event types. Office-based visits and Outpatient events that are informal phone calls, and informal Home Health care are not included. Starting in 2020, office-based and outpatient telehealth events are included in the estimates.

Several changes have occurred in the collection and processing of MEPS condition data that may impact analysis of trends over time:

(1) Starting in 2007, new survey questions were introduced into MEPS asking participants about whether they had been told they have certain priority health conditions. This change in the survey methodology may have impacted responses for utilization and expenditures related to the following conditions: hypertension, heart disease, cerebrovascular disease, COPD, asthma, hyperlipidemia, cancer, diabetes mellitus, and osteoarthritis.

(2) From 1996-2015, household-reported medical conditions were coded into ICD-9 and CCS codes, which were then collapsed into broad Condition categories. Starting in 2016, household-reported medical conditions were coded into ICD-10 and CCSR codes before collapsing into Condition categories. This discontinuity is represented by the ICD-9/CCS and ICD-10/CCSR delineation in the graph. Extreme caution must be taken when comparing data on medical conditions before and after this transition, due to fundamental differences between the ICD-9 and ICD-10 codes, as well as the CCS and CCSR codes. In addition, several of the collapsed condition categories in the MEPS Summary Tables have been updated. For example, “Appendicitis” and “Other GI” conditions are now included in the “Other stomach and intestinal disorders” category.

The transition from ICD9/CCS codes to ICD10/CCSR codes is an ongoing process. The data in these tables may be updated whenever updated CCSR codes are released. Crosswalks between the CCS[R] and collapsed Condition categories can be found at the AHRQ GitHub site. More information on CCS[R] coding can be found at the HCUP website:

• ICD9/CCS: https://www.hcup-us.ahrq.gov/toolssoftware/ccs/ccs.jsp
• ICD10/CCSR: https://www.hcup-us.ahrq.gov/toolssoftware/ccsr/ccs_refined.jsp

The “Body System” corresponding to the Condition Category is derived from the body systems defined by the first 3 digits of the CCSR codes, which generally correspond to the ICD-10 chapter descriptions. For collapsed categories that contain multiple CCSR body systems (e.g. “Complications of surgery or device”), the most common CCSR body system was selected as the Condition Category body system.  Refer to the MEPS GitHub repository for more information.

Respondents were asked to report the age of each family member as of the date of each interview for each round of data collection. The age variable used to create these estimates is based on the sample person’s age as of the end of the year. If data were not collected during a round because the sample person was out of scope (e.g., deceased or institutionalized), then age at the time of the previous round was used.

The census region variable is based on the location of the household at the end of the year. If missing, the most recent location available is used.

Northeast: Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, New York, New Jersey, and Pennsylvania.

Midwest: Ohio, Indiana, Illinois, Michigan, Wisconsin, Minnesota, Iowa, Missouri, North Dakota, South Dakota, Nebraska, and Kansas.

South: Delaware, Maryland, District of Columbia, Virginia, West Virginia, North Carolina, South Carolina, Georgia, Florida, Kentucky, Tennessee, Alabama, Mississippi, Arkansas, Louisiana, Oklahoma, and Texas.

West: Montana, Idaho, Wyoming, Colorado, New Mexico, Arizona, Utah, Nevada, Washington, Oregon, California, Alaska, and Hawaii.

Education for each person is based on the highest education level completed when entering MEPS. A small percentage of persons (< 2 percent) had a missing response for education.

Employment status is based on the person’s employment status at the end of the year. If missing, the most recent non-missing employment status variable is used. A small percentage of persons (< 2 percent) had a missing response for employment status.

Office-based physician visits are a sub-category of Office-based events, and Outpatient physician visits are a sub-category of Outpatient events.

A home health event is defined as one month during which home health service was received.

For prescription medicines, an event is defined as a purchase or refill.

Other medical equipment and services are expenses for medical equipment such as eyeglasses, hearing aids, or wheelchairs. Starting in Panel 21 Round 5 and Panel 22 Round 3 (the last half of 2017), questions about Other Medical expenses are asked in every round (previously only questions about glasses/contact lenses were asked every round). The increased frequency of questions and reduced length of reference periods likely led to more reporting due to improved recall. goes to if he/she is sick or needs advice about his/her health.

Uninsured: Individuals who did not have health insurance coverage for the entire calendar year were classified as uninsured. The uninsured were defined as people not covered by Medicaid, Medicare, TRICARE (Armed Forces-related coverage), other public hospital/physician programs, private hospital/physician insurance (including Medigap coverage) or insurance purchased through health insurance Marketplaces. People covered only by non-comprehensive State-specific programs (e.g., Maryland Kidney Disease Program) or private single service plans such as coverage for dental or vision care only, or coverage for accidents or specific diseases, were considered uninsured.

Any private: Individuals classified as having any private health insurance coverage had private insurance that provided coverage for hospital and physician care (including Medigap coverage and TRICARE) at some point during the year.

Public only: Individuals are considered to have public only health insurance coverage if they were not covered by private insurance or TRICARE and they were covered by Medicare, Medicaid, or other public hospital and physician coverage at some point during the year.

65+, No Medicare: Individuals classified as 65+, No Medicare either had private coverage at some point during the year that is not identified as Medigap coverage or were uninsured throughout the year.

Marital status is based on the person’s marital status at the end of the year. If missing, the most recent non-missing marital status variable is used. A small percentage of persons (< 2 percent) had a missing value for marital status.

The MEPS respondent was asked to rate the health of each person in the family at the time of the interview according to the following categories: excellent, very good, good, fair, and poor. For persons with missing health status in a round, the response for health status at the previous round was used, if available. A small percentage of persons (< 2 percent) had a missing response for perceived health status.

The MEPS respondent was asked to rate the mental health of each person in the family at the time of the interview according to the following categories: excellent, very good, good, fair, and poor. For persons with missing mental health status in a round, the response for mental health status at the previous round was used, if available. A small percentage of persons (< 2 percent) had a missing response for perceived mental health status.

Each sample person was classified according to the total annual income of his or her family. Possible sources of income included annual earnings from wages, salaries, bonuses, tips, and commissions; business and farm gains and losses; unemployment and Worker’s Compensation; interest and dividends; alimony, child support, and other private cash transfers; private pensions, individual retirement account (IRA) withdrawals, Social Security, and Department of Veterans Affairs payments; Supplemental Security Income and cash welfare payments from public assistance, Aid to Families with Dependent Children and Aid to Dependent Children; gains or losses from estates, trusts, partnerships, S corporations, rent, and royalties; and a small amount of ‘other’ income. Poverty status is the ratio of family income to the corresponding federal poverty thresholds, which control for family size and age of the head of family. Categories are defined as follows:

Negative or Poor: Household income below the Federal poverty line.

Near poor: Household income over the poverty line through 125 percent of the poverty line.

Low income: Household income 125 percent through 200 percent of the poverty line.

Middle income: over 200 percent to 400 percent of the poverty line.

High income: over 400 percent of the poverty line.

Classification by race and ethnicity is based on information reported for each family member. Starting in 2002, specifications changed so that individuals could report multiple races. Respondents were asked if the race of the sample person was best described as American Indian, Alaska Native, Asian or Pacific Islander, black, white, or other. Prior to 2002, race categories in the tables for American Indian, Alaska Native, Asian or Pacific Islander, multiple races, white, and other are collapsed into the single category of White and other.

For all years, respondents were asked if the sample person’s main national origin or ancestry was Puerto Rican; Cuban; Mexican, Mexicano, Mexican American, or Chicano; other Latin American; or other Spanish. All persons whose main national origin or ancestry was reported in one of these Hispanic groups, regardless of racial background, are classified as Hispanic. Since the Hispanic grouping can include black Hispanic, white Hispanic, and other Hispanic, the race categories of black, white, and other do not include Hispanic people.

Private: Includes payments made by insurance plans covering hospital and medical care (excluding payments from Medicare, Medicaid, and other public sources). Payments from Medigap plans or TRICARE (Armed-Forces-related coverage) are included.

Medicare: A federally financed health insurance plan for the elderly, persons receiving Social Security disability payments, and most persons with end-stage renal disease. Medicare Part A, which provides hospital insurance, is automatically given to those who are eligible for Social Security. Medicare Part B provides supplementary medical insurance that pays for medical expenses and can be purchased for a monthly premium.

Medicaid: A means-tested government program jointly financed by federal and state funds that provides health care to those who are eligible. Program eligibility criteria vary significantly by state, but the program is designed to provide health coverage to families and individuals who are unable to afford necessary medical care.

Other: Includes payments from the Department of Veterans Affairs (excluding TRICARE); other federal sources (Indian Health Service, military treatment facilities, and other care provided by the Federal Government); various state and local sources (community and neighborhood clinics, State and local health departments, and State programs other than Medicaid); payments from Workers’ Compensation; and, other unclassified sources (e.g., automobile, homeowner’s, or liability insurance, and other miscellaneous or unknown sources). It also includes private insurance payments reported for persons without private health insurance coverage during the year, as defined in MEPS, and Medicaid payments reported for persons who were not enrolled in the Medicaid program at any time during the year.

Update Sept. 2022: Prescribed drugs with missing NDCs are now included in the table estimates, resulting in increased estimate values for some drugs compared to the previous version of these summary tables. In addition, the drugs displayed are now limited to those that have reliable estimates in at least one year post-2013.

Due to the COVID-19 pandemic, additional procedures for developing weights for the 2020 MEPS data were designed to correct for potential biases in the data due to changes in data collection and response bias. However, evaluations of MEPS data quality in 2020 – corroborated in analyses of other Federal surveys fielded in 2020 – suggest that users of the MEPS 2020 data should exercise caution when interpreting estimates based on these data, including the comparison of such estimates with those of other years.

2018 Design Change – Impact on Use and Expenditures: Starting with interviews conducted in 2018, the MEPS Household Component questionnaire was revised to improve respondents’ reporting of health care use. These improvements likely contribute to observed increases (and may dampen any actual decreases) in events (i.e. total purchases) and expenditures from 2016 to 2018, particularly from 2017 to 2018.

Expenditures: Expenditures include payments for medical events reported during the calendar year. Expenditures in MEPS are defined as the sum of direct payments for care provided during the year, including out-of-pocket payments and payments by private insurance, Medicaid, Medicare, and other sources. Payments for over-the-counter drugs and phone contacts with medical providers are not included in MEPS total expenditure estimates. Indirect payments not related to specific medical events, such as Medicaid Disproportionate Share and Medicare Direct Medical Education subsidies, also are not included. Any charges associated with uncollected liability, bad debt, and charitable care (unless provided by a public clinic or hospital) are not counted as expenditures.

Expenditures shown over time are not adjusted for inflation.

Estimates are for prescribed drugs obtained by household members. The data do not include drugs administered in hospitals or provider offices. Data source for generic drug name is Cerner Multum Inc. Prescribed drugs with inadequate precision for all years are not shown.

Prescribed drugs are identified using a list of generic names from the Multum Lexicon that are created for physicians and are edited to fit into a fixed amount of space. In general, a component of a drug name such as a salt, chemical or estername is included only if it is important to identify the drug and a physician is likely to use it. In most cases, they will be excluded. For example, “buspirone hydrochloride” will appear as “buspirone.” In a combination drug with two ingredients, the ingredients are separated by a dash. In a combination drug with three or more ingredients, the ingredients are separated by a “/” and common drug name abbreviations may be used for some ingredients. These include “ASA” for aspirin, “APAP” for acetaminophen and “PPA” for phenylpropanolamine.

Estimates are for prescribed drugs obtained by household members. The data do not include drugs administered in hospitals or provider offices. Data source for therapeutic class is Cerner Multum Inc. Therapeutic classes with inadequate precision for all years are not shown.

The overwhelming majority of items in the “Not Ascertained” category are medical supplies and devices, such as test strips, lancets, and glucometers.

Users should be cautious when assessing trends in therapeutic classes, because Multum’s therapeutic classification has changed across the years of the MEPS. The Multum variables on each year of this table reflect the most recent classification available in the year the MEPS Prescribed Medicines files were originally released. Four changes explain breaks in the trends:
1.    From 1996-2004, antidiabetic drugs were a subclass of the hormone class, but in subsequent years, the antidiabetic subclass is part of a class of metabolic drugs.
2.    From 1996-2004, antihyperlipidemic agents were categorized as a class. In subsequent years, antihyperlipidemic drugs were a subclass in the metabolic class.
3.    From 1996-2004, the psychotherapeutic class comprised drugs from four subclasses: antidepressants, antipsychotics, anxiolytics/sedatives/hypnotics, and CNS stimulants. In subsequent files, the psychotherapeutic class comprised only antidepressants and antipsychotics.
4.    From 1996-2007, genitourinary agents were in the miscellaneous agent therapeutic class. In subsequent years, they are their own class.

Smaller changes may occur each year. In 2015, for example, the therapeutic class for sulfasalazine was switched from anti-infectives to gastrointestinal agents. Changes may occur between any years, so for more precise estimates, it is prudent to use the RXDRGNAM variable in the Prescription Medication public use files and Multum Lexicon Addendum Files to MEPS Prescribed Medicines Files to create a consistent classification over time.