adverse selection The tendency of persons who present a poorer-thanaverage health risk to apply for, or continue, insurance to a greater extent
than do persons with average or better-than-average expectations of health.

benefit package The covered services each patient is entitled to under a managed care contract. capitation An arrangement in which managed care plans pay a fixed monthly or annual fee to physicians for each patient in their care. Doctors receive the same fixed amount each month regardless of how much care
the plan member receives.

claim- A request by either an individual or his or her physician asking an insurance company to pay for services the insured obtained from a health care professional.

copayment- The percentage or proportion of a health insurance claim that is paid directly “out of pocket” by the patient.

deductible- The fixed amount of money that an individual must pay...