Access: The ability to get medical care.

• Capitation: A method of paying for medical services in which providers receive set payments based on the number of people they treat rather than the actual cost of care provided.

• Carrier: A health insurance company.

• COBRA: A program in which employers with group health plans give laid-off or terminated employees the opportunity to temporarily continue their group coverage, usually at the employees' expense.

• Closed access: A requirement that the insured individual must get medical services only from network providers chosen by the insurance company.

• Co-insurance: A method of sharing the costs of care between the insurance company and the individual; often the insurer pays 80 percent and the individual makes a 20 percent co-payment.

• Co-ops: Private, nonprofit health organizations set up by some states to compete with private health insurers.

• Drug formulary: A list of prescription drugs that a health insurance plan will pay for.

• Employer health care tax credit: A government incentive program that gives tax breaks to small employers for the costs of setting up employee health plans.

• Employer benefits exemption: A tax break for employees on the value of their company-paid health benefits. Some overhaul programs would limit or end this.

• Employer mandate: A requirement in some of the reform proposals that employers offer health insurance programs for their employees and pay a portion of the cost.

• Entitlement programs: Federal programs such as Medicare and Medicaid that give qualified individuals the right to receive benefits.

• Gatekeeper: A primary care physician required under some insurance policies to coordinate an individual's care; often the individual will need the gatekeeper's referral to go to a medical specialist.

• Guaranteed access: A proposed requirement that insurers must sell health insurance and renew policies without regard to an individual's health status.

• Health reimbursement account: A tax-exempt account individuals can set up, funded entirely by them, to cover health care expenses.

• High-deductible health plan: A health insurance plan with low premiums but high deductibles.

• Health maintenance organization (HMO): Health insurance plans in which the insurance company provides health care services to those it insures.

• High-risk pool: Programs under which states provide health insurance for individuals unable for health reasons to buy commercial insurance.

• Individual mandate: Requirement that all individuals obtain health insurance.

• Long-term care: Health care in the home or in nursing homes on a long-term basis for the aged or chronically ill.

• Managed care: A system for providing health care services in which the insuring entity controls what services are provided in return for a prearranged payment. Often uses primary care physicians as ``gatekeepers'' whose referrals are needed to go to medical specialists.

• Medicaid: Insurance programs by federal, state and local governments that provides health care for qualified low-income individuals.

• Medicare: Federal entitlement insurance program to cover individuals 65 and older and younger people with disabilities. Funded in part by deposits from payroll taxes.

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