What is Case Management
Case management is a system embraced by employers and insurance companies to ensure that individuals receive appropriate, reasonable health care services.

What is Case Manager?
A doctor or nurse affiliated with a managed care plan that arranges and approves medical care for the insured.

What is Capitation ?
Capitation represents a set dollar limit that you or your employer pay to a health maintenance organization (HMO), regardless of how much you use (or don't use) the services offered by the health maintenance providers. (Providers is a term used for health professionals who provide care. Usually providers refer to doctors or hospitals. Sometimes the term also refers to nurse practitioners, chiropractors and other health professionals who offer specialized services.)

What is Closed Panel?
Also known as the gatekeeper system, this is the procedure used by managed care plan in which the member's primary care physician makes referrals to other network health care providers.

What is Coinsurance?
The amount you are required to pay for medical care in a fee-for-service plan after you have met your deductible. The coinsurance rate is usually expressed as a percentage. For example, if the insurance company pays 80 percent of the claim, you pay 20 percent.

What is Comprehensive Insurance?
A combination of Basic Insurance and Major Medical Insurance.

What is Continuing Care Retirement Community?
A housing community that provides different levels of care from independent living to nursing home.

What is Coordination of Benefits?
A system to eliminate duplication of benefits when you are covered under more than one group plan. Benefits under the two plans usually are limited to no more than 100 percent of the claim.

What is Co payment?
The out-of-pocket amount you pay every time you receive a medical service (for example, $5 for every visit to the doctor). The insurance company pays the rest.

What is Covered Expenses?
The medical procedures the insurer agrees to provide coverage. Most insurance plans, whether they are fee-for-service, HMOs, or PPO, do not pay for all services. All the services the insurance company agrees to pay for will all be listed in the policy.