Copay: The portion of a provider's or hospital's bill you must pay. The amount can be as simple as an office co-pay of $10.00 or 10 percent of the cost of a procedure.

Closed Formulary: A specified list of several hundred medications the plan has determined to be the most cost effective. The closed formulary applies to both retail and mail-order plans. Most HMOs have a closed formulary which means enrollees cannot get a drug that is not on the formulary unless their doctor gets a medical exception for it. .

Deductible: The amount you pay before the plan begins paying. The Ohio Med PPO has an annual deductible enrollees must pay before the plan begins to pay benefits.

National Committee for Quality Assurance (NCQA): A private, not-for-profit organization dedicated to assessing and reporting on the quality of managed care plans. NCQA's accreditation process provides an overview of how a health plan's systems are operating by using standards that are meaningful to purchasers, health plans and consumers. All HMOs offered to state employees must be NCQA-certified.

Network: Hospitals, physicians and other providers who have a contract with the plan administrator to accept its payment as payment in full. In the Ohio Med PPO, enrollees pay the lowest co-payments when they see network providers. In the HMOs, enrollees cannot visit an out-of-network provider.

Non-Network: Hospitals, physicians and other providers who may not accept the plan's payment as payment in full and can bill you for the difference. While the Ohio Med PPO allows enrollees to go out of network (at a higher co-payment), HMOs do not allow enrollees to see any providers out of their network.

Out-of-pocket maximum (OPM): The amount you must pay toward eligible expenses before the plan pays in full. This puts an annual limit on how much an enrollee would pay before the plan starts paying 100 percent. For example, as enrollees make co-payments of their 10 percent of the bill, the co-payments are added up. Once the enrollee reaches the OPM, the enrollee will not have to pay the 10 percent co-payments. Office visit co-payments are not counted toward the OPM.

Primary Care Physician (PCP): The plan physician you select to manage your health care and make any needed referrals. Some plans require you to designate a PCP, others do not.