Health Insurance Glossary – R Terms
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
R
Reasonable and Customary
A term used to refer to the fee or rate typically charged by a health care provider for a particular service in a particular geographic area. Health plans normally only cover costs up to the reasonable and customary level, and any excess over this level must be paid by the individual.
Also referred to as Usual, Reasonable and Customary or Prevailing Rate.
Rider
An amendment or modification to an insurance policy used to add, exclude, or amend coverage. Also known as an Endorsement.
Risk
The chance or degree of probability of loss, or the amount of possible loss.
Insurance companies use risk to determine if they will underwrite an insurance policy and the level of premium charged for that policy. For example, it is generally accepted that smoking increases an individual's risk of developing lung cancer, therefore insurers will often charge a higher premium to insure a smoker because there is a greater risk that individual will require significant medical treatment.
