R


Rationing

The threat of rationing is an argument used against health care reform, claiming that more government control of the health care system will result in the government restricting care by not paying for specific medication or procedures, or limiting care for those who are elderly or terminally ill. Some in favor of health reform argue that health care is already rationed, due to the limited access to health care, and the rising cost of medical care.

Reinsurance

A system of reimbursement to protect insurance companies from having to pay expensive claims, which typically involves a third party to pay a portion of the insurer’s claims, once they have reached a limit. Reinsurance allows for the regulation of the health insurance market, and ensuring coverage stays available and feasible to pay for.

Rescission

The cancellation of an insurance plan, where an insurance plan revokes your benefits due to alleged misrepresentation, which can sometimes be due to a mistake made on your application for health insurance.  The Affordable Care Act has banned insurance companies from legally rescinding health plans, unless the client has committed true fraud or intentional misrepresentation. For more on rescission, read this brief article.

Rider

An amendment to an insurance plan, which can be attached by insurers when they do not wish to pay for a pre-existing condition, body part, or body system. As of 2010, children with conditions are exempt from having a rider attached to their coverage, and insurance must cover their condition. On January 1, 2014, health insurance companies will no longer be allowed to use exclusionary riders.

Risk

The likelihood, or amount of potential loss to a health insurance company. Outside of the insurer’s context, risk refers to the possibility of complications during surgery, exposure to infection, experiencing side effects from medications, or potential of having health issues as a result of lifestyle choices. A common example of a high risk individual would be someone who smokes cigarettes having a higher likelihood of getting cancer.

 


 

Sources:

1. HealthInsurance.org, “Health insurance glossary”. http://www.healthinsurance.org/glossary/

2. HealthCare.gov, “Glossary – R”. http://www.healthcare.gov/glossary/r/index.html