Glossary
Health Insurance
R to S

You will find an expanded list and definition of terms in this glossary health insurance R to S section.

Use it often, especially when you begin to review your health insurance policy and benefits.

R

respite care: Temporary care provided to a terminally ill patient allowing a family member who may be the primary caretaker to take a break from nursing duties.

rider: An attachment or supplement to a policy explaining any changes or additions to the health plan.

risk contract: An arrangement in which a health provider offers a range of health services to a group of patients for a pre-paid amount.

routine annual exam: A yearly medical "checkup," during which your doctor will perform simple medical care such as checking your height, weight, vision and blood pressure, as well as screening for problems like colon cancer, cervical cancer, prostate cancer and high cholesterol.

S

short-term disability: This type of coverage pays a percentage of your salary (usually 50, 60 or 66 2/3 percent of your weekly salary) if you become temporarily disabled, meaning that you are not able to work for a period of time due to sickness or injury (excluding on-the- job injuries, which are covered by workers compensation).

short-term medical coverage: A major medical plan designed to protect you in the event of an illness or injury during "gaps" in your traditional medical coverage -- when you are between jobs or plans, a recent graduate, on strike, etc. Short-term plans do not cover routine exams and preventive care.

skilled nursing: A level of care given if you need intensive, 24-hour nursing supervision. This can take place in your home or in a skilled nursing facility, which offers services such as rehabilitation and specialized nutrition

small business health insurance: Also known as "small group health insurance", this type of coverage is available to small businesses with 2 to 50 employees. It often offers less expensive premiums, tax advantages to business owners, and in most cases, coverage cannot be denied.

state continuation coverage: This program, which is somewhat similar to COBRA, is available in some states, stating that if you are in a fully insured group health plan with fewer than 20 employees, then you also have rights to continue your health coverage when your job ends.

Supplemental Security Income (SSI): A program that provides cash benefits to some very low income, disabled and elderly individuals. If you qualify for the SSI program, that means you generally qualify for Medicaid too. Medicaid coverage often continues for a limited time if your income increases so that you no longer qualify for SSI.

specified disease insurance: Coverage that provides benefits for only a single disease, such as cancer, or for a group of specified diseases. Benefits are usually limited to payment of a fixed amount for each type of treatment. This is not available in some states.

standard risk: Person who, according to an insurer's underwriting standards, is entitled to purchase insurance without paying an extra premium or accept special restrictions. standard risk rate: The risk category that is composed of proposed insureds who have a likelihood of loss that is not significantly greater than average.

stop-loss insurance: Protection purchased by self-insured and some managed care arrangements against the risk of large losses or severe adverse claims experience.

stop-loss limit: Also known as an "out-of-pocket limit." A dollar amount the insured must pay before the health plan starts paying 100% of covered expenses.

stop-loss provision: A major medical policy under which the insurance company will begin to pay 100% of accrued medical expenses, after you have reached a specified amount of out-of-pocket expense in deductible and coinsurance payments.

subrogation: The practice of a secondary insurer collecting from a primary insurer for claims paid. A health insurer may pay the claims of an insured who is hurt in an auto accident and then "subrogate" against the auto insurance carrier to recover the cost of those paid claims.

substandard insurance: Insurance issued to you with an extra premium or special restriction if you do not qualify for insurance at standard rates.

substandard risk: Persons who cannot meet the health requirements of a standard health insurance policy.

supplemental accident: This kind of coverage provides extra financial security for you and your family in the event of accidental death or dismemberment.


Return from Glossary Health Insurance R to S to Affordable Health Insurance