Glossary

Reasonable Charge

A limit set by a health plan on the amount it will pay for a medical service. This limit is often determined by reference to amounts typically charged for a particular health care service by other providers in the same geographic area, although some plans may refer to other payment standards (such as the amount paid by Medicare). Also called "usual, customary and reasonable (UCR)" or "customary and reasonable."

Referral

In some health plans, you must receive a referral from your primary care doctor to see a specialist or receive certain health care services. A referral is a specific set of directions or instructions from your doctor. A referral may be written or electronic.

Reimbursement

Payment from a health benefits plan to reimburse an individual's covered medical expenses or directly to a health care professional in payment for services rendered to plan participants.

Retiree Reimbursement Account (RRA)

Retiree Reimbursement Accounts (RRA) are health reimbursement arrangements designed to be used in retirement to pay for insurance premiums and/or qualified medical expenses. Contributions to an RRA are made by an employer. Balances rollover from year to year in accordance with rules established by the employer. Funds in an RRA may be used to pay for unreimbursed medical expenses as well as health premiums, including Medicare Part B and Medigap policies. Reimbursements from an RRA are not considered taxable income to the retiree.

Rollover Feature

The ability to carry forward or "roll over" any remaining balance in a health fund to use for covered medical services in subsequent years.