The process of directing or redirecting (as a medical case or a patient) to an appropriate specialist or agency for definitive treatment. Your health plan may require written referral requests for any overseas care.

A modification made to a Certificate of Insurance regarding the clauses and provisions of a policy (usually adding or excluding coverage).

The chance of loss, the degree of probability of loss, or the amount of possible loss to the insuring company. For an individual, risk represents such probabilities as the likelihood of surgical complications, medications’ side effects, exposure to infection, or the chance of suffering a medical problem because of a lifestyle or other choice. For example, an individual increases his or her risk of getting cancer if he or she chooses to smoke cigarettes.