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Student HMO Terms You Should Know

  • Co-payment: A type of cost sharing where insured persons pay a specified fee for service or a percent of the amount allowed as reimbursement for a covered service. Also referred to as “co-insurance”.
  • Premium: A monthly payment to insurance company. In exchange, student health plans will cover most of your healthcare services.
  • Deductible: It is the amount of expenses that must be paid out of pocket before an insurer will cover any expenses.
  • Exclusions: Conditions, situations, and services not covered by the student health care plan.
  • Health Care Provider: A doctor, hospital, laboratory, nurse, or anyone who delivers medical or health-related care.
  • Pre-existing Conditions: A condition for which medical advice, diagnosis, care or treatment, including use of prescription drugs, was recommended or received from a licensed health practitioner during a specified period of time immediately preceding the effective date of coverage.
  • Primary Care Physician: The doctor in your Student HMO network who coordinate the member’s medical care. Your primary care physician provides you with routine medical care and will refer you to a specialist when necessary.

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