HMO and PPO doctors have agreed they will accept what the insurance company will pay them. Age-rated plans vary in cost depending upon the age of the student enrolling. Medically underwritten plans can exclude students based upon the results of a physical exam. As the exam is usually done after the premium is paid, there may be a lag time during which a student who is turned down is uninsured and is awaiting a refund from the insurance company. Some plans have per diem caps on fees.
Students are responsible for paying the difference between the per diem and the actual charge.
The difference was borne by the students. Most plans will not cover emergency room treatment for non-emergency conditions as defined by the insurance company. Generally, emergency treatment must be authorized by the insurance company. Most traditional plans exclude preventive care such as immunizations, pap smears, and contraceptives. HMO's provide comprehensive health coverage for one annual fee.