Reading Your Explanation of Benefits
Your Explanation of Benefits (EOB) is a simple recap of how your insurance paid for care and services received. You'll get one after every visit to a care provider and you may get multiple EOBs for some services, like surgeries.
Remember, this is not a bill.
What You'll See on Your EOB
The EOB statement shows how we apply coverage to claim(s) by date of service.
This is your Explanation of Health Care Benefits statement. It shows how we applied your coverage to claim(s) submitted to us.
- Patient Account Number and Health Care Provider
- Amount Charged: What your health care provider charged for services.
- Network Savings: The discount your insurance company negotiated with in-network providers to help lower your out-of-pocket costs.
- Amount Paid by Health Plan (your insurance company)
Amount Paid by You:
- Deductible: The amount you pay before your plan pays.
- Copayment: A flat amount you pay directly to your provider.
- Coinsurance: A percentage you pay for specific services.
- Amount Not Covered (by your insurance company for each service)
- Other Insurance Paid: If you have additional coverage, the amount contributed by that plan is listed here.
- The Sum of your Deductible + Copayment + Coinsurance + Amount Not Covered: What you owe. If you have not already paid it, your provider will send a bill separately.