Reading Your Explanation of Benefits
Your Explanation of Benefits (EOB) is a simple recap of how your health plan paid for medical care or services you received. You'll get one after every visit to a care provider. You may get multiple EOBs for some services, like surgeries. It's important to know your EOB is not a bill.
Reviewing your EOBBelow is an example of an EOB. Your statement can be broken down into three important sections:
The EOB statement shows how your health plan applies coverage to claim(s) by date of service.
Every EOB includes information about your claim, including the patient, date of service, provider and the type of service received.
Your EOB may include information about more than one claim or more than one patient.
This section will help you understand how Wellmark covered the cost of your service or visit.
You'll see the Amount Charged Glossary popover by your provider, how much you saved by staying in-network in Network Savings Glossary popover and the amount your plan paid toward the service or visit, which is known as Amount Paid by Health Plan Glossary popover.
Based on your specific plan, you may be responsible for part of the cost in the form of a deductible, copayment, or coinsurance. There may also be services that aren't covered or some costs that are covered by other insurance.
The sum of your Deductible Glossary popover + Copayment Glossary popover + Coinsurance Glossary popover + Amount Not Covered Glossary popover is the amount you may owe your provider. If you haven't already paid it, your provider will send you a bill separately.
It's important to remember your EOB is not a bill, and you shouldn't pay anything to Wellmark when you receive your EOB.
How to get your EOB
You can easily review your EOBs online through the secure, member portal myWellmark®. With online EOBs, you have quick and convenient access to the information you need, when you need it.
myWellmark allows you to track and sort your EOBs by date, provider or patient. And, it will keep all those records safely stored in your account for 24 months.
You can start receiving an email notification at any time. Simply log in or register for myWellmark and follow these three easy steps:
- Select Profile from the menu at the top.
- Click the Notifications tab.
- Choose Email for Explanation of Benefits (EOB), then Agree and Save.