Understanding Explanations of Benefits
After you receive a treatment or procedure and there is a cost share (copay, deductible, coinsurance), you’ll receive an Explanation of Benefits Statement, or EOB. This document gives you a detailed look at those health care services and shows:
- What was covered by your health plan
- How much was covered
- Any out-of-pocket costs you are responsible for
An EOB is not a bill.
Here’s an example of how the process works:
- You pay your monthly plan premium.
- You head to the doctor.
- Depending on the service and your benefit plan, you may have to pay a copay.
- You receive an EOB. You can receive it by mail or electronically. It is not a bill but it will give you an idea of how much you may have to pay the doctor.
- You receive a bill from your doctor.
- You pay your bill directly to the doctor’s office.
To view a detailed record of your EOBs, log in to your online member account. Click on “My Claims.”
Need help accessing or understanding an EOB? Contact us.