This is not a bill.
Explanation of Benefits
If it's not a bill, then what is it?

An Explanation of Benefits (EOB) is a simple recap of what your insurance has paid for. Every time one of your health care providers files a claim, you'll get a notification via mail. Or if you've signed up for online EOB's, you'll get an email alerting you that an EOB is available online.

It's important for you to review your statement. It will help you make sure you are getting the most value out of your health care spending.

The EOB will tell you:
Cash register
How much your provider charged for each service.
How much your health insurance company paid for each service.
How much you saved by staying in-network.
How much you are responsible for paying out of pocket.
If a service isn't 100% covered...
The EOB will provide you an explanation of:
  • Why it wasn't covered.
  • How much you will be expected to pay out of pocket.
Always make sure the services listed on your EOB are accurate. If you receive a bill from your provider, compare the charges to your EOB.
How to Read an Explanation of Benefits

An Explanation of Benefits statement looks like this…

Section of Explanation of Benefits form
bullet 1
Patient Account Number and Health Care Provider
bullet 2
Amount Charged – The amount your health care provider charges for services.
bullet 3
Network Savings – The discount your insurance company has negotiated with in-network providers to help lower your out-of-pocket costs.
bullet 4
Amount Paid by Health Plan – The amount paid by your insurance company.
Amount paid by you...
bullet 5
Deductible – An amount you agree to pay before insurance is applied.
bullet 6
Copayment – A flat amount you pay directly to your provider.
bullet 7
Coinsurance – A percentage you pay for specific services.
bullet 8
Amount Not Covered – The remaining amount not covered by insurance for each service.
bullet 9
Other Insurance Paid – If you have additional coverage, any amount contributed by that plan will be listed here.
bullet 10
The sum of numbers 5-8 – Shows what you will be financially responsible for. You may have already paid this amount. If not, a bill from your provider will be sent separately.