If you’ve ever used your health insurance for a doctor’s visit, test, or procedure, chances are you’ve received something in the mail, your email inbox, or via your online insurance portal called an “Explanation of Benefits,” or EOB.
At first glance, it can look a lot like a bill, which is why so many people toss it aside in confusion or concern. But here’s the truth: an EOB isn’t a bill at all. It’s a summary, and understanding it can help you catch billing errors, track your deductible progress, and avoid surprise charges later on.
An EOB is a document your health insurance company sends after you’ve had a medical service processed through your insurance plan. It explains how the claim was handled, what your provider charged, what your insurance covered, and what you may still owe.
While the layout can vary by insurer, most EOBs include the date of service, the name of the provider, a description of the service, the amount billed, the allowed amount (what your insurer agrees is a fair charge), how much the insurer paid, and how much (if any) you’re responsible for paying.
You’ll typically receive an EOB after any service that involves a claim, whether it’s a routine check-up, diagnostic test, prescription, or hospital visit. In some cases, you may receive multiple EOBs for a single visit if different providers or specialists were involved.
When you receive an EOB, don’t ignore it!
The first step you should take is to check that the services listed are accurate and reflect the care you received. Next, compare the EOB with any bills you may have received from your healthcare provider. If your EOB says you owe something, wait to pay until you receive the actual bill from the provider, not from the insurance company.
Lastly, if you spot discrepancies or charges you don’t recognize, call your insurer’s customer service line to ask for clarification. Mistakes can and do happen, and catching them early can save you money and frustration.
Understanding your EOB empowers you to take a more active role in managing your healthcare expenses. It might not be the most exciting document you’ll receive, but it’s one of the most important. If you would like to learn more about EOBs and health insurance options available to you, let’s connect!