An explanation of benefits, or EOB, is a document you receive from your insurance plan after a provider has filed a claim. EOBs outline what your plan covers and what you owe for services. An EOB is not a bill, but rather an explanation of services provided and how the cost is split between you and your insurer. Typically, you’ll receive an EOB shortly after a visit to a provider or after you make a purchase covered by your insurance — such as a prescription or piece of medical equipment.
When should you get an EOB?
Typically, you’ll receive an EOB 30 to 60 days after receiving care.
What’s included in an EOB?
Your explanation of benefits is an overview of the services you received and what they cost. The document you receive will likely include:
- An account summary: This will list your name, address, member ID, and insurance group number.
- An overview of services provided: This will include the services provided, provider’s name, location, date, and any applicable reference numbers or medical codes.
- The cost of service: This outlines how much was billed for the service, the amount your plan pays, and your financial responsibility.
Your EOB will outline whether your insurance claim was approved or denied. It could also include additional information, such as services your plan didn’t cover and your progress toward your deductible.
Here’s an example EOB, broken down line-by-line, to help you confidently read and interpret your own.