Explanation of Benefits – What is it?

An Explanation of Benefits (EOB) is a document the health insurance provider sends after a Doctor’s appointment. EOB’s typically generate 4-6 weeks after the appointment and are available online and/or via mail. It outlines the details of the services received and breaks down the costs associated with them. One of the main purposes of an EOB is to explain how health insurance coverage was applied to the services received. It shows how much the healthcare provider charged,
network discounts, how much the insurance provider paid, and how much the member (you) may be responsible for paying out of your own pocket. An EOB is not a bill. It is an explanation of benefits received and the cost associated with them. It helps the consumer (you) understand how the insurance works and provides a summary of the costs involved. Below is an example of an EOB and how it is broken down.

This is an example. The layout of an EOB will be different based on the insurance company.