Think to the last time you had a doctor appointment. You went to the doctor, paid your copay and went home. Weeks later, you likely got a letter in the mail with “THIS IS NOT A BILL” scrolled across the top. It looked important, with cost breakdowns and dollar amounts, but you may not have been quite sure what to do with it. Did you throw it out? Put it into your “I’ll get to it someday” pile? If you did, you’re not alone. The document is called an Explanation of Benefits statement, usually referred to as an “EOB.” And it’s an important paper to hold onto. Explanation of Benefits statements show all the services you received at your doctor appointment. It shows costs your insurer paid, and what your health insurance didn’t cover. If there were services not covered by your insurer, you’ll receive a separate bill that shows what you owe. Keep your EOB statements for your records so you can compare the information with what’s on your bills. It’s important to create a file for all health care information, not just EOBs. Other information in the file should include medical receipts, bills and insurance information. To better understand your explanations of benefits, here's a snapshot of what's included. Blue Cross Blue Shield of Michigan and Blue Care Network members can view their EOBs online at bcbsm.com.
- Member contract information that includes name, address, and the group and contract information that’s listed on the insurance card along with the name of your family member who received the medical care.
- Summary of Services lists the medical services received since the last statement date, any savings received through participating providers and any charges owed.
- Summary of Deductibles and Copayments shows how much of the copays and deductibles have been paid to-date.
- Details of Services shows what type of care was received, the date of the appointment and the doctor’s name.
- Balance. The out-of-pocket amount owed. The patient will be billed separately for any charges they are responsible for.
- Customer Service contacts. EOBs typically have a toll-free phone number and address to contact the insurer with questions about the statement.
For more health insurance tips visit bcbsm.com/101 or follow the hashtag #Covered101 on our social channels. If you have a specific question, please submit your query online through our Customer Action Center.
Photo Credit: Petras Gagilas