Explanation Of Benefits

What Does Explanation Of Benefits Mean?

An Explanation of Benefits (EOB) is a statement provided by the insurance company to the insured, outlining the processing of a claim. It details how much the insurer will cover for the claim and specifies the amount the insured is responsible for paying out of pocket. Reading an EOB is easier once you understand how premiums, deductibles, copays, and coinsurance work together to split the bill between you and your insurer.

Insuranceopedia Explains Explanation Of Benefits

An Explanation of Benefits (EOB) document, typically sent by mail, provides details about a specific insurance claim and the associated monetary amounts. These amounts are categorized to show how much the insurance company will pay and how much the insured must cover through copayments or deductibles. The document also outlines any instances where the insurance company will not cover the claim. If your EOBs keep showing high patient-responsibility amounts, it can be worth reviewing your plan and looking at ways to lower your health insurance costs.