What is an “EOB” or explanation of benefits and why does my insurance company send them to me? Is an “EOB” a bill that I have to pay?
Health insurance companies send out an Explanation of Benfits (EOB’s) every time you go to the doctor. EOB’s are commonly confused with bills from the insurance company. They are not bills! The purpose of an EOB is simply to inform the patient how much the doctor was paid, discounts applied, and how much copay you paid at the time of the visit. The EOB often has a section that is called “Estimated Insured’s Responsibility” which may become a bill from your provider at a later date. This amount generally refers to the deductible and coinsurance portion of your health plan. (If you are in an 80/60 PPO plan your portion of the bill will be 20% in network and 40% out of network.) The best bet is to call the Claims Department of the health insurance company to get a full explanation of the EOB.
Related Questions
- Will the insurance company continue to pay benefits on any illness or injury that happens while I am covered under the short term health insurance plan even after my coverage expires?
- Why do I have to pay my co-pay and coinsurance at the appointment instead of waiting for the insurance company explanation of benefits?
- What is an "EOB" or explanation of benefits and why does my insurance company send them to me? Is an "EOB" a bill that I have to pay?
