What Is an EOB?

July 22, 2022

An explanation of an Explanation of Benefits...

For Patients

What’s inside? 

An Explanation of Benefits, or EOB, is a document your insurance provider sends you listing the costs of medical goods and services it will cover. Whenever you or your healthcare provider sends a claim to your insurance company, the insurer follows up with an Explanation of Benefits. 

It is not a bill. Every EOB will make this clear; it's something else. (If you can't tell from the sample below, you might need new eye meds!)

A sample EOB

A typical EOB will contain:

  1. Your name and address
  2. Your insurance information
  3. Patient and service details, as well as claim and provider information
  4. Financial information like cost of services, amount paid by your insurance company, deductible and copay amounts, etc. 
  5. The total amount of benefits claimed
  6. The total amount your insurance company paid
  7. The total of how much you MAY owe, including co-payments, deductibles, co-insurance, and any amounts not covered by insurance

What’s It For?

As any good healthcare professional, insurer, or EOB itself will tell you, an Explanation of Benefits is not a bill.

Instead, EOBs explain the value of your health insurance plan. They also tell you useful budgeting info, like how much more you need to spend before you meet your deductible. It’s in the insurance company’s best interest to show you how much money they saved you. But be wary: it is not in their best interest to show you how much you could’ve saved with another company’s plan. Despite the cheerful name, Explanations of Benefits can be complex, even intentionally misleading.

If you look at your EOB and it feels like question marks are appearing above your head, reach out to us for assistance. We can help you navigate your benefits, handle your medical bills, file your claims for you, or find you the best, most cost-effective plan for your needs. The SuperBill is here for you.

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This post was written and researched by
Harry Gatlin

Harry (he/him/his) is a freelance writer and web designer who has worked in the health and tech spaces for over 2 years now. He is passionate about the power of language to make complex systems like health insurance simpler and fairer. He received his BA in English Literature from Williams College and his MFA in Creative Writing from The University of Alabama. In his spare time, he writes fiction and obsesses over Bob Dylan. You can reach him at harrison.gatlin@thesuperbill.com.

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