What is an Explanation of Benefits?

After you use your health plan benefits, Blue Cross will send you an Explanation of Benefits (EOB).

What is an EOB?

An EOB is a statement that shows the healthcare services you received. It also shows what your health plan paid and the amount you owe.

An EOB is not a bill, but it helps you keep track of some important information:

  • How much your provider charged for services
  • How much of those charges your health plan covers
  • The amount your health plan paid
  • The amount you owe, including deductibles, copays or coinsurance

 

How do I read an EOB?

An EOB from Blue Cross and Blue Shield of Minnesota or Blue Plus includes this information:

  • The name of the person who received services (you or a family member your plan covers)
  • The claim number, group name and number, and patient ID
  • The doctor, hospital or other healthcare professional that provided services
  • Dates of services and the charges
  • A summary of how the claim was paid, including how much your plan paid and how much you owe
  • Notes about the process of your claim

Learn how to read an EOB

 

Why do I need an EOB? 

An EOB gives you a handy snapshot of how you’ve used your benefits and how the claim is being processed.

Always compare the EOB to the bill you receive from your provider to make sure they match. If the provider’s bill shows the amount you owe, simply pay the provider. If the amount doesn’t match your EOB, call the number on the back of your member ID card or contact your provider.

Have EOB questions?

If you have questions about your EOB, or if you believe there is an error on the EOB, call the number on the back of your member ID card.

This is general information about how plan benefits work. Review the Summary of Benefits and Coverage and your specific health plan benefit booklet for information about how your plan works.

It’s up to you to always check if your provider is in your health plan network before you receive services. Not all providers are in every network. You may pay more or for all of your healthcare costs if your provider is out of your network or does not have a contract with Blue Cross (this is called a non-participating provider). You can verify if your provider is in your network by calling customer service at the number on the back of your member ID card.