Explanation of Benefits

Individual Explanation of Benefits (EOB)

Your Explanation of Benefits, or EOB, is a form that gives you details about your claim status. An individual EOB is available for each claim filed.

Each EOB features important information about health care services you received, how much your health plan covered, how much you may owe your provider and much more. You can find most of the quick details you're looking for in a convenient Summary Information box. The details about your claims are in column format, so you can easily track information about each service you received. You'll also find helpful definitions. You can view your individual EOBs by logging in to My Health Toolkit®.

View a convenient guide that walks you through a typical EOB.

Summary Explanation of Benefits (EOB)

Please note: Summary EOBs are available for some, not all, health plan members at this time.

Summary Explanation of Benefits, or Summary EOBs, offer a convenient way to organize information about your medical bills. Summary EOBs give the status of all of your health insurance claims filed during a certain time period. Each Summary EOB gives information for claims we processed for all individuals under your member ID during the 21-day period. If you had claims filed or processed during that time period, your health plan will mail the Summary EOB to your home. If no claims are filed or processed, you won't receive a Summary EOB for that period.

The Summary EOB provides all the information you need about your health insurance claims — and it's easy to read and understand. The summary section outlines the costs your health plan covered and the amounts you owe specific providers. It also shows other insurance or Medicare payment amounts, if applicable. You'll also find definitions of some terms and an explanation of your appeal rights. The claims detail section gives more information about each claim, such as charges, allowed amounts and coinsurance. It also explains where you stand on deductible and out-of-pocket amounts.

If you receive Summary EOBs but would like to view an individual EOB for a particular claim, just log in to My Health Toolkit and click "Health Claims Summary." Then choose the "View EOB" link below the claim.

View a guide that walks you through a typical Summary EOB line-by-line to make understanding your benefits easier.