Explanation of Benefits (EOB) FAQ
The explanation of benefits (EOB) explains the costs for services you received. This includes what the provider billed for, what Highmark paid for, and what you will need to pay. This document is an advanced notice about bills you might receive from a provider or providers. When you get a bill, you can compare it to the EOB to make sure everything looks correct.
Explanation of benefits
Members get an EOB after we process certain types of claims. An EOB might include:
- Patient information
- Member ID number
- Claims information
- What you owe the provider
- Information about your coinsurance, copay and your deductible
The amount not covered by your health plan.
The amount you’ll pay for the service or procedure.
This is the total price for the service or procedure before insurance is applied. It’s the amount you would be billed if you didn’t have insurance.
This is the price for the service after your insurance was applied. We negotiate prices for you, to keep costs down.
Your out-of-pocket cost for a visit to a provider.
The amount you pay before your insurance company starts to pay for covered expenses.
Your share of the costs of a health care service. You and your insurance company each pay for a percentage of the health care costs.
The provider will bill you for this amount.
Log in to your member account to view your EOB. If you're having trouble logging in to your member account, we can help.
Log in to your member account to choose to have your EOB emailed to you.
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