An Explanation of Benefits (EOB) is the notice that your Medicare Advantage Plan or Part D prescription drug plan typically sends you after you receive medical services or items. You only receive an EOB if you have Medicare Advantage or Part D. An EOB is not the same as a Medicare Summary Notice. It is also important to remember that an EOB is not a bill.
EOBs are usually mailed once per month. Some plans give you the option of accessing your EOB online. Your EOB is a summary of the services and items you have received and how much you may owe for them. It tells you how much your provider billed, the approved amount your plan will pay, and how much you have to pay to the provider.
While all EOBs provide the same information, the layout and other specifics may vary by plan. If your EOB shows that an item or service is not being covered, look for a section that includes notes, comments, footnotes, or remarks to find out the reason why. You may have to look on the next page to find this information.
Contact your plan if you have any questions about you EOB. You should also contact your plan for more information if any of your services or items were not covered. You may decide to file an appeal, depending on what your plan tells you.
Try to save your EOBs. You might need them in the future to prove that certain costs have been covered/paid for. For instance, you may need old EOBs if a provider’s billing department makes a mistake or if you claimed a medical deduction on your taxes.