Understanding Your EOB

A few weeks after a doctor visit, you'll get a piece of mail that looks like a bill, panics you, and isn't a bill. That's your Explanation of Benefits.

What an EOB actually is

It's a summary from your insurance company showing: what the doctor charged, what the insurer negotiated the price down to, what they paid, and what (if anything) you owe. The provider sends the bill separately. Always wait for both before paying anything.

Reading an EOB line by line

• Billed amount — what the provider charged. This number is almost always inflated.
• Allowed amount — the price your insurer negotiated. This is the real price.
• Plan paid — what your insurance covered.
• Patient responsibility — what you owe. This is the number to compare against your eventual bill.