An Explanation of Benefits (EOB) is a statement from your insurer showing what was billed, what the plan paid, and what you owe. It is not a bill — you don’t pay from it.
A simple example
After a $1,000 visit, your EOB shows: billed $1,000, allowed amount $600, plan paid $480, your responsibility $120. A separate bill for that $120 then arrives from the provider.
Why it matters to you
The EOB is your receipt and your error-checker. Compare it to the bill the provider sends you — if the numbers don’t match, call and ask before you pay. Billing mistakes are common.
Good to know
- The “allowed amount” is the discounted price your insurer and an in-network provider agreed on — usually far less than the “billed” amount.
- If something was denied, the EOB includes a reason code that tells you why — and whether it might be appealed.
- Watch for out-of-network surprises from providers you didn’t choose; you may have protections under the No Surprises Act.
Definition: HealthCare.gov — EOB; billing help: CFPB. See also In- vs out-of-network.
Educational use only. This content is general health and cost information — not medical advice, diagnosis, or treatment, and not financial, legal, or insurance-coverage advice. Specifics vary by plan and situation. Talk with a qualified clinician about your care and verify coverage with your insurer or provider. In an emergency, call 911.