An Explanation of Benefits (EOB) is a statement from your health, dental, or vision insurance provider that outlines how a medical claim was processed. It details what portion of the cost was covered by your insurance, what amount you owe, and how those payments affect your deductible and out-of-pocket totals.
An EOB typically includes:
-
The total cost of the service or claim
-
The amount covered by your insurance plan
-
The portion you are responsible for paying
-
Updates on your deductible and out-of-pocket maximum
An EOB is not a bill, but an informational summary. Lively may request an EOB to verify a claim or to activate certain benefits, such as your Post-Deductible HRA.
Substantiation is the IRS-required process used to confirm that reimbursements are made for qualified expenses. Supporting documentation, such as an EOB or receipt, may be required to ensure compliance.
Updated: