Explanation of Benefits
What to Know
PPO members: After you visit a provider, you’ll receive an Explanation of Benefits (EOB) from Anthem Blue Cross.
An EOB provides information about:
- How your claim was paid
- The amount you’ll be reimbursed or may still owe
Here are some terms and definitions to know when reviewing your EOB. Visit the glossary page for additional definitions.
Service Date. The date(s) on which you received health care services.
Amount Charged. The amount billed by the provider who performed each service.
Applied to Deductible. An amount that is considered part of your deductible (the amount you must pay for covered health care costs before your benefits are paid). You are responsible for this amount.
Benefit year. The time frame in which the medical plan is effective. The medical benefit plan year runs July 1 through June 30 of each year.
Copayment. The set amount that you pay for benefits. You are responsible for this amount.
Coinsurance. The amount remaining after the plan pays its share of covered services, usually shown as a percentage of negotiated charges. You are responsible for this amount.
Amount Paid. The total amount paid to you or your provider.