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What is an Explanation of Benefits (EOB)?

  • Your Explanation of Benefits (EOB) outlines the costs for services you receive. 
  • An EOB is not a bill. You do not need to respond to this document. It is for your records only. 
  • Sign up to go paperless and we will notify you by email when a new EOB is ready. 
health services summary
  1.  This is a summary of your visit, including the claim number.
  2.  The amount that your doctor billed - what the price would be without insurance.

  3.  The price Highmark BCBSWNY has negotiated for you - the price with insurance.

  4.  This is the amount of that bill that Highmark Blue Cross Blue Shield of Western New York paid.

5. Copay: An amount you may be required to pay as your share of the cost for a medical service or supplies, or prescription drugs. A copay is usually a set amount, rather than a percentage

6. Deductible: The amount you must pay for health care or prescriptions before your insurance begins to pay. 

7. Coinsurance: An amount you may be required to pay as your share of the cost for services after you pay any deductibles. Coinsurance is usually a percentage. 

8. The amount you are responsible for. You have either already received a bill from your doctor or medical facility for this amount, or will receive a bill. 

Interested in learning other health insurance terms?