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What is an EOB?

The Explanation of Benefits (EOB) shows the details of your medical and pharmacy expenses and how health insurance covers each. It's a summary of your claims activity that includes:

  1. Total charge: The total amount a provider charged for the services, treatment, device or drug
  2. Health Advantage member discount: The discount you get from having Health Advantage insurance and using in-network doctors
  3. Your plan(s) paid: The amount paid by your benefit plan, based on the terms of your plan
  4. Your responsibility: Providers can bill you for this amount, if you have not already paid

You may have paid your responsibility already. If not, this is the amount you can expect to be billed from your healthcare provider at some point. You will not receive a bill from us.

EOBs are sent every two weeks. Each EOB will include any medical or pharmacy claims we processed for you within that time. You may be able to see information about a claim before your EOB is ready when you sign in to our My Blueprint member portal.

Example of an EOB