Can You Read Your Health Insurance Statement?

Senior couple going over their medical bills.  They are confusedFor many the answer is no. Sometimes it appears that some items are covered one time and not another. How do you figure out whether the information is correct?

We need to start with how to read the health insurance statement. Most insurance companies send you a form after each of your healthcare visits called an “Explanation of Benefits” form (or “EOB” for short). This form will list all of your healthcare services and what is being paid for each service. The form should include the services for everyone in your family that is covered by the policy.

It is important to review each EOB you receive. It is surprising how often healthcare providers bill the wrong services or bill the correct services to the wrong person. Some organizations have reported that 8 out of 10 hospital bills have errors on them. It pays to check.

Second, you want to compare what is being covered with your insurance plan. You probably have a deductible and co-pays on your policy. When you review the EOB, you should see that your insurance company is paying the proper amount for the services.

This is often why you cannot easily figure out your EOB. For example, if you get services at the start of the year, many items might not be covered because you haven’t yet met your deductible. However, some services, such as preventative care, may be covered without first needing to meet your deductible.

Checking your EOB can often save you thousands of dollars by making sure the insurance company pays the correct amount.

Have you had problems reading your health insurance bills? We’d love to hear from you!

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