What is an Explanation of Benefits (EOB)?

Medicare Supplements and EOBs

If you receive a healthcare service, your provider will have to file a claim with your insurance carrier. For individuals on a Medicare supplement, your provider will file the claim with Medicare, who will then approve or deny the charges. If Medicare approves this claim, the remaining balance will be forwarded to your insurance carrier (BCBS, UHC, MOO) who will then pay the remaining charges on the Medicare approved services.

Medicare Advantage and EOBs

For individuals on Medicare Advantage plans, your provider will bill your insurance carrier directly, who will then accept or deny the claim according to the level of coverage that you have chosen.

In either case, you will receive EOBs from your insurance carrier outlining what Medicare and your insurance carrier will cover and what your provider may bill you. In some instances, the EOB may show an amount that you will be charged or may state that Medicare denied a claim or charge. Below are a few reasons to keep in mind when reviewing your EOB:

  • Remember your EOB is not a bill
  • In many cases, Medicare and your carrier have not fully processed your claim. It may take several months before the claim is fully processed
  • Our best advice is to contact us when you receive an actual bill from your healthcare provider. (If a bill is issued, we will be better able to determine why a claim was denied)

While it is important to keep track of the services listed on your EOB. We ask that you be patient with the process, as most possible charges will be resolved before you receive an actual bill. Remember, we are always happy to help you with the process.

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Regardless of whether you purchase a policy or not, we are always happy to help in any way we can.

Client Testimonials

What is an Explanation of Benefits (EOB)? | Wooten Agency

  • "This is a family-owned business who cares about their potential clients. I was looking for help with health insurance and even though it turns out I don't need new health insurance at this time, I feel compelled to write a review because of how thorough Brendan was. He was very knowledgeable and easy-going. He didn't seem pushy at all and listened to everything I had to say. He made sure he was getting all the information correct. I would recommend this agency for any insurance needs." - - Cary, NC
  • "I sought help from Wooten Agency; Ed, along with Nancy, took the bull by the horns and sorted things out for us very quickly. Shortly thereafter Ginny took over. She is definitely most qualified as a plan selector for Medicare plans and issues related to Medicare. My appreciation to Crystal for the gracious way she always responds to telephone calls and makes every effort to ensure one is not forgotten. And Dana....the one contact we had was enough to find out you are similarly inclined to help a client." - - Raleigh, NC
  • "You [Aaron] have been so helpful, and you have all taken a personal interest in my individual and specific questions in order to make the best insurance choices for my needs. Thank you all! I look forward to working together in the future months and years." - - Morrisville, NC

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