How to read your explanation of benefits statement
Who is this for?
If you’re a Blues member, this information will show you how to read your explanation of benefits statement.
After you go to the doctor you’ll receive an explanation of benefits statement, or EOB, in the mail or online.
Briefly, your explanation of benefits statement shows you medical care we pay for, services we can’t pay for and why, and any charges you may owe out of your own pocket.
What you’ll find on your statement
- Member contract information that includes your name, address, and the group and contract information that’s listed on your insurance card. You’ll also see the name of your family member who received the medical care.
- Customer Service contacts. Your EOB has a toll-free phone number and address to contact us with questions about your statement. You can also find this info on your enrollee ID card.
- Summary of Services lists the medical services you, or a family member, received since your last statement date. You’ll see any savings you received through participating providers and any charges that you may owe. Match this information with your bills to make sure it’s accurate.
- Summary of Deductibles and Copayments shows you how much of your copays and deductibles you’ve paid to date.
- Details of Services shows you what type of care you received, the date of your appointment and your doctor’s name. Compare this information with what is on your health care bills.
- Balance. Learn how we calculate payments and balances you may owe.
If you still have questions, please call the Customer Service number on the back of your enrollee ID card or your EOB and we'll help.