How do I read my Blue Cross Blue Shield of Michigan explanation of benefits?

Who is this for?

Michigan Health Insurance – Customer Service – How To

Blue Cross Blue Shield of Michigan and Blue Care Network members.

When you get health care, the doctor, hospital or dentist asks us to pay for the service they provided by submitting a claim.

After we process the claim, you get an explanation of benefits, or EOB. It’s the statement that says This is Not a Bill.

If it’s not a bill, what is it?

What's in an EOB

EOBs show you the costs associated with the services you received, including:

  • What was billed
  • Any discounts
  • What we pay
  • Total covered
  • What you pay

Since an EOB isn’t a bill, what you pay is for your information only.  If you owe the doctor, hospital or dentist, they’ll send you an invoice. Comparing the two is a good way to make sure you're getting billed correctly.

Not all claims generate an EOB. For example, you won’t get an EOB for a prescription. Here’s what you can expect to see in your medical and dental EOBs.

Read EOBs in your member account

Most members can see EOBs by logging in on our website or using the Blue Cross mobile app.

For subscribers

If you’re the person whose name is on your Blue Cross ID card, look for the Explanation of Benefits link in the menu under Claims.

If you’re not the subscriber

After you’re logged in, go to Claims. Select a claim to see its details. If an EOB is available, you’ll see it there.

How to stop paper EOBs

Subscribers—the person whose name is on your Blue Cross ID card—can tell us to stop sending a paper copy of EOBs in the mail. Then we email when a new EOB is ready to view. To stop or start paper statements:

  • Log in to your member account on our website or mobile app
  • Go to Account Settings on our website, My Account on the app
  • Choose Paperless Options

You can change your settings whenever you want.

Questions members ask about EOBs

"Why don’t you tell me which person or plan an EOB belongs to when you email that it’s ready to view?"

EOBs are considered protected health information. Because email isn’t secure, we can’t provide any details that might identify who the EOB is for.

"Why do you take so long to post or send my EOB?"

Statements go out on a four-week schedule. You can get information about a claim before your EOB is ready in your member account. Just go to the Claims section.