An Explanation of Benefits (EOB) is a statement provided by your health insurance company that details the medical services you've received, the portion of the costs covered by your insurance, and what you still owe out-of-pocket. It’s important for understanding how your health benefits are coordinated, and is crucial for submitting the remaining amounts to your Health Spending Account (HSA).
Why is an EOB Important?
The EOB helps us verify the portion of medical expenses was covered by your insurance. For claims where insurance covers a part of the expense, the EOB helps us determine the remaining amount eligible for reimbursement from your HSA. It provides a clear breakdown of costs, payments, and a calculation of what we should be reimbursing you!
Where do I find my "Explanation of Benefits?"
Most insurance Providers have the "Explanation of Benefits" easily accessible to you. If you cannot find it using the following general steps, you may need to reach out to the providers customer service for more assistance.
Log In: Visit the insurance provider’s website and log in to your account or mobile app.
Look for a menu or navigation bar at the top or side of the homepage.
Find where your insurance provider stores your historic claims data.
Within the claims section, there will often be a link labeled "Explanation of Benefits," "EOB Statements," or simply "EOB."
Click on the desired EOB to view the detailed breakdown of services and payments.
There is usually an option to download the EOB as a PDF for your records or for submission to your Health Spending Account platform. If you don't see this, you can also take a screenshot for us.
When Do You Need to Submit an EOB?
You are required to submit an EOB to myHSA with your claims in the following scenarios:
Insurance Paid a Portion: If you indicate to us that a portion of the expense was covered by insurance, but we cannot see on the documents provided what was covered, we will ask for an EOB.
Coordinating Insurance: If your employer's plan design states that you have coordinating insurance coverage. This means they have asked us specifically to require proof - because they know that their benefits package has both insurance and an HSA!