Explanation of benefits (EOB)
Updated September 30, 2026
Definition
A summary from your health plan of the charges for care you got, what your plan paid, and what you may owe. It isn't a bill.
An explanation of benefits (EOB) is your health plan's record of a claim. It shows what the provider charged, the amount your plan allows, what your plan paid, and what you may owe. It isn't a bill. The bill comes separately from the provider.
You'll get an EOB by mail or in your plan's app after a provider sends a claim. It may also list a remark code that explains a denial or a lower payment.
For example, say a provider charges $400 for a visit. Your EOB shows an allowed amount of $150, a plan payment of $120, and $30 that you may owe. Your bill from that provider should ask for $30, not $400. Before you pay a bill, compare it with the EOB for the same visit. Our guide to comparing a medical bill and an EOB shows how.
Related terms
Guides that use this term
- GuideMedical bill vs. EOB: how to compare them line by lineYour bill and your EOB should tell the same story. Here's how to compare them in 20 minutes, with a worked example and what to do if they don't match.
- GuideWhy is my medical bill higher than my EOB?Your bill asks for more than your EOB says you owe? See the usual reasons, a worked example, and the steps to get a corrected bill before you pay.
- GuideDenial codes on your EOB, explainedWhat do CO-45, PR-1, and CO-16 mean? Look up common claim denial codes, learn who's responsible for each amount, and see what to do about each one.
Sources
- Reading your explanation of benefits (EOB), Centers for Medicare & Medicaid Services. Accessed September 30, 2026.
- Health insurance terms you should know, Centers for Medicare & Medicaid Services. Accessed September 30, 2026.
This is general information, not legal or medical advice. Rules can depend on your plan and your state. Romi Care isn't an insurer, law firm, collection agency, or government program.