Romi Care

Summary of Benefits and Coverage (SBC)

Updated September 30, 2026

Definition

A short, standard summary of a health plan's costs and coverage. Every plan uses the same format, so you can compare plans side by side.

The Summary of Benefits and Coverage (SBC) is a short document that explains a health plan's costs and coverage in plain language. Every plan uses the same format, so you can compare plans side by side. It shows your deductible, copays, coinsurance, and out-of-pocket limit, plus what the plan covers.

You get an SBC when you apply for coverage or renew it, and you can ask your plan for one any time. It includes coverage examples, like having a baby or managing diabetes. Those are examples, not cost estimates. The SBC doesn't show your premium, which comes separately.

Keep your SBC handy when a bill arrives. It shows what your share should be for common services. If a bill or your explanation of benefits (EOB) doesn't match it, ask your plan why. Our guide to choosing a health plan shows how to use the SBC to compare options.

Related terms

Guides that use this term

Sources

  1. Summary of Benefits and Coverage (glossary), HealthCare.gov. Accessed September 30, 2026.
  2. Summary of Benefits and Coverage, HealthCare.gov. Accessed September 30, 2026.
  3. Summary of Benefits and Coverage template, U.S. Department of Labor, Employee Benefits Security Administration. 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.