NW Florida Medicare Serving the Panhandle

Medicare Explanation of Benefits: What You Need to Know

In the United States, about 96% of people over 65 are receiving medicare coverage. However, many people don’t know how many benefits you can get from your Medicare coverage. 

Are you looking for a Medicare explanation of benefits? Keep reading for more medicare information, to learn more about Medicare plan types, and to learn more about Medicare benefits!

What is a Medicare Explanation of Benefits? 

First, it is important to understand what a Medicare Explanation of Benefits is. Essentially, it summarizes what items or services you received that were paid for by your Medicare plan. Even if your plan only paid for a part of these items or services, it will show up on your Explanation of Benefits, also known as an EoB. 

Generally, you get an EOB every month. It will show what was billed to Medicare and how much money they paid for each service. If there is an additional payment required, it will show you what you owe for the services and items you received. 

On your EOB, you will see information about your plan, and it will also show you the claims you have made since you last received an Explanation of Benefits. Whether you went to a doctor, got a new prescription, or even got medical equipment, these will be on your Explanation of Benefits. 

Not only will it tell what items and services you received, but it also tells you when the service was the service provider and even a description of the services you received. An EOB is not a bill. Instead, it shows what has been billed and what was paid by which party. 

Why is Medicare EOB Important? 

One of the reasons that an Explanation of Benefits is important for your Medicare plan is because it shows you what you are paying for treatment. If you find that you are paying more than you expected, you can find other plans that offer better savings. 

It also shows you whether or not your claims are being covered. If you find that a service or prescription you need regularly isn’t covered, you may be paying completely out of pocket for your treatment. If this is the case, you can find a new plan with better services available. 

Finally, your EOB will help you keep your medical records. When you have a record of what services you received in any month, you will reference them in the future.

It also helps if you were charged for a medical expense that you disagree with. For example, if you are getting charged for things that have been covered or were already pay for, having an EoB can help you prove this!

By having a Medicare Explanation of Benefits, you will ensure that you are saving the most money possible, and it will help you cut costs for your Medicare plan.

How To Access Explanation of Benefits

As shown above, you generally get an Explanation of Benefits sent to you each month. However, there are other ways you can access this information. 

Rather than storing a physical copy of your EOB, you can often see them online. If you are unsure of how to access this, you can go to www.medicare.gov to check the status of a claim and to see your EOB. 

Otherwise, you can wait for your Medicare provider to send you a copy of your EOB after you make a claim!

What is in a Medicare Explanation of Benefits? 

There are many different parts of your EOB. Regardless of where you get your plan, they will all include the same information. 

First, it will list any prescriptions or medical services you received in the past month. Not only will it list your claims over the last month, but it will also show you the total cost of the services and how much you paid out of pocket. 

If there are any updates to the medications covered by your plan, these updates will also be listed on your EOB. 

It will also include a summary of the payments. As was mentioned before, it will show what costs you had to pay out of pocket. It will also show what your plan covered and what other organizations paid for. 

How to Monitor Your EoB

Because it is easy to make mistakes when dealing with Medicare and insurance coverage, you must regularly monitor your Explanation of Benefits to check for mistakes. 

First, make sure the claims listed on your EoB are accurate and show the correct cost, services, and more. If there are any mistakes, you may be getting charged more money than you owe!

It is also important that you monitor your plan for changes in things that are covered. For example, some Medicare plans may not cover certain prescriptions that they once covered. Ensure you check for updates to the list of covered drugs to make sure you get help covering your prescription medications. 

Get Medicare Help Today

Understanding your Medicare benefits or your Medicare Explanation of Benefits can be difficult if you are not familiar with the Medicare system. However, you can find help! Whether you need help comparing the cost of Medicare plans, help with enrollment, or changing plans, NW Florida Medicare can help!

Our team specializes in Medicare, financial services, and retirement planning. We can help you make an informed decision on your healthcare options. Contact our team today to learn more about our services, or you can book an appointment online!

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