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Understanding what you owe after receiving care just got easier

By James LaCorte | February 4, 2019 | Insurance Education

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We often hear from customers that health care is too confusing or too complicated. We hear you. We know that benefits can be hard to understand and sorting through all the paperwork can be burdensome. Each day we’re working to make health care easier for you, and we’re excited to announce that we’re taking a big step forward by rolling out new EOBs for Medicare Supplement Members.

What is an Explanation of Benefit (EOB)?

EOB stands for Explanation of Benefits and it’s just that. An EOB is a document you’ll receive after you visit a doctor, hospital or health care provider that gives a breakdown of how your claims are processed through your health plan. It is not a bill. Instead, it tells you how much of your claim was paid by Blue Cross NC and how much, if any, you owe as the patient. If a payment is owed by you, you will be billed separately. 

Why It’s Important to Review Your EOB?

Whenever you get your EOB in the mail, it’s important for you to read it in its entirety and compare it against any medical bills you receive. This is the best way to make sure services received and billed amounts are accurate. If something does not add up, contact your provider to discuss the potential problem. You can also call the customer service line on the back of your member ID card to get answers to any questions you may have. Also, The EOB not only shows who is responsible for payment but the full cost of care.

Why Are We Changing Our EOBs?

As an organization, we’re working to ensure our messaging and tone is consistent across all touchpoints and channels – including simplifying the language so health care is easier for everyone to understand.  We believe no one should have trouble understanding their health insurance documents.

When we began thinking of how we wanted to change our EOBs we knew we had to go directly to the source—our members. We met with our Member Advisory Group to hear and better understand the pain points they’ve experienced with EOBs, obtained member feedback by utilizing surveys, and evaluated questions members asked our customer service team. For us, it was important to capture member input from various places to make sure we had a full understanding of our member’s needs. The findings we gathered went directly into our revised EOBs, but this process is not over. We’ll continue to meet with our Member Advisory Group and conduct usability testing to make sure we’re providing the best resource for our members.

EOB Changes

So how are our EOBs changing and when will you begin to see them? For our Medicare Supplement Members, new EOB’s should begin arriving in your mailbox in June. We plan to continue making improvements and will roll out to other member groups throughout this year and next.  Our commercial plans will begin receiving updated EOB’s later in 2019. Medicare Advantage members will receive updated EOBs in 2020. When you take a look at the document you’ll see that a lot of things have changed, but the key things we want to point out to you include:

  • Color Enhancements: We’ve added color to our EOBs to make them easier to scan. As you’ll see the color-coding will be consistent throughout the document. For example, everything covered by Original Medicare will be in green and everything covered by Blue Cross NC will be in blue.
  • A New Overview Page: Gone are the days of the overview page being hard to understand. We’ve revised it to put the key information up front, including how many claims are in the EOB, what the total of those claims is and how much you may owe. We’ve also included a detailed description of what each section means so you can easily understand how your costs break out.
  • A Helpful Terms and Resources Section: After the overview page, you’ll see two new sections, one with helpful terms and the other with resources to take advantage of. In these sections, you’ll find definitions to words found in your EOB and where to go for additional tools, information and support. If you have questions or difficulty understanding a term on your EOB, this is a great place to start.

We’re excited to begin rolling out our new EOB’s to our Medicare Supplement Members and hope that the changes we’ve made will make it easier for you to understand your health care. If you are a Medicare Supplement member, when you log in to Blue Connect, you can learn more about the new EOB.


Download the Explanation of Benefits Reference Guide.

For our Medicare Supplement Members, new EOB’s should begin arriving in your mailbox in June.
We plan to continue making improvements and will roll out to other member groups throughout this year and next.