Having a health plan means you may get lots of mail. Why so much? By law, health plans are required to mail certain information to their members.
While everything your health plan sends you is important, there are some letters you should pay closer attention to. Anything that requires you to do something (like paying a bill) should be clearly marked as such. Here’s a field guide to what you can expect:
Evidence of Coverage (EOC)
This is the thick packet you get after joining a new plan. The Evidence of Coverage or Benefit Document details everything that is and may not be covered in your plan. It is a good idea to read it — and file it with your important paperwork. You’ll want to have this on hand if you have questions about your plan later.
Benefit Updates
When changes have been made to your coverage (a health service your health plan will pay for), you will be mailed an update letter that describes those changes. File this with your Evidence of Coverage.
Explanation of Benefits (EOB)
This is the document that may look like a bill even though it says, “This is not a bill.” Most health plans are required to send an Explanation of Benefits letter after a claim is processed.
The EOB breaks down:
- what kind of care you received,
- how much the provider billed,
- how much money your health plan gave toward payment, and
- any remaining balance.
If there is a balance, you may be sent a bill from your provider (your doctor, lab, or hospital).
Bills
All bills for your health care services will come from your health care providers (your doctor, lab, or hospital). Payments for services are due to them, not your health plan.
Statements
If your plan has a health reimbursement arrangement (HRA) or a health savings account (HSA), you will receive periodic statements. Similar to a bank statement, these will show the activity and balance of your account.