Group Insurance

It’s Not a Bill - It’s an Explanation of Benefits

May 2019 

Every time medical services are provided, doctors, dentists, hospitals, and other health care providers will submit claims to Wellmark or Delta Dental to receive payment. After the insurance carriers process claims, you get an Explanation of Benefits, or EOB. While the EOB resembles a bill, it is not a bill.

What is an EOB?
The EOB provides details about a health claim that has been processed and explains what portion was paid to the provider and what portion of the payment, if any, is your responsibility. Not all claims generate an EOB. For example, you won’t get an EOB for a prescription.

Since the EOB is not a bill, any portion of the health or dental expenses not covered by Wellmark or Delta Dental (such as coinsurance, copay, or deductible) will be billed by the provider and should be paid directly to the provider.

Because the EOB shows what portion of the payment is your responsibility, you can use an EOB as documentation to be reimbursed from your Health Flexible Spending Account.

Examples of how to read EOBs are available at both the DAS Health Insurance and Dental Insurance web pages.

Get paperless EOBs
Both Wellmark and Delta Dental provide you the option to receive paperless EOBs. Sign up to receive EOBs electronically at MyWellmark or at Delta Dental’s Member Connection.