The Pulse of SchoolCare, August 2020

Everything you need to know about the Explanation of Benefits (EOB)

Published August 4, 2020

What is an Explanation of Benefits (EOB)?

Maybe you forgot about a recent doctor visit, when an envelope from Cigna arrives in the mail or you notice a description in your myCigna account labeled Explanation of Benefits. What is this? A bill? Don’t worry – it’s not a bill. An Explanation of Benefits often referred to as an EOB, is a statement sent to the primary account holder from their insurance provider to communicate details of recently received services such as what was covered and what you are expected to pay.

It’s important to remember that the EOB is NOT a bill. You should receive an EOB for every health care service received, even if you owe nothing. Any bills will be sent from your medical provider's office, not Cigna. If possible, you should read each EOB as they arrive and compare with the bill to help ensure you don’t overpay for health care services.

Understanding your EOB

The Cigna EOB is broken down into 3 pages:

Summary: Gives an overview of how your benefits were applied. You can can see what claim was submitted, what has been paid and what you may still owe.

Glossary: Provides a list of words and terms to help you understand coverage details. Additionally, you will see Your “Rights of review and appeal” to give direction on what to do if you disagree with a decision made on the claim.

Claims: This detailed page includes information on what you have left in your deductible or out-of-pocket expenses and specific notes on discounts and amounts not covered.

Click here for an example of a Cigna EOB.

Where to find your EOB

Depending on how you set up your myCigna account, you may receive EOBs in the mail. You can also access all of your EOBs by logging into under Claims > Explanation of Benefits. Sort by medical or dental claims, covered patient, and timeframe to view specific EOB statements.

Questions about an EOB? Call Cigna 24/7/365 at 800-244-6224.

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