What is an Explanation of Benefits statement?

An Explanation of Benefits (EOB) statement is a summary of your prescription claims and costs all in one document.[1] This gives you the opportunity to review how your prescription claims were paid.

Your EOB statement is the best way to review your prescription claims and understand your medication costs. You can view, print, or download your statements to your computer at any time through your online account.

EOB Example

Your EOB will show:

  1. Your name, your member ID, and the dates when the claim was received and processed.
  2. Information about the claim including the pharmacy name, prescription number, and the drug name. Claims will appear on your EOB from all points of service (MTF, retail pharmacies, and home delivery).
  3. The pharmacy claim amount, the amount that was paid, and the amount owed (if applicable). [2]

You can also choose how you want to receive your EOB – by mail, text, or email. If you do not choose to receive your EOB by text or email, your EOB will be mailed to you. By choosing text or email for your EOB, you will be notified as soon as your statement is available to view online. Read more about how you can view your EOB statement online.

To start receiving a text message or email when your EOB is ready to view:

  1. Log in to your online account.
  2. Visit Account in the top menu and select Communication Preferences.
  3. Choose your preferred communication method.

[1] Your Explanation of Benefits statement is not a bill.

[2] Cost may not always account for Government discounts.

Published on 4/11/2024.

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