What is an Explanation of Benefits (EOB)?
Quick Answer
An EOB is a statement from TRICARE showing services billed, amounts TRICARE paid, and any amount you owe. It is not a bill.
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Key Takeaways
- EOB is not a bill
- Shows what TRICARE paid
- Review for accuracy
- Available online
Detailed Answer
The Explanation of Benefits (EOB) summarizes how TRICARE processed your claim.
What an EOB Shows
- Services received
- Provider who submitted claim
- Charges submitted
- TRICARE-allowed amount
- Amount TRICARE paid
- Amount you may owe
- Deductible applied
Important Notes
- EOB is NOT a bill
- Bill comes from provider
- May receive EOB before or after bill
- Review for accuracy
How to Read EOB
- Patient name and ID
- Date of service
- Description of service
- Billed amount vs allowed amount
- TRICARE payment
- Your responsibility
What to Check
- Correct patient information
- Services match what you received
- Charges seem reasonable
- Your cost share is accurate
Accessing EOB
- Online at beneficiary portal
- Mailed to you
- Keep for records
- Use for disputes if needed
Related TRICARE Terms
Related Questions
How do I file a TRICARE claim?
Network providers file claims for you. For non-network providers or overseas care, submit DD Form 2642 with itemized bills to your regional contractor.
How do I appeal a TRICARE decision?
Appeal denied claims or coverage decisions within 90 days by submitting a written appeal with supporting documentation to your regional contractor.
What do most military families add to their TRICARE coverage?
Supplemental health insurance is the most common addition — it covers dental, vision, and out-of-pocket costs that TRICARE leaves uncovered. Life insurance and a legal will are also highly recommended.
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