Explanation of Benefits
EOB
Quick Definition
Statement showing how TRICARE processed your claim.
Video Explanation
Full Definition
An Explanation of Benefits (EOB) is a detailed statement from TRICARE that explains how your claim was processed and what you may owe. It's not a bill—it's an informational document showing the breakdown of services, charges, and TRICARE's payment.
What an EOB includes: • Date and type of service received • Provider name and information • Amount charged by the provider • TRICARE-allowable charge • Amount TRICARE paid • Your cost-share or copay • Amount you may owe the provider • Claim processing date
How to read your EOB 1. Verify the services match what you received 2. Check that provider information is correct 3. Compare billed amount to allowable charge 4. Note what TRICARE paid and what you owe 5. Look for denial codes if applicable
You'll receive an EOB after most healthcare visits (except at Military Treatment Facilities). Review EOBs carefully and compare them to bills from your provider. If you find discrepancies or have questions, contact your regional contractor.
Keep your EOBs for tax purposes and personal records. They're available online through your beneficiary portal and are typically mailed within 30 days of claim processing.
Related Questions
How does the TRICARE catastrophic cap work?
The catastrophic cap is your maximum annual out-of-pocket cost. Once reached, TRICARE pays 100% of covered services for the rest of the fiscal year.
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.
What is an Explanation of Benefits (EOB)?
An EOB is a statement from TRICARE showing services billed, amounts TRICARE paid, and any amount you owe. It is not a bill.
What do I do if I receive an incorrect TRICARE bill?
Compare the bill to your EOB, contact the provider billing department first, then call your regional contractor if the issue isn't resolved.
How do I check the status of my TRICARE claim?
Check claim status online through your beneficiary portal, call your regional contractor, or review your Explanation of Benefits (EOB).
Related Terms
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