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What’s an EOB?

What’s an EOB?

You have insurance, had a doctor’s visit, received an EOB, now what?

Knowing how to read your EOB or Explanation of Benefits, is helpful to understanding your medical coverage and may keep your gray hairs at bay. Essentially your EOB is a statement from your health insurance plan which breaks down in complete description the costs they will cover for care and or products you’ve received. This explanation is created and delivered once your provider submits a claim regarding the services you’ve received.

Your EOB Is NOT a Bill

There’s no need to panic! Your insurance provider sends you an EOB to help make clear:

  • Cost of care you received
  • Amount of money you saved by visiting an in-work provider
  • Out-of-pocket medical expenses you will be responsible for

How to Read Your EOB

Please note, EOBs are not bills. They are simply a recorded statement of the medical services you’ve received and details on how your provider plans to share costs. You do not use this to pay an outstanding bill. Your bill can be broken down into a summarization of:

  • Your details and personal information
  • The medical services received and by who
  • Amount billed: The cost of those services
  • Discounts: Money you saved by accessing care from in-network providers
  • Amount covered and paid by your insurance
  • Amount not covered: What costs your health plan didn’t cover
  • Amount that was paid by HRA (if applicable)
  • The outstanding amount you are responsible for paying

Following this information is usually information regarding instructions on how to make an appeal, and then finally, there are more in-depth details about your total cost of care received.

The Purpose of an EOB

When you receive health care, your insurance provider will send you an EOB with the previously stated information. After this is received, you may receive a separate bill for the actual amount you owe. Information on this separate piece of paper will let you know where you can send your payment. Essentially EOBs are helpful because they provide you the value of your health insurance plan and can help you to gauge how much money you potentially have left in accounts related to your health insurance plan. These are also helpful for those who are wondering how close they are to meeting their deductible. That’s all the better because once your deductible is met, your provider will begin to help you pay for services received!

If you need help understanding this information or feel like you’re in need of a different type of coverage, contact me today at 361-652-3005 and we can get started on providing you with the care and coverage you actually need.

Should You Buy Dental Insurance? Key Questions to Ask Before You Buy

3 Questions You Should Ask Before Buying Dental Insurance

Should You Buy Dental Insurance? Key Questions to Ask Before You Buy

While dental check-ups are usually needed every 6 months, you never know when a dental emergency might pop up in yours or one of your family member’s mouths that requires immediate attention and a whole lot of cash up front.

This is when dental insurance comes in handy. Of course, you will probably have to pay a small portion yourself, but with insurance, your provider will usually cover most of the procedure, helping you out financially. 

If you’re unsure if dental insurance is right for you, we have answered a few important questions to ask yourself before jumping into something unnecessary or overpriced.

  1. Does my employer offer similar coverage?

First, it is best to talk with your employer about if they offer a dental package. According to Guardian Direct, about 50% of companies offer dental insurance, so there is a good chance that you could save some money by going with them. This makes the most sense because employers actually pay a percentage of the premiums and can negotiate rates with group plans, therefore making you pay less. 

  1. How much are premiums?

Premiums are how much you are going to spend each month or each quarter, and they vary from provider to provider. They cover anything from dental preventative care, cleanings, root canals, and sometimes more depending on your coverage. 

If your employer does offer dental insurance, it might be a good idea to continue shopping around, as you might be able to find cheaper insurance privately. Knowing how much you are going to pay monthly or quarterly is important in making sure you aren’t getting in over your head and budget. 

In addition, an insurance provider that you can go through privately could offer better benefits, making the price difference worth it. Compare benefits from your employer’s dental insurance to the private one you’re looking into to figure out which one is worth what you will end up paying.

  1. Which dentists can I go to?

Perhaps you’ve already gone to a dentist you liked previously, or maybe you have certain criterias you want a dentist to meet when choosing them as your primary dentist. Either way, it is important to know what dentists are accepted in your dental insurance network that you are looking at getting insurance through. 

Your provider should have a database where you can look up in-network dentists in your area, or search specifically by the name of the dentist you already know and trust. This also makes it easy for when you aren’t sure who to go to, don’t know which dentists are in-network, and don’t feel like calling around to a dozen places and asking.

This can also be used when you are referred to another provider for a specific procedure and want to make sure they are in your network.

How do you buy dental insurance?

Now the big question is, how to go about getting insurance, for an affordable price and getting the most out of your plan. In today’s world, it is really easy to find an insurance provider by browsing the internet. You can go with the bigger guys, or choose a local agent who can help you navigate the best plan for you and your family and answer all your insurance questions. 

Still unsure of how to get dental insurance? Fabian Ramirez can help steer you in the right direction and discover what plan is right for you. Call today. (361) 652-3005.