Explanation of Benefits (EOB): What It Is, How to Read It, and Why It Matters
- wonacedme
- 4 days ago
- 4 min read
If you’ve ever received a document from your insurance company after a doctor visit or medical equipment order and wondered, “Is this a bill?”—you’re not alone. That document is called an Explanation of Benefits (EOB), and understanding it can help you avoid overpaying, catch billing errors, and better use your health insurance benefits.
At WONACE Medical Supply, we work with insurance companies every day and help patients understand their Explanation of Benefits (EOBs), especially when it comes to durable medical equipment (DME), diabetes supplies, mobility equipment, and complex rehab products.
What Is an Explanation of Benefits (EOB)?
An Explanation of Benefits (EOB) is a statement sent by your health insurance company after a medical claim is processed. It explains:
What services or medical equipment were billed
What your insurance covered
What portion was applied to your deductible
What you may owe (if anything)
👉 Important: An EOB is NOT a bill. It’s a summary of how your insurance handled the claim.
Why You Receive an EOB
You’ll receive an EOB anytime insurance is billed for:
Doctor visits
Hospital services
Medical supplies
Durable medical equipment (DME)
Diabetes monitoring supplies (Dexcom, FreeStyle Libre)
Wheelchairs, hospital beds, CPAPs, and rehab equipment
Even if insurance pays 100%, you’ll still receive an EOB for your records.
Key Sections of an Explanation of Benefits (EOB)
Understanding each section helps you know exactly where your money is going.
1. Patient & Provider Information
Lists:
Your name
The provider or supplier (ex: WONACE Medical Supply)
Date of service
Always check that this information is correct.
2. Description of Services or Equipment
This section explains:
What was billed (ex: wheelchair, glucose monitor, gait trainer)
Procedure or HCPCS codes used for billing
For medical equipment, this confirms exactly what was submitted to insurance.
3. Amount Billed
This is the provider’s billed amount—not what you pay.
Insurance companies rarely pay the full billed amount.
4. Allowed Amount
The allowed amount is what your insurance has agreed to pay for that service or equipment under your plan.
This number is key—it determines your responsibility.
5. Insurance Payment
Shows how much your insurance paid directly to the provider.
If your deductible has been met, this amount may be high—or even 100%.
6. Deductible Applied
This section shows how much of the claim was applied to your deductible.
👉 This is why EOBs are important at the end of the year—you can track whether your deductible has been met.
7. Coinsurance or Copayment
If your plan includes coinsurance (for example, 80/20), this section shows your portion.
8. Patient Responsibility
This is the amount you may owe—but again, it is not a bill.
Always wait for an actual invoice from the provider before paying.
Common EOB Terms Explained (Simple Language)
Deductible: Amount you must pay before insurance starts covering costs
Coinsurance: Percentage you pay after deductible
Copay: Flat fee per service
Out-of-Pocket Maximum: The most you’ll pay in a year
Denied Claim: Insurance did not approve payment (often fixable)
Why Your EOB Matters for Medical Equipment
For durable medical equipment and supplies, EOBs help you:
Confirm insurance coverage
Track deductible progress
Avoid double billing
Identify claim denials early
Plan year-end medical purchases
This is especially important for high-cost items like:
Power wheelchairs
Standing frames
Hospital beds
Pediatric adaptive equipment
Diabetes monitoring systems
EOB vs. Medical Bill: What’s the Difference?
EOB | Medical Bill |
Sent by insurance | Sent by provider |
Explains claim | Requests payment |
Not a payment request | Actual amount due |
For review only | Pay only after reviewing |
👉 Never pay based solely on an EOB.
What to Do If Your EOB Looks Wrong
If something doesn’t look right:
Compare the EOB with the provider’s invoice
Check deductible and coinsurance amounts
Call your insurance company for clarification
Contact your medical supplier
At WONACE Medical Supply, we assist patients with:
EOB reviews
Insurance corrections
Appeals and resubmissions
Prior authorization follow-ups
How EOBs Help You Get FREE or Low-Cost Medical Equipment
When your EOB shows:
Deductible met
Out-of-pocket maximum reached
👉 Your medical equipment may be covered at 100%.
This is why reviewing EOBs toward the end of the year is critical—especially before benefits reset in January.
How WONACE Medical Supply Helps with Insurance & EOBs
We don’t just provide medical equipment—we guide you through insurance:
✔ Insurance verification✔ Prior authorizations✔ Claim submissions✔ EOB explanation✔ Patient advocacy
We work with Medicare, Medicaid, and major private insurance plans.
Need Help Understanding Your EOB? Contact WONACE
If you’re confused about an Explanation of Benefits or want to know what equipment you qualify for:
📞 Phone: 281-810-3123 📠 Fax: 877-787-4705 🌐 Website: www.wonace.com
WONACE Medical Supply helps patients turn insurance benefits into real medical solutions—without the confusion.
WONACE Medical Supply — Supplies for Better Care.
Learn Dexcom G7 & FreeStyle Libre 3 CGM insurance coverage in Texas—BCBSTX, pharmacy vs medical benefit, approval guidelines & seamless delivery via WONACE Medical Supply.
Choosing to get your CGM from a Durable Medical Equipment provider like WONACE Medical Supply. From personalized service and expert support to simplified insurance billing and comprehensive follow-up care, we are dedicated to helping you manage your diabetes effectively. Contact us today to learn more about our CGM devices and how we can assist you in achieving better glucose control.
Contact WONACE Medical Supply for medical supplies near you.
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WONACE Medical Supply is a Medicare-approved company trusted by medical doctors, insurance, and hospitals.
Visit: WONACE.COM
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