To help you navigate your healthcare expenses, we've put together some videos and handouts on reading your Explanation of Benefits (EOB) through Imagine 360.
Here's what you need to know:
What's an EOB? Whenever you visit a doctor or use a service covered by our health plan, you'll get an EOB. It's crucial to understand the EOB and compare it to your bills.
What is a Balance Bill? A balance bill happens when you get charged for the difference between what your insurance pays for a medical service and what the provider charges beyond the terms of your health insurance plan. If this occurs call Imagine 360 immediately. Important Benefit Coverage Definitions:
Deductible: A medical plan deductible is the amount of money you have to pay for your medical expenses before your insurance starts helping with the costs.
Co-Insurance: After you've paid your deductible, coinsurance is the percentage of the medical costs that you and your insurance each pay.
Copay: A copay is a fixed amount you pay for certain medical services or medications covered by your insurance plan. It's like a set fee you pay each time you visit the doctor, get a prescription, or use certain healthcare services. Out-of-Pocket Maximum: When you reach your out-of-pocket maximum, it's like a finish line for your medical expenses. It's the most you'll have to pay for covered services in a year. Once you hit this limit, your insurance should cover 100% of the costs for covered services for the rest of the year, and you won't have to pay anything more out of your pocket.
Questions? If anything is unclear, reach out to Imagine 360 using the number on your ID card. Alternatively, contact your Innovative Benefit Guardian for assistance.