When you see an in-network doctor, dentist, or other healthcare provider, they will submit the bill to us. That's called a claim. You might also receive a bill from your provider, but wait to hear from us before paying it.
If you saw an out-of-network provider or paid up front for your care or prescriptions, you can submit a claim yourself.
Instead of getting paper EOBs, you can get them digitally in your online account. We will email you when a new EOB is ready. Then we'll hold onto them for two years, so you don't have to remember where you put a paper copy.
Family members 13 and older can create their own online accounts and can choose whether parents or their spouse can see all claims or only non-sensitive claims.
The default setting is that spouse or parents will see non-sensitive claims. Sensitive claims have to do with any diagnosis or procedure that's related to genetic information, chemical dependency, mental health, reproductive health, pregnancy, sexually transmitted diseases, HIV, and AIDS.
To change settings, sign into or create an online account and select Claims, then Privacy Settings in the left menu.
After a claim is submitted you’ll receive a breakdown of the charges submitted. This is your Explanation of Benefits (EOB). It shows what we pay for and the portion, if any, you are responsible for.