Understand Your Explanation of Benefits (EOB) in Dubai
After a visit to a doctor with UAE health insurance in hand, you will receive a document titled Explanation of Benefits (EOB). You might not know what it is – but worry not! An EOB is essentially a summary of a claim, showing what was billed, what was covered, and what you owed for that treatment.
In today’s article, Pacific Prime Dubai will shed more light on the mysterious document and tell you exactly what it is, why policyholders get it, and what to do in case there’s a mismatch between your EOB and medical bill.
What is an Explanation of Benefits (EOB)?
An Explanation of Benefits (EOB) is a document that your insurance company sends to you each time you file a claim for a treatment. An EOB is not a medical bill, but it shows the actual amounts that the insurance company has been charged with and what amount you might have to cover out of your pocket.
The insurance “benefits” are the services that are payable according to the plan you have. If you have a plan with deductibles or other features that help reduce your medical insurance premiums, it’s in your best interest to understand your EOBs.
Understanding the Explanation of Benefits (EOB) in Dubai
EOBs are very useful, as you can easily notice any medical billing mistakes when you compare them with the actual medical bill. You can see, for example, if you were double-billed or charged for procedures or services you never received.
Unfortunately, mistakes DO happen, so to avoid any misunderstandings regarding your medical bills, you should always check your Explanation of Benefits (EOB) against the medical bill you received from the healthcare provider.
What should you check in your Explanation of Benefits (EOB) document?
There are a few things you should pay special attention to when checking your EOB, in particular:
- Check if your doctor’s name is displayed correctly. You might get overcharged if, for example, your insurance company deems the doctor to be out of network due to a spelling mistake in his/her name.
- Check if the dates displayed on the EOB match the dates when you had your treatment/visits.
- Compare the charges against your medical bill from the healthcare provider. If there are any inconsistencies in the amount charged or charges for services you did not receive, such as a bill for certain services twice, then contact your healthcare provider or insurance company for clarification.
- A deductible or co-insurance will reflect on the EOBs. As a rule, your insurance company will compute charges based first on your deductible and then on your co-pay; if you have those but are not sure about it – it’s better to call your insurance company or a broker for further explanation.
- Check for mistakes on the EOB itself. It may happen that your Explanation of Benefits document has a major mistake on it. For example, if the insurer charges you for visiting an in-network physician, that shouldn’t incur extra charges in your plan.
Get Professional Help to Understand Your Explanation of Benefits (EOB) in Dubai
Understanding your UAE health insurance benefits is the first step in understanding your EOB. All clients of Pacific Prime Dubai get a comprehensive plan comparison and impartial advice on choosing the best-fitting health insurance in Dubai.
That’s why, when the actual EOB arrives, our clients can scan through the documents and be wary of what they might still owe their healthcare provider; otherwise, they can always count on Pacific Prime Dubai’s claims department for help.
We can help you not only choose and secure the best-suited UAE health insurance plan but also help find the right medical center and hospital for your needs, as well as file medical claims and resolve any potential further issues, such as inconsistencies between your EOB and the actual medical bill.
Contact our team for a free quote, plan comparison, and impartial advice today!
Frequently Asked Question
How long will it take for my insurance company to send my EOB?
Typically, an insurance company will send you an EOB right after the claim is processed, which is usually within 30 days. If a delay happens in receiving your EOB, it might be due to errors or delays in claim submission or that further claim investigation is required.
What should I do upon receiving an Explanation of Benefits?
When you receive your EOB, read it carefully and compare it to the medical bills you received from the hospital. The goal is to ensure that the details are accurate and that you understand how your claim is processed by the insurer and what additional expenses you may have to pay out of pocket.
How long to keep EOB statements?
According to IRS tax guidelines, it is highly suggested that you keep health coverage records for 7 years, as it is possible that a claim is revisited a few years later. However, these days EOBs are often sent digitally through the company’s online portal and/or email, making it easier to keep.
What is the EBP plan in Dubai?
The EBP, or Essential Benefits Plan, is Dubai’s policy that establishes the minimum level of health insurance coverage required for all residents to ensure access to affordable healthcare for every worker. The plan costs between AED 550 and AED 650 (USD 150–160) per year and provides up to AED 150,000 (USD 40,850) coverage a year.
What happens if you don’t have medical insurance in Dubai?
It is legally mandated that all residents in Dubai be covered by a health insurance plan, and if uninsured, they may face AED 500 in fines per month. If you are employed, your employer is obligated to provide you with medical insurance and may face a substantial fine if they violate the law.
When she isn’t writing, you are most likely to find Elwira in search of the perfect plant-based burger or enjoying Hong Kong’s great outdoors either at the beach or from the boat - the closer to the sea, the better!
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