If you’re a professional working with people who are enrolled in Medicare Advantage plans, you will want to know how to help them read and understand their Explanation of Benefits (EOB). The EOB provides a snapshot of the services provided under a person's Medicare Advantage plan, what the plan paid for those services, and what the beneficiary might owe their provider.

This case study uses a sample client, Mario, who comes to you with questions about his EOB and payment for an abdominal aortic aneurysm screening.

The EOB case study, developed for us by the Medicare Rights Center, walks through how you as a Medicare professional can:

  • Help Mario to understand what he might owe for the screening
  • Inform him about the steps he might take to file an appeal, and
  • Explain what happens next in this process, and when to pay anything he might owe.