Know How Your MVP Medicare Advantage Plan
Works for You
Your Explanation of Benefits (EOB) isn’t a bill. It helps you understand how your MVP Medicare Advantage plan is working and to help you plan for any bills your health care provider(s) may send you.
Here’s how your coverage works:
- After you see a health care provider, they send a claim to us
- We review the claim and determine how much of the claim your plan covers
- If we cover the care or service, we pay the covered amount and send you an EOB
- Your provider receives our payment (if we cover the care or service) and bills you for the outstanding
or allowed amount
You should keep your EOB for your records. Check your EOB against your provider’s bill before sending them any payments.
Visit our Health Glossary [link to Health Glossary, page ID 18.104.22.168] to find definitions of any unfamiliar terms related to your EOB. Call our Medicare Customer Care Center 1-800-665-7924 (TYY 711) if you have questions about your EOB.
Your Claim Summary
The first page of your EOB includes a claim summary. This includes four key areas:
- Billed Charges: This is the amount your provider billed us. It doesn’t include any discounts we’ve negotiated
to save you money.
- Not Covered/Due from Patient: This amount is for any billed charges that your
MVP Medicare Advantage plan doesn’t cover. We include this amount in the What You Owe total.
- Paid by Plan: This is the amount we’ll pay your provider if we cover the care or service.
- What You Owe: This is the amount you may owe your provider. It may not include any co-pays you
have already paid them. This amount should match the amount on the bill your provider sends you.