Patient Medical Costs
Hospital bills, EOBs, surprise charges — what's normal, what isn't, and what to ask.
An EOB is not a bill. It's a statement from your insurer showing what was billed, what was allowed, what they paid, and what you owe.
The actual bill comes from the provider — and it should match what the EOB says you owe.
The vocabulary you need
Explanation of Benefits — what your insurer paid and what you owe. Not a bill.
A line-by-line breakdown of charges. Always request one before paying a large bill.
Hospital's master list of prices. Rarely what anyone actually pays.
The negotiated rate your insurer agreed to pay an in-network provider.
When an out-of-network provider bills you for the difference between their charge and what insurance paid.
Visit Cost Estimator
Use the insurance calculator to estimate what you'll actually owe.
Visit Cost Estimator
Use the insurance calculator to estimate what you'll actually owe.
What you pay each month for coverage.
Amount you pay before insurance starts paying.
Amount counted toward this year's deductible.
Flat fee per visit.
Your share after deductible.
Negotiated price per visit.
Expected visits this year.
Worst-case in-network ceiling.
"Total annual cost" is what the plan really costs you this year — premiums plus what you pay at the point of care. Compare this across plans, not just the premium.
Where this comes from
Verifiable, publicly available sources you can explore further.
- Healthcare.gov· Marketplace insurance basics
Definitions for premiums, deductibles, copays, and coinsurance.
- KFF· Health policy research and explainers
Independent analysis on insurance, Medicare, and Medicaid.
- CMS· Centers for Medicare & Medicaid Services
Regulator that publishes the underlying coverage and payment rules.