Summary Of Health Plan Payments
The Summary of Health Plan Payments1 breaks down payments for medical services you've received. You'll get this statement if there's a balance remaining after we process the claim and pay our share of the costs. This statement is not a bill. If you owe money, your provider will send you a bill directly.
To learn more, download A Guide to Your Summary of Health Plan Payments.
To better understand the payment overview and details pages, see the information below.
- The payment overview shows the amount charged to Blue Cross, the amount we covered, and what you owe (if anything).
- Up here, you’ll find your account information, including your plan's deductible. A deductible is the amount you pay for medical services before your insurance begins to pay.
- This section shows how the allowed amount was calculated. The allowed amount is most your health plan pays for a covered service. This may also be called the "allowed charge," "payment allowance," or "negotiated rate."
- Your delivery options describes how these statements are delivered and how you can update your preferences.
- Your recent claims, including dates of service, names of providers, the amounts charged, and payment details.
- The amount you owe for each service.
- How we determined what you owe, including copayments, deductible, and co-insurance.
- Additional information on how we processed your claims.
- The final amount you'll owe your provider for services after we cover our share of the cost. If you have additional insurance, this doesn't apply to you.
- A detailed breakdown of your deductible and out-of-pocket maximum, including the amounts you've previously applied towards these.
If you have any questions, please call Member Service at the number on the front of your ID card.
1. Medex®´ members receive statements titled Explanation of Benefits.