ELI5: Explain Like I'm 5

Explanation of benefits (insurance)

Okay, so let's say you get hurt or sick and you have to go to the doctor. Your mom or dad might have an insurance plan to help pay for the things the doctor does or the medicine you need. The explanation of benefits is like a big piece of paper or an email that tells your mom or dad how much the insurance plan paid for all the doctor stuff.

Think of it like getting a present from your grandma. She buys you a toy, but then tells your mom how much the toy cost so your mom knows how much to say thank you. The explanation of benefits tells your mom how much the insurance plan paid so she knows how much she has to pay for the rest.

So if the doctor's visit was really expensive and the insurance plan only paid a little bit, your mom will have to pay more money. But if the insurance plan paid a lot, then maybe your mom won't have to pay much at all. It's like checking the receipt to see how much money was spent.

It's important to know what the explanation of benefits says because your mom or dad might have to pay for part of the doctor stuff, like the co-payment or the deductible. It's not like getting a toy from your grandma because at the end of the day, going to the doctor is serious and can be scary. But the explanation of benefits helps your mom or dad understand what is covered by the insurance plan and what they might have to pay.