Whether a health claim adds up, and whether federal surprise-billing rules apply.
Open the Medical Bill & EOB Checker tool →An Explanation of Benefits is not a bill, and the bill that follows it does not always match. This does two separate checks on the same claim, because they fail in different ways.
The first is arithmetic. Your plan's terms — the deductible, how much of it you have used, the coinsurance share, the out-of-pocket maximum — determine what one claim should cost you: the allowed amount fills what is left of the deductible, coinsurance applies to the rest, and the total is capped by what remains of your out-of-pocket maximum. That is a calculation, so it either reconciles with the notice or it does not. When it does not, the gap is a question worth asking, not proof of an error: a second payer, a deductible that reset mid-year, a family rather than individual accumulator, or a copay applied instead of coinsurance all produce a legitimate difference.
The second is the No Surprises Act, the federal law in effect since January 1, 2022. It bars a balance bill in three situations — an emergency room visit, care from an out-of-network provider during a visit to an in-network hospital, hospital outpatient department, or ambulatory surgical center, and air ambulance services — and it does not reach everything: ground ambulance is outside it, as are vision-only and dental-only plans, short-term and sharing-ministry plans, and fixed indemnity plans. Signing a notice and consent form gives the protection up. You tell this page where the care happened; it never guesses from a document.
What it will not tell you is whether you owe the bill. That turns on the provider's contract, the facility's network status on the day, and whether a consent form was signed — facts this page does not have. It also does not compare what you were charged against typical prices and does not judge medical necessity. It gives you the rule, whether the situation appears to fall inside it, and the free federal channel to raise it through.
This is information about published federal rules applied to figures you entered. It is not legal, medical, or financial advice, and only your plan, your provider, and the help desk can resolve a specific bill.
Computed entirely on your device for U.S. taxes and benefits. Nothing is ever sent anywhere, and it is free forever. Educational information, not financial, tax, investment, or legal advice.