Summary of Benefits and Coverage | Know Your Health Plan

The Summary of Benefits and Coverage (SBC) is an easy-to-understand breakdown of your benefits and coverage.

This document is from your health insurance company. If you have a health care plan, you’ll get a copy of it in order for you to make clear comparisons when you’re looking at plans. Since every company has to follow the same format, you will have the chance to easily compare plans side-by-side. Moreover, the Summary of Benefits and Coverage includes details, called “coverage examples”, which show you what the plan would cover in 2 common medical situations — diabetes care and childbirth.

What’s on your SBC? 

The SBC is like a nutritional label for a healthcare plan. It consists of eight pages that displays information about a health insurance plan. It includes information about overall deductible, out-of-pocket limit, network of providers and services uncovered.

However, the Summary of Benefits and Coverage doesn’t list out doctors in the network. To know about your in-network doctors, you should call your health insurance company. Moreover, your premium amount is not in the SBC as well. To find your premium amount, it’s best to look at your certificate of coverage or to call your insurance company for an accurate info.

Some SBC’s are available online while some are not. If you are willing to wait, you’ll be receiving it around enrollment time, while shopping for coverage or after sending an application for coverage.

Local help is always free.

If there are unclear information on your health plan, or if you have any question regarding health coverage, you can ask for help at no cost. Health Plans In Oregon is your trusted licensed health consultant since 2006. We have been helping Oregonians in getting affordable healthcare for over a decade now. For inquiries, reach us thru 503-928-6918 or simply send an email to info@healthplansinoregon.com for all inquiries on healthcare insurance and Medicare.