What is EOC in insurance?

EOC stands for Evidence of Coverage. An evidence of coverage is a document that describes the details of health care benefits which are covered or provided by a particular health plan. Evidence of coverage provides documentation of what that particular health plan covers and how it works including the amount of money the policyholder has to pay for it. The evidence of coverage also refers to a contract or certificate that is provided to a health plan member which contains all information about the coverage and other rights.
Evidence of coverage provides information on payment eligibility, enrollment and how to get the services. The evidence of coverage also provides an explanation on how to file a grievance or appeal if someone disagrees with the plans decision on his or her care. In some states, a grievance is simply a complaint that service wasn’t good, rather than a request for a review of denial of coverage.