Evidence of Coverage (EOC)

Also called: EOC, certificate of coverage

The evidence of coverage is the full document that spells out your plan's benefits, exclusions, cost sharing, and the rules for getting care approved. It is essentially the contract between you and your insurer. When you appeal, quoting the specific language in your evidence of coverage that supports your case is often decisive.

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Disclaimer: This definition is provided for general educational purposes only and is not legal, medical, or insurance advice. Insurance rules, deadlines, and terminology vary by plan, state, and over time. Always check your own plan documents and confirm current details before acting.