Which document provides detailed information on a member's plan and costs?

The Evidence of Coverage (EOC) is a comprehensive document that outlines the details of a member's healthcare plan, including the specific benefits, costs, and coverage limitations. It serves as a legal contract between the insurer and the member, ensuring that individuals fully understand what is included in their plan.

The EOC typically includes critical information such as what medical services are covered, procedures for obtaining care, member rights, and responsibilities, as well as the costs associated with various services (e.g., deductibles, copayments, and out-of-pocket limits). This document is particularly important for members to reference when navigating their healthcare needs, as it provides clarity on what they can expect in terms of coverage and expenses.

Other documents like the Summary of Benefits provide a more simplified overview, the Annual Notice of Change communicates any updates or modifications to the plan for the upcoming year, and the Provider Directory lists the available healthcare providers under the plan. While all these documents are important for members, the EOC is the most detailed and legally binding, making it the key resource for understanding a member's specific plan and associated costs.