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  • Aflac Series Vsn100 Form

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Vision Now Vision Insurance SM Plan Benefits Eye Examination Vision Correction Specific Eye Diseases/Disorders Eye Surgery Permanent Visual Impairment PATENT PENDING VSN175FL IC(5/05) Vision Now Policy.

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How to fill out the Aflac Series Vsn100 Form online

The Aflac Series Vsn100 Form is essential for accessing vision insurance benefits. This guide will provide you with straightforward instructions on how to fill out this form online, ensuring you understand each component and step involved in the process.

Follow the steps to complete the Aflac Series Vsn100 Form successfully

  1. Click the ‘Get Form’ button to obtain the Aflac Series Vsn100 Form and open it in your preferred online editor.
  2. Begin by entering your personal information as required in the designated fields. Ensure that your name, address, and contact details are accurate.
  3. Provide the policyholder's information if different from your own, including their name and relationship to you. This is crucial for processing claims accurately.
  4. Indicate the covered benefits for which you are filing a claim. Review the options carefully, including eye examinations, vision correction materials, and any specific eye diseases or disorders.
  5. Upload any required documentation as per the instructions provided. This may include receipts from eye examinations or surgical procedures performed by an optometrist or ophthalmologist.
  6. Review all entered information to confirm its accuracy. Mistakes can delay processing, so take a moment to ensure everything is correct.
  7. Once reviewed, save the changes you have made to the form. You can then choose to download, print, or share the completed form as necessary for your records.

Complete your Aflac Series Vsn100 Form online today and secure your vision benefits.

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CHIROPRACTIC TREATMENT BENEFIT: Aflac will pay $25 when a Covered Person receives chiropractic treatment for a structural imbalance from Injuries sustained in a covered accident. This benefit is payable for treatment by a Chiropractor in a Chiropractor's office.

Our Vision Now® supplemental insurance policy pays a Vision Correction Benefit of $80 for materials, such as glasses and contacts, as well as an Eye Exam Benefit of $45. Aflac goes beyond traditional exams and provides benefits for serious eye conditions.

A. EYE EXAMINATION BENEFIT: Aflac will pay $45 (forty-five dollars) when a charge is incurred for an eye examination for a covered person. This benefit is limited to one examination per covered person, per Policy Year. The eye examination must be performed by an Optometrist or Ophthalmologist.

Aflac Vision Now also offers coverage for serious eye conditions,5 including: Permanent Visual Impairment Benefit: $750 $10,000 for visual impairment. Eye Surgeries Benefit: $50 $1,500 for miscellaneous eye surgeries. Specific Eye Diseases and Disorders Benefit: $1,000 for specific eye diseases and disorders.

If you are interested in filing your claim online, register using aflac.com/smartclaim. ¢ Benefits of filing your claim online include faster claim processing time and receiving claim. communications by email.

A. PHYSICIAN VISIT BENEFIT: Aflac will pay $25 when a Covered Person incurs a charge for a visit (including a Telemedicine Visit) to a Physician, Psychologist, or Urgent Care Center. ... The Sickness or Injury of a Covered Person is not required for the Physician Visit Benefit to be payable.

WELLNESS BENEFIT (a preventive benefit; the Accidental-Death, Dismemberment, or Injury of a Covered Person is not required for this benefit to be payable): Aflac will pay $60 if you or any one Covered Person undergoes routine examinations or other preventive testing during the Calendar Year.

Our Vision Now® supplemental insurance policy pays a Vision Correction Benefit of $80 for materials, such as glasses and contacts, as well as an Eye Exam Benefit of $45. Aflac goes beyond traditional exams and provides benefits for serious eye conditions.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232