Get Aflac Vision Claim Form

Filing a vision claim with Aflac can be a straightforward process if you follow the steps outlined below. This guide provides clear instructions on how to fill out the Aflac Vision Claim Form online, ensuring you can efficiently submit your claim for benefits.

Follow the steps to complete your Aflac Vision Claim Form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Provide your policy number and fill in the policyholder's information, including last name, first name, date of birth, telephone number, home address, city, state, and zip code. Ensure all fields are completed as they are mandatory.
3. Complete the patient information section with the patient's last name, first name, and date of birth. Indicate the relationship to the primary policyholder by selecting the appropriate option (primary policyholder, spouse, or dependent child).
4. In the treatment and physician information section, list the physician’s name, phone number, street address, city, state, and zip code. This information is required for validation.
5. For eye exam information, mark the appropriate boxes for the services received (eye exam, treatment date, etc.) and ensure you attach any relevant bills when filing for the Vision Correction Benefit.
6. After reviewing all information for accuracy, sign and date the form at the designated area. If the patient is not the policyholder, indicate the family relationship.
7. Finally, save the changes made to the form. You can download, print, or share the completed form as needed. Ensure that you send it to the specified Aflac claims address or fax number.

Start completing your Aflac Vision Claim Form online today for quick claim processing.