Get Manulife Af1039e 2015-2025

The Manulife AF1039E form is essential for submitting health care claims efficiently. This guide provides clear and concise instructions to help users complete the form accurately and effortlessly, ensuring that all necessary details are captured for processing.

Follow the steps to successfully complete the Manulife AF1039E form online.

1. Click the ‘Get Form’ button to obtain the Manulife AF1039E form and open it in your preferred editor to begin filling it out.
2. In the plan member statement section, enter the required information including the plan number, identification number, and your full name (first, middle initial, last). Next, fill in your address, city/town, province/state, postal/zip code, country, and telephone number.
3. Respond to the questions regarding workers' compensation and other coverage. If applicable, provide your spouse's date of birth, name of their insurance company, and plan number.
4. For patient information, list each patient’s name, date of birth, relationship to you, amount of expense, and if applicable, the spouse’s certificate number. If the patient is a student over 18, include their school, city, hours worked per week, and province/state.
5. For prescription drug expenses, ensure that all receipts are attached to the back of the form. No need to list this information on the form as it will be handled with the attachments.
6. When detailing practitioner/paramedical expenses, attach an itemized receipt that includes patient name, practitioner's name and type, date of service, length of visit, charge for treatment, last paid date by provincial plan, and registration number.
7. For equipment and appliance expenses, include a recommendation letter from your physician detailing the diagnosis and attach any necessary provincial plan statement of payment if applicable. Specify the activities requiring the equipment and the duration required.
8. In the vision care expenses section, enclose an original itemized receipt illustrating the patient's name, costs of glasses/contact lenses, eye exam fees, and the date of services.
9. Review all entries for accuracy and completeness. Ensure original receipts are securely attached for all expenses.
10. Finally, sign the claims confirmation section, provide the date of signing, and calculate the total amount of all receipts submitted. Once completed, save any changes, download, print, or share the form as needed.

Start completing the Manulife AF1039E form online today to ensure your health claims are processed efficiently.