Get Aflac Hospital Indemnity Wellness Benefit Claim Form 2020-2024

1If all documentation is not available upon initial claim filing, you may upload the documents later by clicking “Upload Documents” on the mobile app or “MyClaims” on desktop. Register or Log in: Go to aflac.com/myaflac or download the Aflac SmartClaim Mobile app from the App Store or Google Play Store.

$25 Aflac will pay $25 when a covered person incurs a charge for a physician visit. Services must be under the supervision of a physician. If the type of coverage for the policy is individual, the benefit is limited to three visits per calendar year, per policy.

Aflac can help pay for ambulance trips, physical therapy, CT Scans, MRIs, confinement, blood transfusions, and medical appliances.

First-Occurrence Benefit Aflac will pay $5,000 for the insured, $5,000 for the spouse, or $7,500 for children when a covered person is diagnosed with internal cancer. This benefit is payable only once for each covered person and will be paid in addition to any other benefit in this policy.

INVASIVE DIAGNOSTIC EXAMS BENEFIT: Aflac will pay $100 when a Covered Person requires one of the following exams, with or without biopsy, and a charge is incurred: arthroscopy, bronchoscopy, colonoscopy, cystoscopy, endoscopy, gastroscopy, laparoscopy, laryngoscopy, sigmoidoscopy, or esophagoscopy.

Aflac will pay an indemnity benefit equal to 25% of the amount shown in the Schedule of Operations for the administration of anesthesia during a covered surgical operation.

Some Aflac insurance plans — including critical illness, accident and hospital coverage — may include wellness benefits, paying your employees for out-of-pocket expenses that could include health screening tests performed as a part of preventive care, such as diagnostic procedures like colonoscopies.

Claims for all other benefits covered under this policy must be filed separately using the claim forms available at aflac.com or by calling 1-800-99-AFLAC (1-800-992-3522).