Aflac Cancer Wellness Form. This form is designed to provide an annual cancer screening (after the first 12 months of insurance), for those who have the cancer screening benefit. If your aflac policy also provides one mammogram benefit per calendar year, please mark the appropriate box and indicate the date the mammogram was performed.
Aflac Power Point Presentation
If your aflac policy also provides one mammogram benefit per calendar year, please mark the appropriate box and indicate the date the mammogram was performed. Web cancer screening wellness benefit claim form some of the tests listed may not be covered under the wellness benefit of your policy. Enjoy smart fillable fields and interactivity. Follow the simple instructions below: Easily fill out pdf blank, edit, and sign them. Tax, legal, business and other documents require higher of protection and compliance with the law. 1 information you may need to file your claim policy number patient’s name and date of birth diagnosis description of service date (s) of service name and address of service provider Get your online template and fill it in using progressive features. Web to receive your wellness benefit, complete the form by following theinstructions provided. Access aflac smartclaim from myaflac or the myaflac mobile app.
Web page 1 of 2 05/17 americanfamilylifeassurancecompanyofcolumbus(aflac) attn: Aflac smartclaim guides you every step of the way. Web 37 votes how to fill out and sign printable aflac wellness claim form online? Most aflac accident, hospital indemnity and cancer insurance policies have wellness benefits. Save or instantly send your ready documents. Web cancer screening wellness benefit claim form some of the tests listed may not be covered under the wellness benefit of your policy. This form is designed to provide an annual cancer screening (after the first 12 months of insurance), for those who have the cancer screening benefit. Do not include receipts, statements or other claim documentation with this form. If any of your wellness tests resulted in a diagnosis of cancer, please submit your claim for cancer treatment separately , using the cancer claim form. If your aflac policy also provides one mammogram benefit per calendar year, please mark the appropriate box and indicate the date the mammogram was performed. Please check your policy for specific details on this benefit.
