Get the up-to-date Aflac Benefit Services Request for Reimbursement Form 2024 now

Get Form
benefit services reimbursement Preview on Page 1

Here's how it works

01. Edit your benefit services form online
01. Edit your benefit services reimbursement form online
Type text, add images, blackout confidential details, add comments, highlights and more.
02. Sign it in a few clicks
02. Sign it in a few clicks
Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
03. Share your form with others
03. Share your form with others
Send it via email, link, or fax. You can also download it, export it or print it out.

How to edit Aflac Benefit Services Request for Reimbursement Form in PDF format online

Form edit decoration
9.5
Ease of Setup
DocHub User Ratings on G2
9.0
Ease of Use
DocHub User Ratings on G2

Handling documents with our feature-rich and user-friendly PDF editor is straightforward. Adhere to the instructions below to complete Aflac Benefit Services Request for Reimbursement Form online easily and quickly:

  1. Sign in to your account. Log in with your email and password or create a free account to test the product prior to choosing the subscription.
  2. Import a document. Drag and drop the file from your device or add it from other services, like Google Drive, OneDrive, Dropbox, or an external link.
  3. Edit Aflac Benefit Services Request for Reimbursement Form. Easily add and highlight text, insert pictures, checkmarks, and symbols, drop new fillable fields, and rearrange or remove pages from your document.
  4. Get the Aflac Benefit Services Request for Reimbursement Form completed. Download your modified document, export it to the cloud, print it from the editor, or share it with other people via a Shareable link or as an email attachment.

Benefit from DocHub, one of the most easy-to-use editors to promptly handle your documentation online!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
Contact us
Aflac will pay you a premium refund value based upon the annualized premium paid for the rider, the policy, and any other attached benefit riders. All Return of Premium Benefits/premium refund values paid will be less any claims paid.
Visit aflac.com/login to log in or register your account using your Social Security Number and Mobile Phone Number. Once logged in, select Submit a new claim. Choose a policy, then select Routine Medical Care and complete the steps to file your claim. Check your email for claim updates.
Post Office Box 84075 * Columbus, GA. WELLNESS AND HEALTH SCREENING CLAIM FORM. AUTHORIZATION. Any person w ho knowingly and w ith intent to defraud any insurance company, files a statement of claim containing any materially false, incomplete or misleading information, is guilty of a crime.
Accident Claims Checklist. Z2201218R1. Identify your policy. Policyholders address. What you need to file a claim. HCFA 1500 (non-hospital bill). ER report or operative report. (Please obtain the supporting documents for the corresponding benefit.) Proof of services. My Claims. MyAflac helpful tips: ▪
Additional reimbursement forms can be obtained at aflac.com or via the IVR at 1-877-353-9487. Fax your completed Flex One Request for Reimbursement Form and all documentation to: 1-877-FLEX-CLM (1-877-353-9256). Please allow 48 hours for the receipt of your faxed form before calling to inquire about your reimbursement.

People also ask

What if I want to cancel my coverage? A. Call our Customer Service Center at 800.433. 3036 for cancellation procedures.
Initial Accident Hospitalization Benefit Aflac will pay $1,000 when a covered person is confined to a hospital for at least 24 hours for injuries sustained in a covered accident. If the covered person is admitted directly to an intensive care unit, Aflac will pay $2,000.
Visit aflac.com/login to log in or register your account using your Social Security Number and Mobile Phone Number. Once logged in, select Submit a new claim. Choose a policy, then select Routine Medical Care and complete the steps to file your claim. Check your email for claim updates.

Related links