All about Aflac Wellness Claims
When most people sign up for Aflac, it’s a safety net. It’s for the peace of mind that if something goes wrong, you’ll have assistance in paying for it, but Aflac offers more than that.
Wellness with Aflac varies depending on the plan you have, but generally refers to screenings, tests, and immunizations in order to test for or prevent illness and disease. Unless otherwise specified, Aflac will pay you to $50 for wellness exams each benefit year, this, of course, stacks with any wellness benefits you receive from your healthcare provider or the city.
How it Works
Wellness benefits aren’t reimbursements—they're payouts. That might sound like a semantic difference, but it isn’t. By having any of the procedures listed below done, regardless of how much you paid out of pocket, Aflac will pay you a flat rate.
All you need to do, besides getting the test is send your claim through MyAflac, if you need help with that, check out this guide.
Accident
Aflac’s accident plan covers you in case of… well, accidents. Coverage includes ambulance rides, emergency room visits, prescriptions, major diagnostic tests, and more. The accident plan also provides additional coverage for screenings, tests, and inoculations. Below is a list of some of the more common covered tests, for a full list click here and scroll to page 8.
• Annual physical exams
• Flexible Sigmoidoscopy
• Mammograms
• PSA Tests
• Pap Smears
• Ultrasounds
• Eye Examinations
• Blood Screening
• Immunizations
Each calendar year (Jan-Dec), you and your covered dependents have access to a $50 payout for having any of these tests—you just need to submit a claim.
Critical Illness
Aflac’s Critical Illness plan covers you in case you are diagnosed with a critical illness, but it also provides you with wellness testing so you can catch a critical illness before it becomes a problem.
Under the Critical Illness explanation of benefits, the following types of wellness coverage are listed as “health screening benefits” and largely relate to detecting the problems that the Critical Illness plan covers. Some of the covered screenings are:
• Blood test for triglycerides
• Bone marrow testing • Breast ultrasound
• CA 15-3 (blood test for breast cancer)
• CA 125 (blood test for ovarian cancer)
• CEA (blood test for colon cancer)
• Chest X-ray
• Colonoscopy
• DNA stool analysis
• Fasting blood glucose test
• Flexible sigmoidoscopy
• Hemoccult stool analysis
• Pap smear
• PSA (blood test for prostate cancer)
• Serum cholesterol test to determine level of HDL and LDL
• Serum protein electrophoresis (blood test for myeloma)
• Spiral CT screening for lung cancer
• Stress test on a bicycle or treadmill
• Thermography
• Any other medically accepted cancer screening test
Much like the accident plan, the policy holder receives $50 in benefits for having any of the listed screenings. Mammograms, on the other hand, have a $200 payout. This benefit also is limited to once per calendar year.
These tests apply to both the policy holder and your covered domestic partner, but not dependents. Dependents are automatically enrolled in your Critical Illness plan and can receive 50% of the policy holder’s other payouts at no additional charge.
In order to receive your payout, you must submit a claim.
Hospital Indemnity
The Hospital Indemnity plan pays out during hospital confinement, admission, intensive care, and other hospital related charges. Since this plan is designed to help cover expenses related to being hospitalized, there is no substantial wellness component. The Hospital Indemnity plan does offer payouts for mammograms. In the case of this plan, the mammogram benefit is limited to $100 and can pay out once per year.
In order to receive the $100, you must submit a claim.
Making the most out of your Plans
When you’re signed up for multiple plans, you can “double-dip” your coverage. This essentially means that anytime you see the same test or item show up twice, you can receive a double payout for that screening as long as you haven’t used that benefit already.
Take for example a colonoscopy. If you are signed up for both the Accident plan and the Critical Illness plan, you will receive a $100 payout for having the one colonoscopy. The same goes for a pap smear, COVID-19 testing, mammograms, and bloodwork.
It’s also important to know that it is never too late to file a claim. As long as you had coverage at the time of your wellness screening, you can receive your payout! This even includes people who no longer have coverage.
Filing a Claim
Filing a claim with Aflac is easy! You just need to register with Aflac by going to https://Aflac.com/login. When you register be sure to use your certification number, not your social security number. You can find your certification number on the policy letter we sent to you. If you don’t have that number saved, we can send it to you, please request it by calling 888-315-8027, or by emailing [email protected].
Once you’ve signed up, you can go to https://myaflac.aflac.com and then clicking “File a Claim” on the left hand side. From there you just need to follow the instructions and be sure to provide as much information as possible!
For a full guide on filing a claim click here: https://www.sdpeba.org/news/how-to-file-an-aflac-claim-online.
Signing Up for Aflac
Aflac’s open enrollment period begins in April, but our Aflac specialists can pre-enroll you for coverage today. In order to do so, reach out to Will Stover ([email protected] or Chris Judy ([email protected]), they can help get you set up, go over specific coverage, rates, and help you make the best decision when it comes to receiving care.
If you’d like to read more about our Aflac plans, click here.
If you have other questions, you can contact us directly by emailing us at: [email protected] or calling us at 888-315-8027.