WebClaim Processing Office P.O. Box 559004, Austin, Texas 78755-9004 EARLY DETECTION BENEFIT CLAIM FORM (For Cancer Screening Tests) Policy Number Name of Patient Male Date of Birth Female Name and Address of Primary Insured Male Date of Birth Female Social Security No. Telephone Spouse's Name Primary Insured Spouse Natural Child … WebIf a specified-disease runs in your family, a cancer/specified-disease insurance plan can help you protect your health and finances. Aflac Cancer Insurance can help cover a wide variety of cancer treatments—both …
WELLNESS AND HEALTHSCREENING CLAIM FORM Failure to …
WebWELLNESS CLAIM FORM If you have any questions regarding our determination of your claim, or if you would like to appeal any determination, please contact our Customer Care Center at 1 -800-348-4489 8:00 A.M. to 8:00 P.M. Eastern Standard Time. Claim forms and other valuable information may be found on www.AllstateBenefits.com WebThis form is designed to provide an annual cancer screening (after the first 12 months of insurance), for those who have the Cancer Screening Benefit. Aflac also provides pap … philosophy\u0027s 04
CANCER WELLNESS BENEFIT CLAIM FORM - Revize
WebTo receive your Wellness Benefit, complete the form by following the instructions provided. Please print a separate form for each additional covered family member or call 1-800-99-AFLAC (1-800-992-3522) to request additional forms. Claims for all other benefits covered under your Cancer policy must be filed separately , using the Cancer Claim Form. WebAttn: Cancer Claim. Questions. If you have questions or need assistance, please call us toll free at 1-800-845-7519 and ask to . speak with a Claims Examiner about your cancer and specified disease policy Monday – Friday, 8:00AM-5:00PM, (CST) Central Standard Time. ALL REQUIRED PORTIONS OF THIS CLAIM FORM MUST BE COMPLETED TO WebCancer Screening Wellness Benefit Claim Form Please use black or blue ink only and print legibly when completing this form in its entirety. Keep a copy of the supporting … philosophy\\u0027s 0b