Claim forms
Get your benefits moving with the right claim documents. Choose a category below to find and download the appropriate forms for your specific coverage.
Aflac Dental and Vision Insurance
Dental members
Download and complete our member reimbursement form.
Mail: Aflac Claims Appeals, PO Box 84064, Columbus, GA 31908-9998
Vision members
To access and submit claim forms please log in to your respective member portal.
Aflac Dental policy claims appeals
Please download and complete the Claim Appeal Form to submit your request. Please be sure to explain why you disagree with Aflac’s decision, and include any additional supporting documentation.
You have the right to appeal a decision up to a maximum of three times per claim. All appeals must be submitted within 180 days of the original decision.
Fax: 888.659.1023
Mail: Aflac Claims Appeals, PO Box 84064, Columbus, GA 31908-9998
Providers
Dental providers
Submit claims by accessing the Aflac Provider Portal.
Electronic submission through Clearinghouse using: Payor ID: AFLAC & NEA Number: 451001
Mail to: Aflac Claims, PO Box 2015, Milwaukee, WI 53201