What Does Aflac Cover?

Aflac is an insurance which will cover the cost which is not covered by general insurance. It provides supplemental insurance which means the benefit is paid directly to the insurer when he is in hospital. It will pay the benefits in cash to the people insured by the company. The benefit of this insurance is that it will cover your out of pockets cost which are not covered by your general medical insurance. Other medical insurances pay directly to your hospitals or doctors, but this policy will guarantee that you don’t run out of the cash as the hospitals add bill very fast.

Quick Links:

  1. Aflac COVID-19 Coverage
  2. Aflac Chiropractic Coverage
  3. Does Aflac Cover Braces
  4. How much does Aflac Pay for Surgery
  5. Aflac Pregnancy Payout
  6. How much Aflac pay for the herniated disc
  7. Aflac Accident Payout
  8. Does Aflac pay for Sprains
  9. Aflac Cancer Insurance
  10. Aflac Serious Illness Insurance
  11. Aflac Life insurance
  12. How Much Does Aflac Pay for Stitches?
  13. How much does Aflac pay for Crutches?
  14. How Much Does Aflac Pay for Short Term Disability?
  15. How Much Does Aflac Pay for Chiropractic Visits?
  16. How Much Does Aflac Pay for Blood Work?
  17. How Much Does Aflac Pay for a Torn Rotator Cuff?
  18. Does Aflac Covers Hysterectomy?
  19. Does Aflac Accident Cover Broken Tooth?
  20. Does Aflac Pay for Anesthesia?
  21. Does Aflac Work With Medicaid?
  22. Does Aflac Pay For Back Injuries?
  23. Aflac Group Accident Payout
  24. Aflac Group Accident Insurance is it worth it?

Aflac COVID-19 Coverage

Aflac would pay benefits under those circumstances if you have Aflac’s individual or group hospital indemnity or short-term disability plans. If you are confined to an intensive care unit, Aflac would pay benefits under the individual intensive care, individual specified health event, or group hospital indemnity plans that include an ICU benefit. Please refer to the policy or certificate for benefit amounts and benefits eligibility. This information can be accessed at myaflac.com. Group insureds can visit aflacgroupinsurance.com or call customer service at 1-800-433-3036 to request a copy of their certificate.

In case if you are unable to work and not in the hospital, but in isolation at home. Aflac short-term disability plan pay benefits

In Order to get Cover in this case Documentation with a positive presumptive diagnosis code will be necessary, including both employer and physician statements indicating you are disabled, not working and, if applicable, not receiving 80%* of your pay – or in the case of group products, 60%* of your pay. Any required elimination period would need to be met as outlined by the policy. Benefits for events other than disability will be paid as outlined in the policy.

Need to be tested for COVID-19

Aflac’s accident and some of its critical illness and hospital plans provide an annual wellness or health screening benefit. If you have not already used this benefit this year, it would be available to you because of your doctor’s visit.

In case you are unable to visit Doctor Aflac is committed to our customers and we understand if you prefer to remain at home. Generally, Aflac considers telemedicine to visit the same as an in-person visit to the doctor.

Aflac Chiropractic Coverage

Aflac will pay $25 when a Covered Person receives chiropractic treatment for a structural imbalance from Injuries sustained in a covered accident.
This benefit is payable for treatment by a Chiropractor in a Chiropractor’s office.
Treatment must be received within 72 hours of the accident for benefits to be payable.
This benefit is payable for one treatment per day for up to a maximum of three treatments per Calendar Year, per policy.

Does Aflac Cover Braces

Dental Wellness Benefit Aflac will pay $75 per visit to you or any covered person for any one treatment listed below. This benefit is payable once per visit, regardless of the number of treatments received.

How much does Aflac Pay for Surgery

Surgical Benefit Aflac will pay $100–$2,000 when a covered person has surgery performed for a covered sickness in a hospital or ambulatory surgical center based upon the Schedule of Operations in the policy.

Aflac Pregnancy Payout

Aflac pays for Pregnancy if delivery is cesarean or vaginal. This plan comes under personal sickness and hospital indemnity. And the condition is that you must not be pregnant when you take the policy. There should be 10 month gap to enjoy the benefit of Aflac. As Aflac is a supplemental insurance it will cover your other bills which are not covered in your general insurance. So when you are admitted in hospital for Aflac paternity leave, after everything is done you simply need to take the bills from hospital and file a claim with Aflac. Within a few days you will get your cheque for your bills. Therefore basically you will get paid for having a baby.

Aflac Pregnancy Payout
Vaginal Delivery $300
Cesarean Delivery $400

How much Aflac pay for the herniated disc

This situation comes under the Surgical Procedure, To get the cover treatment must be performed within a year of an accident. 2 or more than 2 surgical procedures performed through the same incision will be considered as 1 operation, and benefits will be paid based on the most expensive procedure.

Ruptured Disc (treatment within 60 days; surgical repair within one year)

There are 3 plans to get Accident Specific-Sum Injuries Benefit Amount cover for Herniated Disc:

Surgical Procedures Essentials Plan PLAN 1 PLAN 2
Ruptured disc $375 $500 $625

Aflac Accident Payout

Take advantage of the Aflac accident insurance policy to maintain peace of mind and help pay for emergency treatment, as well as transportation or accommodation related to treatment.

How it works

  1. Your child was injured while playing soccer and was taken to the emergency room by ambulance.
  2. Your leg is fractured and requires surgery.
  3. The policyholder submits his claim through Aflac SmartClaim® before 3pm and receives benefits in just one day.

Aflac pays you:
Cost Calculator

  1. Accident up to $2,435
  2. Hospital up to $299
  3. Aflac pays you: $2,734

Does Aflac pay for Sprains

One can take advantage of Aflac’s accident insurance policy for emergency treatment, as well as for treatment‐related transportation and lodging. There are plans that include on or off the job accidents 24/7. Sprains, Lacerations, Dislocations, Broken Bones and many more Accidents can happen at any time. You could suffer an injury while working around the house or at work. Or a child may get injured at football practice. When an accident happens, it can be costly. Even with major medical insurance, there may be out-of-pocket expenses that you’ll have to pay.
Aflac pays you:
Cost Calculator

  1. Accident up to $2,435
  2. Hospital up to $299
  3. Aflac pays you: $2,734

Aflac Cancer Insurance

Aflac cancer insurance is here to help you and your family cope better emotionally and financially with a situation where a positive cancer diagnosis is presented. With greater protection and comfort they will have the freedom to focus on more important things.

How it works

  1. The policy holder suffers frequent infections and high fevers.
  2. The doctor’s visit and bone marrow biopsy reveal a diagnosis of leukemia.
  3. The policyholder submits his claim through Aflac SmartClaim® before 3pm and receives benefits in just one day.

Aflac Supplemental Coverage:

  • Hospital up to $1,441
  • Short-Term Disability up to $5,584
  • Cancer/Specified-Disease up to $7,411
  • Aflac pays you: $14,436

Aflac Serious Illness Insurance

Use our insurance for serious illness to help with the costs of treating illnesses and health incidents capable of changing your life, so that you can stay focused on your recovery.

How it works

  1. The policy holder suffers a heart attack and is transported to the hospital by ambulance.
  2. He undergoes cardiac surgery to implant a stent and is hospitalized. Then, he receives physiotherapy.
  3. Several months later, he undergoes heart valve surgery and is hospitalized.
  4. The policyholder submits his claim through Aflac SmartClaim® before 3pm and receives benefits in just one day.

Aflac Supplemental Coverage:

  • Hospital up to $2,450
  • Short-Term Disability up to $2,720
  • Critical Care & Recovery up to $9,859
  • Aflac pays you: $15,029

Aflac Life insurance

If something happened to you, would the financial future of your loved ones be protected? Help relieve your worries with coverage that you and your family can trust.

Ask at your workplace about term life insurance and permanent life insurance. These products are available only through payroll deduction. For youth life insurance, ask at your workplace or contact Aflac to apply now.

How it works

  1. Aflac $ 50,000 Life Insurance coverage is selected.
  2. The Accidental Death Benefits Clause of Aflac is selected.
  3. The insured dies due to injuries suffered in a car accident and used a seatbelt.

Payable to: Beneficiary

$112,500

How Much Does Aflac Pay for Stitches?

Aflac covers the lacerations with and without stitches. If you have taken the accidental insurance of Aflac you will be entitled to the following benefits from them.

Laceration (Treatment within 72 hours) Basic Advanced
Less than 2″ long $62.50 $125
2″ to 6″ long $250 $500
More than 6″ long $500 $1000
Lacerations not requiring stitches $31.25 $62.50
Aflac pays for the largest single laceration requiring stitches.

How much does Aflac pay for Crutches?

If you are advised by the physician to take crutches and you have taken the insurance from aflac, than they are entitled to pay $125 for the crutches. This amount is to be paid only once by the Aflac per person covered.

Aflac Sum Insured For crutches $125

How Much Does Aflac Pay for Short Term Disability?

What will you do if at some point of you life, some part of body stops functioning like your legs or arms. It will not be possible for you to maintain your monthly groceries, household bills and other monthly expenses. In this situation Aflac short term disability plan can come as a rescue option for you and your family.

Benefits will be paid for only one Disability at a time, even if the Disability is caused by more than one Sickness, more than one Injury, or a Sickness and an Injury.

Aflac will pay for short term disability as per the following table:

Aflac Short Term Disability Payout
Monthly Benefit $500–$6,000 (subject to income requirements)
Total Disability Benefit Period 3 months
Partial Disability Benefit Period 3 months
Elimination Periods (Injury/Sickness) 0/7, 0/14, 7/7, 7/14, 14/14

How short term disability works in Aflac?

  • Insurer select Aflac short term disability coverage.
  • He is injured in a covered accident.
  • The employee gets completely disabled and unable to work for next 6 weeks.
  • Aflac will pay to employee which will include benefits upto $1120.

How Much Does Aflac Pay for Chiropractic Visits?

Aflac pays $120 per visit to chiropractor. If you have developed a new condition Aflac will pay you $120 and if you have to give a revisit to chiropractor you will paid $35 for subsequent 6 visits.

Aflac Chiropractic Visits Payout
New Medical Condition $120
Next 6 Visits $35

How Much Does Aflac Pay for Blood Work?

Aflac will pay $200 when a insured person requires to receive blood/plasma and/or platelets for his treatment of the injuries which he has suffered during the accident which is covered by Aflac. Though this insurance does not cover the cost for immunoglobulins. Benefit for this policy is payable only once per covered accident, per individual.

Aflac Pay for Blood Work
Receive Blood Plasma/Platelets $200

How Much Does Aflac Pay for a Torn Rotator Cuff?

Aflac pay $625 for the treatment of torn rotator cuffs which requires a surgical procedure. The treatment should be done within a year of the accident which has been insured through Aflac accidental policy.

Aflac Pay for Torn Rotator Cuff
Torn Rotator Cuff Treatment Aflac $625

Does Aflac Covers Hysterectomy?

Hysterectomy is a surgical procedure by which the uterus of a woman is removed. This surgical procedure can also include removing of ovaries, fallopian tubes and cervix etc. The Aflac insurance covers this procedure under it’s “Hospital Confinement Sickness Indemnity Limited Benefit Policy”. You will receive the monetary benefits from Aflac per 24 hours of the surgery even if it requires more than one surgical operation. You are entitled to highest eligible benefit under the policy.

How Much Does Aflac Pay for Hysterectomy?

For the surgical operations related to hysterectomy, the Aflac policy pays you $400 and $450 respectively depending upon the procedure if it’s partial or vaginal.

Aflac Pay for Hysterectomy
Partial Hysterectomy $400
Vaginal Hysterectomy $450

Does Aflac Accident Cover Broken Tooth?

The accident policy of Aflac covers the broken tooth treatment in its policy. You will be given the money for the treatment of broken tooth repaired with crown which will provide you the benefit of $400 and if the tooth is broken and need extraction, aflac will provide you $130.

Emergency dental work does not include the services including dentures,veneers,bridges, partials, crowns, implants or crowns. The personal will receive benefit of dental procedures only once per accident.

Aflac Accident Cover for Broken Tooth
Broken tooth with Crown $400
Extraction of broken Tooth $130

Does Aflac Pay for Anesthesia?

Anesthesia is required during surgical operations. The surgical procedure can be of any part of the body. This benefit comes under hospital confinement policy. If there surgical procedure or invasive diagnostic exam requires anesthesia you will be paid $300 under this policy cover.

Aflac Pay For Anesthesia
Surgical Procedure with Anesthesia $300
Diagnostic Exam with Anesthesia $300

Does Aflac Work With Medicaid?

Aflac does not pay for the expenses that are covered by medicaid. Though Aflac pays for the expenses which are not covered by medicaid and that are directly paid to the insurer. For instance, if you are admitted in the hospital, medicaid will pay your hospital bills but Aflac will pay you each day for other expenses such as rent. Therefore we can say that Aflac and medicaid dont work together. They have their own benefits and that’s why Aflac is known as supplemental insurance in addition to your general medical insurance.

Does Aflac Offer Health Insurance?

Yes, the Aflac offers health insurance. There are different types of health policies that are being offered American Family Life Assurance Company (AFLAC) which came into existence on Nov 17, 1955. Aflac is one of the fortune 500 companies and listed in New York Stock Exchange (NSE).

Health insurance policies that are being provided by Aflac are:

  • Hospital intensive care – It will pay for the stay of the patient in an intensive care unit (ICU)of the hospitals.
  • Hospital confinement sickness indemnity – It covers the benefits related to doctors visit, surgery, diagnostics and hospitalization of the policyholder.
  • Hospital confinement indemnity – This plan will cover the daily cost a policyholder will incur when he has to spend more than 24 hours in the hospital.
  • Cancer / specified disease – The benefit covers treatment , chemotherapy, hospital stays during the treatment of this deadly disease.

Does Aflac Pay For Back Injuries?

Yes, the Aflac covers every injury which is occured during accidents. Back injuries are certain to happen during an accident and the patient may require things like a wheelchair, body jacket, body brace, walking boot which are covered as follows:

Aflac Pay for Medical Equipments in Back Injuries
Wheelchair $300
Body Jacket $300
Walker $100
Knee Scooter $300
Leg Braces $125
Crutches $100
Walking Boot $100

Aflac Accident Insurance Payout

You never know what is going to happen next second. So better be prepared to endure the forthcoming circumstances. While we are on the road we don’t know when we will face any accident. That’s when we get the advantage of Aflac group accident cover. This policy also covers your family if they are involved in the accident. You and your family members will also get the insurance benefits of this policy from Aflac. Here is the detail of Aflac group accident insurance plan.

Accident Emergency Treatment Benefit Aflac will pay $120 for the insured and the spouse, and $70 for children if a covered person receives treatment for injuries sustained in a covered accident. This benefit is payable once per 24-hour period and only once per covered accident, per covered person.

How Aflac Group Accident Plan Works?

  • You have selected Aflac High Group plan.
  • You met with an accident and injured leg and you are taken to hospital with the help of an ambulance.
  • You are diagnosed and there is a fracture in your leg.
  • Doctor treats you for the fracture.
  • You are on the crutches when you leave the hospital
  • Aflac plan will pay you $3050

Now we will demonstrate through table what will be the expenses covered with Aflac Group Accident Payout. Here are the benefits and aflac group accident claim payouts for various injuries and hospitalization charges.

Aflac Rates Sheet 2020

Hospital Benefits Member Spouse Child
Hospital Admission $10000 $1000 $1000
Hospital Confinement $200 $200 $200
Hospital Intensive Care (Per Day) $400 $400 $400
Medical Fees (for each accident) $125 $125 $75
Paralysis (Quadriplegia/Paraplegia) $10000/$5000 $10000/$5000 $10000/$5000

Accidental Death and Dismemberment (90 Days)

Accidental Death and Dismemberment (90 Days) Member Spouse Child
Accidental Death $50000 $10000 $5000
Accidental Common Carrier Death (Plain, Train,Boat or Ship) $100000 $50000 $15000
Single Dismemberment $6250 $2500 $1250
Double Dismemberment $1250 $500 $250
Loss of one or more finger or toes $10000/$5000 $10000/$5000 $10000/$5000
Partial Amputation of Finger or toes $100 $100 $100

Major Injuries Covered by Aflac

Fractures (Closed Reduction) Member Spouse/Child
Hip/Thigh $4500 $4000
Vertebrae (except processes) $4050 $3600
Pelvis $3600 $3200
Skull(depressed) $3375 $3000
Leg $2700 $2400
Forearm/Hand/Wrist $2250 $2000
Foot/Ankle/Knee Cap $2250 $2000
Lower Jaw (mandible) $1800 $1600
Skull (Simple) $1575 $1400
Shoulder Blade/Collar Bone $1800 $1600
Upper Arm / Upper Jaw $1575 $1400
Facial Bones (except teeth) $1350 $1200
Vertebral Processes $900 $800
Coccyx / Rib / Finger / Toe $360 $320
Dislocations Member Spouse/Child
Hip $3600 $2700
Knee $2600 $1950
Shoulder $2000 $1500
Foot / Ankle $1600 $1200
Hand $1400 $1050
Lower Jaw $1200 $900
Wrist $1000 $750
Elbow $800 $600
Finger/Toe $320 $240

Aflac Group Accident Insurance is it worth it?

As we have seen aflac group accident insurance plan covers all the family members, so it ensures the safety of the family and also prevents from large bills which are generated when you are being treated in the hospitals. So it’s recommended that one should take aflac group accident insurance 2019 for the well being of the family and be secured if some mishappenings occurs in the future.

14 thoughts on “What Does Aflac Cover?”

  1. I can say all my experience with Aflac has been great. It takes time especially when you have to get paperwork but I was on bedrest and 25 weeks pregnant. Now 28 weeks still on bedrest but I used my policy and they paid for every day I don’t work in 2 month inquires. It’s now Oct but I’m due in Jan but have a short cervix so best wishes. It took them 2 weeks to process and get paid 2 days direct deposit.

  2. I have finally sat down to submit for reimbursement on my Aflac policies. Aflac is extremely quick in issuing payments. For some claims, they added on benefits I did not know I was entitled to. Very happy with coverage and payments.

  3. Aflac is a reliable, honest company. My mom had Aflac for over two decades prior to me enrolling through my work 7 years ago. It helped her through some really tough times when we were younger, and has helped me significantly the past few years. They pay claims quickly and effectively communicate about any missing documentation for a claim.

  4. My husband and I have had three policies with AFLAC through my work for over 7 years. During that time, we’ve had occasion to file claims under each of the policies (cancer, specified event and accident). We have had nothing but great experiences with AFLAC – very responsive and quick to pay. Also, my AFLAC agent is great, very helpful. I would recommend AFLAC to anyone.

  5. I have been an AFLAC policyholder 8 years. I have about five different plans with AFLAC. I enrolled in these plans because I am on the road a lot and want to have an extra protection. I am very grateful that I have never had to use my AFLAC for serious things. However, I have used my plans for everyday things that can happen like falling on my knee, wellness, and even having a tooth injury. The claims process is as simple as using Aflac’s app. I highly recommend AFLAC!

  6. Aflac itself has unique insurance products. They pay cash to policy holders when you get sick or hurt. Each plan covers different things. Cancer plans cover cancer, accident plans cover accidents, etc. Aflac pays me quickly for claims, which I really appreciate that they are not like most insurance companies that take forever to process claims.

  7. My Husband fell 2 weeks after our Aflac went in effect. They have paid everything the say in a day after I send in the paperwork. I recommend it to anyone.

  8. Very upset aflac Puerto Rico service, I call they do not answer the phone I went personally and there was no technician available, he would attend to me from the office he contacted my representative I was to go to my work and it has been 4 months and he has not even called me I have 2 colleagues already given Low service in lousy Ponce PR I’m still trying to talk to a supervisor. I have been with aflac for 28 years and it is the first time that I have been assigned to such a busy superstore that she does not have time to help resolve policy issues. If I don’t get it this month, I canceled and I have 4 policies with aflac.

  9. I have been with Aflac for 4 years and when I got it, they told me that it covered on and off work and it turns out that they did not come out with that it only covers accidents outside of work?

  10. I have been trying for several days to communicate with the lady who attends me at AFLAC, the same one who made me my insurance policy, and there is no way for her to answer me.
    I have left him voice messages, I have sent him emails AND NOTHING, there is no way !!!
    If this is the attention, then from this moment I begin to PUBLISH my experience on all social networks and let SEE THE TRUTH about this company.
    In some calls, the little sign “CALL WAITING” appears, so the lady IS USING HER PHONE AND YES SHE IS SEEING THAT I AM CALLING HER.
    DOES NOT ANSWER BECAUSE IT DOESN’T GIVE YOU THE WIN … OR BECAUSE FOR SOME REASON IT DOESN’T SUIT YOU.

  11. I will NEVER use Aflac again!!! I’ve been off 4 weeks and have spent time and money running around getting documents filled out then emailed in. They tell me they never received any paperwork. I resent it to the agent and she uploaded it into their system herself. I’ve been hearing 24 to 48 hours for review process to be completed. Then I’d be paid but a week and still nothing.

  12. This company could care less about the people they hire. They collect all your licensing fees up front, no training, i know i trained several people myself to help them to try and make a living with aflac.

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