Vision Insurance

¹ The above example is based on a scenario for an Aflac vision plan in Nebraska (domicile state), plan option 2, that includes the following benefit conditions: eye exam benefit of $45, and $175 vision correction benefit for new glasses. This example is for illustrative purposes only.

The plans advertised herein offer supplemental insurance coverage and are not major medical insurance plans.

This is a brief product overview only. Coverage may not be available in all states including. Benefits/premium rates may vary based on plan selected. Optional riders are available at an additional cost. Policies and riders have limitations and exclusions that may affect benefits payable. Refer to the policy and rider forms for complete details, limitations, and exclusions. For costs and complete details of the coverage, please contact your local Aflac agent.

Coverage is underwritten by American Family Life Assurance Company of Columbus. In New York, coverage is underwritten by American Family Life Assurance Company of New York.

Aflac Supplemental Vision – VSN100 series:
In Arkansas, Policy VSN100AR. In Delaware, Policy VSN100. In Idaho, Policy VSN100ID. In New York, Policy NYVSN100. In Oklahoma, Policy VSN100OKR. In Oregon, Policy VSN100OR. In Pennsylvania, Policy VSN100PA. In Texas, Policy VSN100TX. In Virginia, Policy VSN100VA.

Limitations and Exclusions for residents of Arizona
The policy does not cover losses caused by or resulting from:

1. Services that are not recommended by an Optometrist, Ophthalmologist, or a Physician.
2. Cosmetic surgery that is not due to eye disease, disorder, or Injury.
3. Treatment or diagnosis received while outside the territorial limits of the United States or, if outside the United States, the territorial limits of the place where your policy was issued.
4. Intentionally self-inflicting bodily Injury or attempting suicide, while sane or insane.

If you change your Vision Correction Benefit option, this benefit will be subject to a new waiting period, if any, beginning with the Effective Date of the new option. YOU ARE ELIGIBLE TO CHANGE YOUR VISION CORRECTION BENEFIT OPTION ONLY ONCE EACH YEAR, WITH THE CHANGE TO BE EFFECTIVE ON YOUR NEXT POLICY ANNIVERSARY DATE.

PRE-EXISTING CONDITION LIMITATIONS: A pre-existing condition is a disease or disorder for which, within the 12-month period before the effective date of coverage, medical advice, consultation, or treatment was recommended or received, or for which symptoms existed that would ordinarily cause a prudent person to seek diagnosis, care, or treatment. Care or treatment caused by a pre-existing condition will not be covered unless it begins more than 12 months after the effective date of coverage. The pre-existing conditions provision does not apply to the Eye Examination Benefit or to the Vision Correction Benefit.

Limitations and Exclusions for residents of Idaho
This policy does not cover losses caused by or resulting from:

1. Services that are not recommended by an Optometrist, Ophthalmologist, or a Physician.
2. Cosmetic surgery that is not due to eye disease, disorder, or Injury, except that “cosmetic surgery” shall not include reconstructive surgery when the service is incidental to or follows surgery resulting from trauma, infection or other diseases of the involved part, and reconstructive surgery because congenital disease or anomaly of a covered dependent child.
3. Treatment or diagnosis received while outside the territorial limits of the United States or, if outside the United States, the territorial limits of the place where your policy was issued.
4. Intentionally self-inflicting bodily Injury or attempting suicide, while sane or insane.

If you change your Vision Correction Benefit option, this benefit will be subject to a new waiting period, if any, beginning with the Effective Date of the new option. YOU ARE ELIGIBLE TO CHANGE YOUR VISION CORRECTION BENEFIT OPTION ONLY ONCE EACH YEAR, WITH THE CHANGE TO BE EFFECTIVE ON YOUR NEXT POLICY ANNIVERSARY DATE.

PRE-EXISTING CONDITIONS: A pre-existing condition is a disease or disorder for which, within the six-month period before the effective date of coverage, medical advice, consultation, or treatment was recommended or received. Care or treatment caused by a pre-existing condition will not be covered unless it begins more than 12 months after the effective date of coverage. The pre-existing conditions provision does not apply to the Eye Examination Benefit or to the Vision Correction Benefit.

Limitations and Exclusions for residents of New Jersey
This policy contains a 30-day waiting period. If a covered person has an eye disease or disorder, other than one caused by an Injury, diagnosed before coverage has been in force 30 days from the Effective Date of coverage shown in the Policy Schedule, benefits for treatment of that eye disease or disorder will apply only to treatment occurring after 30 days from the Effective Date of the policy. The 30-day waiting period does not apply to the Eye Examination Benefit or the Vision Correction Benefit.

This policy does not cover losses caused by or resulting from:

1. Services that are not recommended by an Optometrist, Ophthalmologist, or a Physician.
2. Cosmetic surgery that is not due to eye disease, disorder, or Injury.
3. Treatment or diagnosis received while outside the territorial limits of the United States or, if outside the United States, the territorial limits of the place where your policy was issued.
4. Intentionally self-inflicting bodily Injury or attempting suicide, while sane or insane.

PRE-EXISTING CONDITION LIMITATION: A pre-existing condition is a disease or disorder for which, within the 12-month period before the effective date of coverage, medical advice or treatment was recommended by a physician or received from a physician, or for which symptoms existed that would ordinarily cause a prudent person to seek diagnosis, care, or treatment. Care or treatment caused by a pre-existing condition will not be covered unless it begins more than 12 months after the effective date of coverage. The pre-existing condition limitation provision does not apply to the Eye Examination Benefit or to the Vision Correction Benefit.

Limitations and Exclusions for residents of Virginia
The policy contains a 30-day waiting period. If a covered person has an eye disease or disorder, other than one caused by an Injury, diagnosed before coverage has been in force 30 days from the Effective Date of coverage shown in the Policy Schedule, benefits for treatment of that eye disease or disorder will apply only to treatment occurring after 30 days from the Effective Date of the policy or, at your option, you may elect to void the policy from its beginning and receive a full refund of premium. The 30-day waiting period does not apply to the Eye Examination Benefit or the Vision Correction Benefit.

The policy does not cover losses caused by or resulting from:

1. Services that are not recommended by an Optometrist, Ophthalmologist, or a Physician.
2. Cosmetic surgery that is not due to eye disease, disorder, or Injury.
3. Treatment or diagnosis received while outside the territorial limits of the United States or, if outside the United States, the territorial limits of the place where the policy was issued.
4. Intentionally self-inflicting bodily Injury or attempting suicide, while sane or insane.

If you change your Vision Correction Benefit option, this benefit will be subject to a new waiting period, if any, beginning with the Effective Date of the new option. YOU ARE ELIGIBLE TO CHANGE YOUR VISION CORRECTION BENEFIT OPTION ONLY ONCE EACH YEAR, WITH THE CHANGE TO BE EFFECTIVE ON THE NEXT POLICY ANNIVERSARY DATE.

PRE-EXISTING CONDITIONS LIMITATION: A pre-existing condition is a disease or disorder for which, within the 12-month period before the effective date of coverage, medical advice, consultation, or treatment was recommended or received, or for which symptoms existed that would ordinarily cause a prudent person to seek diagnosis, care, or treatment. Care or treatment caused by a pre-existing condition will not be covered unless it begins 12 months or more after the effective date of coverage. The preexisting conditions provision does not apply to the Eye Examination Benefit or to the Vision Correction Benefit.

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