Aflac account claim form 2026

1. Click ‘Get Form’ to open the aflac account claim form in the editor.
2. Begin by filling out the Participant Information section. Enter your name, Social Security Number, and address if it has changed. Provide your employer's name and a daytime contact method (email and phone). Don’t forget to sign and date this section.
3. Move on to the Dependent Care section. List each dependent care expense separately, including their name, age, provider's name, date of service provided, and requested amount. If you don’t have a receipt, use the provider certification space.
4. Next, complete the Unreimbursed Medical section similarly. Document each medical expense with patient name, provider name, description of service, date provided, and requested amount. Again, use the certification space if needed.
5. Review the Terms and Conditions carefully before submitting your completed form. Ensure all fields are filled accurately to avoid delays in processing.
6. Finally, submit your completed form via fax or mail as instructed at the end of the document.

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