• How To File
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  • Submitting Claim Forms

Home Health Care/Adult Day-Care Claims

To file a health care claim, please complete the appropriate claim form and following the guidelines below:

  • Complete Part 1 and sign the Authorization to Release Information (Form H-C0020).
  • Have the attending physician complete Part 2.
  • Have the home health care/adult day-care provider complete Part 3 and attach an itemized bill showing the dates, types of services, and charges incurred.
  • Include an authorization signed and dated by the patient with every claim.

Home Health Care & Adult Day Care Insurance Claims | Aflac Insurance