Pharmacy Ledger

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In order to take advantage of the Prescription Benefit under the Group Accident or Group Hospital plan you will need to provide a Pharmacy Ledger with your claim form to AFLAC Headquarters. 

There are two ways to obtain the required documentation: (Example pictures below)

  • Keep the "White Paper" slip that comes attached to your prescription at pickup
  • Ask your pharmacist for a Pharmacy Ledger print out

To know you have the correct documentation it should state:

  • Doctor/Provider Name 
  • Name of person receiving prescription (This has been removed from the example docs)
  • Prescription Fill Date
  • Prescription Name
  • Prescription Quantity

**Note: A payment receipt will not be sufficient as they do not list the information required by AFLAC

*Note: Prescription Benefit is for Group Accident plans enrolled in, on or after, 8/1/2019

Please refer to the Group Accident and the Group Hospital brochure for more details or speak to an SDPEBA representative to discuss your plan by emailing claims@sdpeba.org or calling (888) 315.8027 

 

"White Paper" slip (Example)

White_Paper_Slip__Example_.png

Pharmacy Ledger (Example)

Pharmacy_Ledger__Example_.png

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