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Reimbursement Request

CIGNA HealthCare members: Get your plan's reimbursement forms. Log in to myCIGNA.com, or register today for access to the forms in three business days.

Please select a form:


Health Care Reimbursement Account

Before submitting a Health Care Reimbursement request, please be sure to read about eligible and ineligible health care expenses.

Please enter your Reimbursement Account (Flexible Spending Account) number:

Your account number appears on your statement, explanation of benefits (EOB) or check issued by your FSA. If you still can't find your account number, contact your Employer's Human Resources or Benefit Manager for assistance.

 

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Dependent Day Care Account

Before submitting a Dependent Day Care Reimbursement request, please be sure to read about eligible and ineligible day care expenses.

Please enter your Reimbursement Account (Flexible Spending Account) number:

Your account number appears on your statement, explanation of benefits (EOB) or check issued by your FSA. If you still can't find your account number, contact your Employer's Human Resources or Benefit Manager for assistance.

 

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