Does it come with a pillow case? If not what kind of pillow case fits the pillow?

No, it is only a body pillow insert. You can buy a 20x54 Inch new pillow cover on AMAZON

Do you think it will fit a pillow case 20x40?

The 20x40 is going to be a little short. This pillow is a true size of 20x52

No clue, I just buy the generic pillow cases from target and they fit.

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