WINFertility
If you enroll in an Anthem medical plan, you have access to a variety of support services around all aspects of fertility treatment through WINFertility.
WINFertility is an industry leader in fertility management services whose foundation is built on value and delivering the highest quality fertility care. Through the program, you will have 24/7 access to WIN's Nurse Care Manager who can help you learn:
- About the types of drugs used for infertility treatment
- About the side effects, storage and proper usage of your fertility drugs
- How to select a provider
- How to find a high-risk maternity group and health plan programs to join
- How to access Anthem's National Network of Reproductive Endocrinologists
WINFertility also provides 24/7 access to Nurse Care Managers who can answer your questions, help you find providers and listen to your concerns while you are trying to get pregnant and provide assistance with managing your prescription drugs for fertility treatment. For more information call 1 (833) 204-2713.
Aetna’s Infertility Unit
If you enroll in an Aetna medical plan, you have access to a variety of resources through Aetna’s Infertility Unit for questions that come up through the fertility process. Your Citi Health Concierge can also provide personalized support and guide you to the right resources when you need them. You can contact your Citi Health Concierge by calling the phone number on your medical ID card.
Fertility Benefits Coverage
These benefits are available to employees enrolled in one of Citi's national medical plans through Aetna and Anthem. Also, please note that you must call your Citi Health Concierge and indicate that you need to pre-certify for fertility treatment.
Eligibility
The Plan provides fertility care services regardless of a fertility diagnosis. Fertility care services are available to enrolled employees, covered spouse/partners and covered dependent children regardless of sex, sexual orientation, gender, gender identity or expression.
Covered Services
Basic infertility expenses include:
- Covered expenses, such as charges made by a physician to diagnose and to surgically treat the underlying medical cause of infertility
- These expenses do not count toward the medical lifetime maximum
Comprehensive infertility services benefits:
- Ovulation induction
- Intrauterine insemination
Advanced reproductive technology (ART) benefits:
- In vitro fertilization (IVF) cycles, including freeze-all cycle (fertilization and culture of embryo)
- Reciprocal IVF cycles
- Intrauterine embryo lavage
- Embryo transfer
- Elective single embryo transfer
- Artificial insemination
- Gamete intrafallopian tube transfer (GIFT)
- Zygote intrafallopian tube transfer (ZIFT)
- Low tubal ovum transfer
- Assisted hatching
- Pre-implantation genetic diagnosis (PGD) and screening (PGS), when it is medically necessary
- Evaluation by a reproductive endocrinologist or infertility specialist, drug therapy and intracytoplasmic sperm injection (ICSI)
- Cryopreserved embryo transfers
- Oocyte (Egg) thaw cycles
- ART services for procedures that are covered expenses including charges associated with storage and procurement of partner's sperm for ART and Testis Biopsy, when the partner is also covered under the Plan
- Sperm sourcing includes specialized sperm retrieval techniques including vasal sperm aspiration, microsurgical epididymal sperm aspiration (MESA), percutaneous epididymal sperm aspiration (PESA), electroejaculation, testicular sperm aspiration (TESA), microsurgical testicular sperm extraction (TESE), seminal vesicle sperm aspiration and sperm recovery from bladder or urine for retrograde ejaculation are considered medically necessary to overcome anejaculation or azoospermia
Cryopreservation
In addition to covering cryopreservation (freezing of eggs or sperm) when medically necessary, Citi has expanded egg freezing to be available for members who choose to have this procedure done electively. For more information and eligibility, please contact your Citi Health Concierge.
Lifetime Fertility Maximum
The lifetime fertility maximum per individual is:
- $24,000 for medical services
- $7,500 for prescription drug costs
The following counts toward the lifetime fertility maximum:
- Only expenses for elective cryopreservation, comprehensive fertility services, and advanced reproductive technology count toward the medical lifetime maximum.
- Expenses for diagnosis and treatment of any underlying medical conditions do not count toward the medical or prescription drug lifetime maximum.
- Prescription drug expenses associated with infertility treatment and elective cryopreservation are covered up to the prescription drug lifetime maximum.
Additional Family Planning Benefit
If you’re considering adoption or surrogacy, Citi provides financial support through the Adoption and Surrogacy Assistance Program. Through this program, Citi reimburses up to a lifetime maximum of $30,000 per family to help with eligible expenses.