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Health Care 101

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Last updated date: 7/18/2024

Overview

To help you take care of your and your family’s health, we’ve created the following guide to health care. It includes important information and helpful tips designed to make health care easier to understand and use.

Explore this page to become more knowledgeable about the health care experience and be better equipped to make the most of your Citi benefits.

The content below walks you through a few basics you should know, including:

Got a Question? Call Your Citi Health Concierge

When in doubt, start with your Citi Health Concierge as your first call. Your Citi Health Concierge can provide personalized health care support and guide you to the right resources when you need them, so you get the most out of your Citi benefits.

Your Citi Health Concierge is there to help with:

  • Estimating medical costs, finding a doctor or getting a new medical ID card
  • Offering guidance and support if you’re diagnosed with a new medical condition
  • Providing assistance if you’re overwhelmed and need help finding resources

Call your Citi Health Concierge when you need health care help:

  • Aetna members – Call 1 (800) 545-5862 | 8 a.m. to 11 p.m., ET, Monday – Friday | 8 a.m. to 4:30 p.m., ET, Saturday
  • Anthem members – Call 1 (855) 593-8123 | 8:30 a.m. to 8 p.m., ET, Monday – Friday
  • All Citi employees and family members – Call Health Advocate for general health care support and research: 1 (866) 449-9933 | 8 a.m. to 9 p.m., ET, Monday – Friday

Preventive Care

Under all Citi medical plans, in-network preventive care is free — so you have coverage that protects both your wallet and your long-term health. When you get preventive care, you take proactive measures to monitor your health status, prevent illness and identify health risks early to address conditions before they become more serious. Preventive care may include:

  • Routine check-ups
  • Vaccinations
  • Health screenings, such as blood pressure checks, cholesterol tests, depression screenings
  • Cancer screenings, such as mammograms, colonoscopies, prostate exams, and Pap smears*
  • Dental check-ups**

A primary-care provider (PCP) is your go-to resource for coordinating your preventive care. They’ll ensure you get the right screenings and vaccinations at the right time. It’s also important to build a trusting relationship with your PCP so you have someone to turn to when you have questions about your health. In addition to providing medical care, your PCP can direct you to resources and specialists to meet your needs, address your health goals and fit your lifestyle and preferences.

*Coverage for specific cancer screenings will depend on your age and other risk factors. Your PCP will let you know which preventive screenings you should get.

**Not covered under a Citi medical plan. Preventive dental care is covered in full under Citi’s dental plans.

Preventive Care Is Good for You and Your Wallet

Did you know that according to the CDC, chronic diseases (including diabetes, heart disease and cancer) are the leading cause of death and disability in America? Regular preventive care, such as cancer screenings or dental cleanings, can catch signs of disease early, allowing you to start treatment sooner or change habits to avoid the onset of more serious and costly illness. Not only is preventive care free to you through your Citi medical plan’s in-network coverage, but the Live Well at Citi Program offers you Pulse Points for completing preventive care-related actions, making it an all-around smart choice for your physical and financial health.

Preventive Care vs. Diagnostic Care: What’s the Difference?

While preventive care aims to keep you healthy and prevent illness, diagnostic care is focused on identifying and addressing existing health concerns and symptoms. Both types of care are crucial for maintaining optimal health: preventive care helps you stay ahead of potential health problems, and diagnostic care allows for timely diagnosis and treatment when issues arise. Keep in mind, that while in-network preventive care is covered in full by your Citi medical plan, diagnostic care will be billed according to your plan coverage.

If you receive diagnostic care during a preventive care visit, you will be billed for the cost of the diagnostic care according to your plan design. Be sure to ask your doctor about the cost of any care provided during your preventive care visit to ensure you do not receive any surprise charges. Things like evaluating a health care problem or getting tests related to symptoms you’re having usually fall outside of the definition of preventive care.

Prevention Is More than a Doctor’s Visit

Taking care of your health and well-being extends beyond your doctor’s office — it also includes following through on healthy habits and nourishing your whole well-being. Activities like regular exercise, getting quality sleep, and eating a balanced diet are proven methods to ensuring your long-term health. Check out the Live Well at Citi Program for resources designed to help you enhance your overall well-being.

Preventive Care in Action

Check out some real-life stories below to understand how different activities fall under preventive care:

Vaccinations

With children in day care, getting sick is just status quo for Remy. To help everyone stay healthy, Remy’s entire family gets the annual flu and COVID-19 vaccines.

Vaccinations

Health Screenings

In preparation for starting a family, Ariel is focused on maintaining good health and schedules cholesterol, blood pressure and other screenings.

Health Screenings

Routine Check-ups

Jordan knows that a PCP is there for ongoing health help. After starting a new medication, Jordan sets up a recurring PCP appointment to track results and side effects.

Routine Check-ups

Cancer Screenings

With a family history of colon cancer, Robbie may have a genetic predisposition to cancer. As a result, Robbie receives a colonoscopy as recommended every few years.

Cancer Screenings

Where to Go for Care

Your primary care provider (PCP) forms the foundation of your medical care and is the best place to start when you have a health concern. They’re your go-to resource when you’re feeling unwell or just have a question. Of course, if you’re experiencing an emergency, dial 911 or go to the nearest emergency room.

How to Find a PCP

There are two ways to find a primary doctor:

  • Contact your medical plan carrier by calling the number on your ID card or logging into your medical plan website – Both Aetna and Anthem have access to doctor profiles, credentials, certifications and quality ratings to help you choose the right in-network doctor.
  • Contact Health Advocate or Included Health – Both of these free services work with top doctors and specialists across the country. A representative from Health Advocate or Included Health can identify the highest quality physicians for your unique needs.

To prepare for your visit with your primary doctor:

  • List the things you want to discuss (symptoms, dietary habits, health history, family background or other questions).
  • Prepare a list of your medications, allergies and other doctors you see.
  • Bring your medical ID card.
  • Ask your doctor to submit your lab work to an in-network Aetna or Anthem lab.
  • Create a list of common questions you can ask your doctor whether you’re getting a checkup, talking about a problem or health condition, getting a prescription or discussing a medical test or surgery.

Find the Best Option for Your Needs

If you can’t see a PCP and your medical issue isn’t an emergency, consider one of the following care options if you’re enrolled in an Aetna or Anthem medical plan through Citi:

Telehealth MinuteClinic / HealthHUB Urgent Care Clinic Live Well at Citi Onsite Clinics / Telehealth
Use it
When you want the convenience of at-home or on-the-go care and have a non-emergency medical issue that can be diagnosed by phone or online video visit When you want free,* convenient medical care to treat a minor illness, monitor a chronic condition or administer a routine vaccination When you have an injury or illness that needs immediate care but is not life- or limb-threatening On-site Clinic: When you have minor health care needs that don’t require immediate medical attention

Premise Telehealth: When you have a minor illness that can be diagnosed by phone or online video visit
Examples
  • Colds and allergies, flu/cough
  • Fever, ear infections, pink eye
  • Rashes
  • Headaches
  • Mental health care
  • Sore throat, fever
  • Eye infection
  • Vaccines
  • Rashes
  • Headaches
  • Injuries that may have caused a broken bone, sprain or muscle strain
  • Cut requiring stitches
  • Anxiety attack
  • Travel health
  • Preventive care screenings (such as blood pressure or cholesterol screenings)
  • Vision tests for driver’s license renewals
Cost
Low
You pay: $
Low
You pay: $0 for many services*
Moderate
You pay: $$
Low
You pay: $0 for many services*
Availability
Open 24/7 365 days a year with no appointment or long wait.

Available to all Citi employees and family members covered by a medical plan.
Open during extended hours, including evenings and weekends. Walk in or schedule an appointment online using the links below.

Available to all Citi employees and family members covered by a medical plan.
Open during extended hours, including evenings and weekends for walk-in service.

Available to all Citi employees and family members covered by a medical plan.
Open during regular business hours.

Available to Citi employees at certain locations (on-site clinics) and employees residing in certain states (telehealth) only.
Find it
Visit the Teladoc Health website (Aetna) or LiveHealth Online website (Anthem) for more information on telehealth.** Use the CVS location finder tools: Use the Anthem or Aetna provider finder. On-site Clinic: At select Citi offices

Premise Telehealth: Use the My Premise Health portal to create a login and schedule a virtual telehealth appointment at your convenience.

*Any associated lab tests and prescriptions will be covered at standard cost according to your plan’s coverage. High Deductible Plan with HSA members using MinuteClinic/HealthHUB will pay $0 for free services after meeting the plan deductible.

**If you’re an Anthem member, you must select “Anthem Blue Cross Blue Shield” from the drop-down menu and enter your member ID.

If you’re enrolled in an HMO through Citi, call the number on the back of your ID card to find out what options are available to you.

Other Kinds of Virtual Care

Terms to Know

You’ll likely come across the following commonly used terms as part of your health care experience. Understanding what they mean will help you get the most from your benefits and make smart health care choices.

Before-tax Contributions — HCSA, DCSA, LPSA and HSA

Before-tax contributions to your heath savings and spending accounts are deducted from your pay before federal taxes (and in many cases, state and local income taxes) are withheld.

Centers of Excellence (COEs)

COEs are top-rated facilities that deliver high quality medical care for complex specialties like bariatric, orthopedic, and transplant services. Depending on the medical plan you have, you may need to be treated at a COE to receive full in-network coverage for certain procedures or to receive any coverage for bariatric procedures. (This requirement doesn’t apply to the In-network Only Plan.)

Choice Plan

The Choice Plan has higher paycheck deductions than Citi’s other medical plans and a lower annual deductible than the High Deductible Plan with HSA. Once you meet your annual deductible, you and the plan share the cost of covered services through coinsurance. Both in-network and out-of-network services will apply to meeting the deductible. Like all Citi plans, 100% of the cost for recommended in-network preventive care is covered.

Coinsurance

The portion of a covered expense that you pay after satisfying the deductible. For example, if the Plan pays 80% of certain covered expenses, you will pay the remaining 20%, which is your share of the costs.

Copay

A flat fee you pay for medical care. In some cases, the deductible does not apply. For example, if you are enrolled in the In-network Only Plan and need to go to the doctor to address a health concern, you’ll pay either $25 for a primary care visit or $45 for a specialist visit. You do not need to satisfy a deductible first. When you go to the hospital for treatment with this same plan, you must first meet the medical deductible, then you pay the applicable copay for the type of treatment you need (emergency room, outpatient or inpatient care).

Covered Expenses

Covered expenses are the medical and related costs that qualify for reimbursement under your medical plan. These may also be referred to as “allowed” charges or “reasonable and customary” (R&C) costs.

CVS HealthHUB

Like a CVS MinuteClinic, CVS HealthHUB facilities offer convenient, same-day treatment options for minor conditions. In addition, HealthHUB offers expanded services, a wellness room, and access to wellness products; some HealthHUB locations staff a wider range of professionals, such as licensed therapists. Many HealthHUB services are free* under your Citi medical plan.

Use the online locator to find a HealthHUB near you.

*If you are enrolled in the High Deductible Plan with HSA, your deductible will apply before your cost becomes $0. For all medical plans, standard costs will apply for any lab tests or prescriptions ordered as part of your visit.

CVS MinuteClinic

CVS MinuteClinic facilities are available in select CVS pharmacies and offer convenient, same-day treatment options for minor conditions like ear infections, rashes, minor burns and cold or flu symptoms. Many MinuteClinic services are free* under your Citi medical plan.

Use the online locator to find a MinuteClinic near you.

*If you are enrolled in the High Deductible Plan with HSA, your deductible will apply before your cost becomes $0. For all medical plans, standard costs will apply for any lab tests or prescriptions ordered as part of your visit.

Deductible

The amount of eligible expenses you and each covered dependent must pay each calendar year before the medical plan begins to pay benefits.

Note: Prescription copays and coinsurance do not apply to the medical plan deductible for the Choice Plan and In-network Only Plan. There is a combined prescription and medical deductible for the High Deductible Plan with HSA.

Dependent

Eligible dependents include your legal spouse, your eligible children, your partner (which includes a civil union partner), and your partner’s eligible children.

Diagnostic Care

Health care provided when a condition or illness arises. Diagnostic care typically results in out-of-pocket expenses in accordance with the way your medical plan option covers benefits.

Evidence of Insurability (EOI)

Evidence of Insurability, or proof of good health, is a statement of medical history and related information which is used to determine whether you (or a dependent) will be approved for certain types of coverage, such as life insurance.

Family Coverage

If you need to cover more than just yourself, you can elect employee + spouse, employee + children or family, based on your coverage needs. Keep in mind that with the High Deductible Plan with HSA, all coverage levels other than individual are considered family coverage for the purposes of Health Savings Account (HSA) funding, HSA contribution limits, deductibles and out-of-pocket maximum.

High Deductible Plan with HSA

The High Deductible Plan with HSA has lower paycheck deductions and higher annual deductibles than Citi’s other medical plans. Once you meet your annual deductible, you and the plan share the cost of covered services through coinsurance. There are different annual deductibles for in-network and out-of-network care that accumulate separately. Like all Citi plans, 100% of the cost for recommended in-network preventive care is covered.

Health Savings Account (HSA)

An HSA is available to employees who participate in the High Deductible Plan with HSA. It is designed to be used in conjunction with the High Deductible Plan with HSA to pay for eligible health care expenses until you satisfy your deductible and thereafter, with tax-free dollars.

HSA funds can also be saved for future health care expenses. If you open an account, Citi will contribute money into your HSA each year that you are enrolled in the High Deductible Plan with HSA, even if you do not contribute to your HSA.

Health Maintenance Organization (HMO)

HMOs are only available to employees in specific locations. You must use in-network doctors and hospitals. If you do not use in-network doctors and hospitals — except in an emergency — the HMO will not cover that care. Like all Citi plans, 100% of the cost for recommended in-network preventive care is covered.

In-network

In-network doctors and hospitals have agreed to a discounted rate negotiated by the insurer. If you enroll in the Choice Plan or High Deductible Plan with HSA, this means you can typically save money by using in-network services. If you enroll in the In-network Only Plan or an HMO, you must stay in-network or your medical care won’t be covered, except in an emergency.

The easiest way to find in-network doctors in the plan in which you’re currently enrolled is to log in to your online Aetna or Anthem and use the provider search feature.

In-network Only Plan

The In-network Only Plan provides coverage only when you receive care from a smaller network of doctors and hospitals who consistently deliver high-quality care at lower costs. If you do not use doctors and hospitals in the smaller network — except in an emergency — the cost of your care will not be covered.

The plan has a lower annual deductible than Citi’s other medical plans. The deductible only applies for some services, such as care provided at a hospital. For doctor visits and prescriptions, you’ll pay a flat copay. Like all Citi plans, 100% of the cost for recommended in-network preventive care is covered.

Out-of-network

Out-of-network doctors and hospitals are not part of the insurer network. If you enroll in the Choice Plan or High Deductible Plan with HSA, this means you’ll typically pay higher costs for care (deductible, coinsurance, and amounts billed over the allowed amount). When you see an out-of-network doctor, you’re responsible for filing a claim for reimbursement. If you enroll in the In-network Only Plan or an HMO, the cost of care you receive from out-of-network doctors or hospitals won’t be covered, except in an emergency.

Out-of-pocket Maximum

The out-of-pocket maximum is the maximum amount you’ll pay in the plan year for eligible expenses—including copays, deductibles, and coinsurance—for yourself and your covered dependents. Once you meet your out-of-pocket maximum, the medical plan pays 100% for in-network services.

Note: Prescription copays and coinsurance do not apply to the medical plan out-of-pocket maximum for the Choice Plan and In-network Only Plan. There is a combined prescription and medical out-of-pocket maximum for the High Deductible Plan with HSA.

Paycheck Deductions

The amount you pay for plan coverage out of your paycheck.

Preventive Care

In-network preventive care is covered free of charge regardless of which plan you choose. Preventive care services include routine physical exams and diagnostic tests, immunizations, well-child and well-woman exams.

Primary Care Provider (PCP)

A health care practitioner who serves as your first point of contact when you need health care and can help coordinate your preventive, diagnostic and medical care.

Spending Accounts

Spending accounts allow you to pay for certain health care, dependent day care, transportation, and parking expenses with before-tax payroll contributions.

Telehealth

Telehealth is a convenient virtual health care option available through your Citi medical plan. Doctors are available anytime, with no appointments or long waits. During your video visit, the doctor will assess your condition, provide a treatment plan, and send prescriptions to the pharmacy of your choice, if needed. Telehealth services are available any time of day or night, 365 days a year.