Health Care 101

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

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.

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.

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.

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.)

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.

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.

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 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.

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 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.

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.

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

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, 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.

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.

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.

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.

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 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.

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 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.

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.

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

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.

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

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.