In-network Only Plan
Offers coverage from a select network of doctors and hospitals in certain locations that deliver high-quality care at lower costs, and is priced in between the other plans.
Your needs are unique to you, so Citi provides you with different medical options from which to choose. Each plan offers comprehensive benefits to help you and your family stay healthy throughout the year.
Depending on your location, you may be able to choose from the following medical options:
Choice Plan
Offers coverage with higher paycheck deductions, a lower deductible and the flexibility to choose any doctor or hospital when you need care, though you’ll pay less when you stay in-network.
High Deductible Plan with HSA
Offers coverage with the lowest paycheck deductions, highest deductible and access to a Health Savings Account (HSA) that Citi contributes to, giving you long-term saving and investment opportunities.
Health Maintenance Organizations (HMOs)
Available to employees in specific locations, offers coverage only when using in-network providers.
With the In-network Only Plan, administered by Aetna and Anthem, you’re covered only when you receive care from a smaller network of doctors and hospitals who consistently deliver high-quality care at lower costs. These smaller networks — the Aetna Premier Care Plus Network (APCN+) and Anthem’s National Blue High Performance Network (Blue HPN Non-Tiered) — are subsets of the broader Aetna and Anthem networks available through the Choice Plan and the High Deductible Plan with HSA.
You pay a flat copay for most health care, which keeps your costs more predictable. There’s a deductible to meet for some services, like when you need care at a hospital, but it’s lower than in Citi’s other plans. The deductible doesn’t apply to most care received outside a hospital, including doctor’s office visits, urgent care, physical therapy and much more.
How to Check the Networks
- To check the Aetna network, use the customized doc finder tool:
- Enter your home ZIP code in the 2022 Provider Search box, then click “Start Your Search.” This automatically brings you to the APCN+ network directory.
- Enter your ZIP code again and continue as a guest to search for in-network doctors.
- To check the Anthem network, use the Find Care tool:
- Select the “Guests” tile then choose “Medical” for the type of care.
- Choose the state you want to search in.
- Select “Medical (Employer-Sponsored)” for type of plan.
- Select “National Blue High Performance Network (Blue HPN Non-Tiered)” for the plan/network.
- Click the “Continue” button and enter your ZIP code on the next screen to begin your search.
- You can also learn more about this Anthem network by watching a video, taking an interactive quiz and reading information online.
- For personalized assistance, call your Citi Health Concierge:
- Aetna members:
1 (800) 545-5862 - Anthem members:
1 (855) 593-8123
- Aetna members:
- Or, call your doctor’s office.
Here’s an overview of the In-network Only Plan's key features, which are the same whether you’re enrolled through Aetna or Anthem.
| Features | In-network Only |
|---|---|
| Preventive Care | 100% covered, no copay or deductible |
| Medical Care | Primary care physician visit – $25 copay
Specialist visit – $45 copay
Urgent care visit* – $45 copay
Emergency room* and outpatient hospital services – $200 copay after deductible
Inpatient hospital stay – $400 copay after deductible |
| Annual Deductible | $250 individual
$500 family |
| Out-of-Pocket Maximum (includes deductible and copays) |
$4,000 individual
$8,000 family |
*You receive the same in-network coverage if you go to an out-of-network urgent care facility or emergency room. The emergency room copay is waived if you're admitted to the hospital.
How the In-network Only Plan Works
In-network Doctors and Hospitals
When you need health care, you’ll choose a doctor or hospital from the network you selected when you enrolled in the plan — either the Aetna Premier Care Plus Network (APCN+) or Anthem’s National Blue High Performance Network (Blue HPN Non-Tiered). These networks are made up of a select group of doctors and hospitals that consistently deliver high-quality care at lower costs.
Preventive Care
Your preventive care will be covered at 100% with no out-of-pocket cost to you and is not subject to a deductible or copay. This includes annual physicals, well-child checkups, immunizations, flu shots and cancer screenings, as well as certain preventive prescription medications.
Copay
A copay is a flat fee you pay for medical care. When you 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. When you go to the hospital for treatment, you must first meet the medical deductible, then you pay either $200 for emergency room (waived if admitted) and outpatient care or $400 for inpatient care.
For prescriptions, you’ll pay a copay for generic and preferred brand-name drugs after meeting the separate annual deductible for prescription drugs. This deductible is the same as the prescription drug deductible for the Choice Plan. (Non-preferred brand name drugs and some specialty drugs charge a coinsurance percentage, instead of a flat copay.)
Annual Deductible
The deductible does not apply to office visits — all you pay is the copay. The deductible does apply if you need care at a hospital, such as outpatient surgery or an inpatient admission. You’ll pay your hospital fees up to the plan’s annual medical deductible ($250 individual/$500 family), plus a copay ($200 for emergency room and outpatient care or $400 for inpatient care; the emergency room copay is waived if you're admitted). Note: Your prescription drug copays and coinsurance are subject to a separate annual deductible ($100 individual/$200 family).
Out-of-pocket Maximum
The medical out-of-pocket maximum is $4,000 individual/$8,000 family. This amount represents the most you will have to pay out of your own pocket in a calendar year for medical services. Once the out-of-pocket maximum has been satisfied, no additional medical copays will apply for the rest of the plan year. Note: Your prescription drug copays and coinsurance are subject to a separate out-of-pocket maximum ($1,500 individual/$3,000 family).
Can’t get to an in-network doctor? Use telehealth!
Like Citi’s other medical plans, the In-network Only Plan gives you 24/7 access to low-cost virtual doctor visits through either Teladoc for Aetna members or LiveHealthOnline for Anthem members. With telehealth, you can see an in-network board-certified doctor anywhere, anytime — even if you’re traveling out of your network area. Additional costs apply for telehealth visits.
With the Choice Plan, administered by Aetna (Choice POS II Open Access) and Anthem BlueCross BlueShield (PPO Preferred Provider Organization plan), you’ll pay higher paycheck deductions than the other plans, but have a lower deductible than the High Deductible Plan with HSA.
You must meet the annual deductible before the plan will share in the cost of benefits. Both in-network and out-of-network services will apply to meeting the deductible.
Here’s an overview of the Choice Plan’s key features, which are the same whether you’re enrolled through Aetna or Anthem.
| Features | In-network | Out-of-network |
|---|---|---|
| Preventive Care | 100% covered, no deductible | 100% of maximum allowed amount (MAA) |
| Annual Deductible* | $500 individual $1,000 family |
$1,500 individual $3,000 family |
| Out-of-Pocket Maximum*
(includes deductible, coinsurance and medical copays) |
$3,000 individual $6,000 family |
$6,000 individual $12,000 family |
| Coinsurance
(after you meet the deductible) |
Plan pays 80%; you pay 20% | Plan pays 60%; you pay 40% |
*The annual deductible and out-of-pocket maximum combine in-network and out-of-network expenses.
How the Choice Plan Works
Preventive Care
Your in-network preventive care will be covered at 100% with no out-of-pocket cost to you and is not subject to a deductible or coinsurance. This includes annual physicals, well-child checkups, immunizations, flu shots and cancer screenings, as well as certain preventive prescription medications.
Annual Deductible
If you visit an in-network provider, you will need to meet an annual in-network deductible of $500 individual/$1,000 family before any benefit will be paid. Once you meet your deductible, the plan will pay 80% of covered in-network expenses. Note: Deductible expenses cross-apply between in-network and out-of-network limits.
Coinsurance
Coinsurance refers to the portion of a covered expense that you pay after you have met 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.
Out-of-pocket Maximum
The medical in-network out-of-pocket maximum is $3,000 individual/$6,000 family. This amount represents the most you will have to pay out of your own pocket in a calendar year for in-network services. Once the out-of-pocket maximum has been satisfied, no additional in-network medical copays or coinsurance will apply for the remainder of the plan year. Note: Your prescription drug copays are subject to a separate out-of-pocket maximum.
Save When You Stay In-Network
Using in-network doctors and services saves you money through lower rates that Aetna and Anthem negotiate. It’s also more convenient because you don’t have to file claims. If you use out-of-network doctors, you will pay more, and you may be required to submit claim forms.
Find a provider in the Aetna or Anthem networks. If you need additional assistance in finding an in-network provider, use Health Advocate.
With the High Deductible Plan with HSA, administered by Aetna (Choice POS II Open Access) and Anthem BlueCross BlueShield (PPO Preferred Provider Organization plan), you take charge of your health — and your money.
The High Deductible Plan with HSA shares the cost of covered services after you meet the annual deductible and covers 100% of the cost for recommended in-network preventive care. In addition, the High Deductible Plan with HSA pairs with a Health Savings Account (HSA) in which you contribute before-tax dollars to pay for your deductible and other eligible out-of-pocket expenses. Citi also contributes to your account: up to $500 for individuals, and up to $1,000 for families.
Benefits of the High Deductible Plan with HSA
With lower paycheck deductions, a higher annual deductible than Citi’s other medical plans and Citi-funded HSA dollars, you can:
Save
Keep more of your money each paycheck.
Control
Have more control over when and how you spend your health care dollars.
Plan
Save for future expenses with a tax-free Health Savings Account (HSA).
Here’s an overview of the High Deductible Plan with HSA’s key features, which are the same, whether you’re enrolled through Aetna or Anthem.
| Features | In-network | Out-of-network |
|---|---|---|
| Preventive Care | 100% covered, no deductible | 100% of maximum allowed amount (MAA) |
| Annual Deductible
(includes eligible prescription drug expenses) |
$1,800 individual $3,600 family |
$2,800 individual $5,600 family |
| Out-of-Pocket Maximum
(includes deductible, coinsurance and medical/prescription drug copays) |
$5,000 individual $10,000 family* |
$7,500 individual $15,000 family* |
| Coinsurance
(after you meet the deductible) |
Plan pays 80%; you pay 20% | Plan pays 60%; you pay 40% |
| Health Savings Account (HSA)
Citi’s contribution |
Up to $500 individual
Up to $1,000 any other coverage level |
|
| Health Savings Account (HSA)
Total contribution allowed by IRS
(including Citi’s employer contribution) |
$3,850 individual
$7,750 any other coverage level
$1,000 catch-up contribution for age 55 and older |
|
*For in-network services, each of your covered family members has an individual out-of-pocket maximum of $6,850. After an individual reaches that amount, the Plan will cover 100% of that individual’s in-network expenses for the rest of the year. Once the $10,000 family in-network out-of-pocket maximum is met, the Plan will cover 100% of the family’s in-network expenses for the rest of the year. For out-of-network care, the family out-of-pocket maximum can be satisfied as a family or by an individual within the family.
How the High Deductible Plan with HSA Works
Preventive Care
Your in-network preventive care will be covered at 100% with no out-of-pocket cost to you and is not subject to a deductible. This includes annual physicals, well-child checkups, immunizations, flu shots and cancer screenings, as well as certain preventive prescription medications.
Annual Deductible
There are different annual deductibles for in-network and out-of-network care that accumulate separately:
- For individual coverage, you must meet the annual deductible of $1,800 for in-network and $2,800 for out-of-network care.
- For coverage levels other than individual coverage, all eligible family members contribute toward the family deductible. Once you meet the family deductible of $3,600 for in-network care or $5,600 for out-of-network care, the Plan will pay each eligible family member’s covered expenses based on the coinsurance level.
Coinsurance
Once you meet your annual deductible, you and the Plan share any further costs through coinsurance until you meet your out-of-pocket maximum. Generally, for in-network care, you pay 20% and the Plan pays 80%.
Out-of-pocket Maximum
The Plan limits the amount you have to pay each year for medical care. Your out-of-pocket maximum is $5,000 individual/$10,000 family (out-of-network $7,500/individual and $15,000/family).
Each of your covered family members has an individual out-of-pocket maximum of only $6,850 for in-network coverage. After reaching that amount, your plan will cover 100% of that individual's in-network health care expenses for the rest of the year.
Health Savings Account (HSA)
The HSA is available to employees who participate in the High Deductible Plan with HSA. It allows you to pay for eligible health care expenses, including your deductible, with tax-free dollars — and Citi will contribute money into your HSA each year that you are eligible.
Note: You should consider the HSA when you’re planning for retirement. Your unspent HSA dollars carry over year after year — you will never lose them. That means you can use your HSA to accumulate tax-free health spending money over time — you can take it with you if you leave the company, and you can even use it for health expenses in retirement.
Download the apps
Aetna Health app
Download the Aetna Health app to your personal device today.
Anthem Engage app
Download the Anthem Engage app to your personal device today.
Below are ways you can help make the most of your medical plan coverage, if you are enrolled in the In-network Only Plan, Choice Plan or High Deductible Plan with HSA:
Contact Citi Health Concierge
When in doubt, start with your personal Citi Health Concierge as your first call. Available through your health plan, your Citi Health Concierge can provide personalized support and guide you to the right resources when you need them, so you get the most out of all your Citi benefits – even if your question isn’t specific to your medical coverage.
If you elect the In-network Only Plan, Choice Plan or High Deductible Plan with HSA, your Citi Health Concierge will be there to help with:
- Estimating medical costs, finding a doctor or getting a new medical ID card
- Support if you’re diagnosed with a new medical condition
- Backup childcare or elder care referrals
- If you’re overwhelmed and need help finding resources
You can contact your Citi Health Concierge by calling the phone number on your medical ID card.
Learn About Your Medical Options
Get help from ALEX — the independent, fun and interactive benefits tool to help you pick the right medical plan.
Choose a Primary Care Provider
Having a primary doctor is the first step in maintaining better health and saving on health care costs. It’s more than just having a doctor you see for minor health issues.
It’s about having a partner who knows your medical history and your family background, who can make sure you get the age-appropriate preventive care you need and who can help you find a specialist if you need one. 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.
There are two ways to find a primary doctor:
- Aetna and Anthem — Citi’s medical plan carriers — both provide credentials, certifications and quality ratings to help you choose the right in-network doctor. Ask if your doctor accepts Aetna or Anthem insurance or find one who does.
- Included Health works with top doctors and specialists across the country and identifies the highest quality physicians for your unique needs.
Check If Your Doctors Are In-Network
Stay in-network to keep all your health care costs as low as possible, including physical, mental health, and related lab work and/or testing.
The In-network Only Plan does not provide coverage for out-of-network care, except in an emergency. To find an in-network doctor:
- Aetna: enter your home ZIP code in the Provider Search box, then click “Start Your Search;” enter your ZIP code again and continue as a guest to search for in-network doctors; or call
1 (800) 545-5862 . - Anthem: select the “Guests” tile then choose “Medical” for the type of care; choose the state you want to search in; select Medical (Employer-Sponsored) for type of plan; select National Blue High Performance Network (Blue HPN Non-Tiered) for the plan/network; click the “Continue” button and enter your ZIP code on the next screen to begin your search; or call
1 (855) 593-8123 .
The Choice Plan and High Deductible Plan with HSA pay higher benefits for in-network services, and you pay less out of pocket. To find an in-network doctor:
- Aetna: select the Aetna Open Access, Choice POS II Open Access Plan, or call
1 (800) 545-5862 . - Anthem BlueCross BlueShield: access an in-network provider through the BlueCross BlueShield Association BlueCard® PPO Program, select “Find a Doctor” or call
1 (855) 593-8123 .
If you use out-of-network doctors, you will pay more, and you may be required to submit claim forms. Visit Your Benefits Resources™ (YBR™), available through My Total Compensation and Benefits to access the Find a Provider tool.
Practice Preventive Care
Are you doing all you can to stay healthy? Take advantage of the Live Well at Citi Program to earn Live Well Rewards while taking actions to improve your health. And remember, in-network preventive care, including certain preventive prescription drugs, is covered at 100% with no cost to you. Getting your annual physical and any recommended screenings or immunizations can help detect any issues early on and potentially prevent more serious and costly conditions from developing.
Know Where to Go for Care
When you need immediate medical care and your doctor isn’t available, you have different alternatives to the emergency room that provide quality care, save time and cost less. Consider urgent care centers and telehealth (telephone or video appointments with a doctor, psychologist or therapist from your home or work).
- Be prepared: know where and how to access these services to save time and money. Once you’ve met your annual deductible, your Citi medical plan will pay a percentage of these costs.
- Download the Aetna mobile app or Anthem mobile app to find nearby urgent care centers.
- Visit the Teladoc Health website (Aetna) or LiveHealth Online website (Anthem) for more information on telehealth.* Be sure to register for telehealth now so you have quick access to care when you need it.
- Take the Right Place to Get Care quiz.
*Please note: If you’re an Anthem member, you must select “Anthem Blue Cross Blue Shield” from the drop-down menu and enter your member ID.
Pay Less for Prescriptions
Here are some ways to save money on the medications you take.
- Use generic drugs when possible. Requesting generic prescriptions is one of the easiest ways to potentially save money on your overall medical costs. When you’re prescribed a drug, always ask your doctor if there is a generic alternative.
- Check if your preventive drugs are covered. The High Deductible Plan with HSA covers the cost of certain preventive drugs without having to meet a deductible. You will pay the applicable copay or coinsurance, which will count toward your combined medical and prescription drug out-of-pocket maximum. For a list of these preventive drugs, call CVS Caremark at
1 (844) 214-6601 . You can also visit www.caremark.com. - Go to a network pharmacy. You can go to one of the thousands of pharmacies nationwide that participate in the CVS Caremark network. If you go to an out-of-network pharmacy, you will pay the full cost yourself, and then you can file a claim to be reimbursed at the contracted rate after you meet your deductible and pay the applicable copay.
- Use PrudentRx for specialty medication. If you take specialty medication and enroll in the In-network Only Plan or Choice Plan, you can save money with PrudentRx (offered through CVS Caremark). This program will optimize coupons that are available for certain specialty medications. If you use the program, these medications will be free; otherwise, you’ll pay 30% coinsurance. You’ll receive more information from CVS if this applies to you. You can also visit www.caremark.com or call
1 (844) 214-6601 for more information.
Compare Quality and Costs
Since the Choice Plan and High Deductible Plan with HSA won’t start sharing in the cost of your services until you meet your deductible, it’s in your best interest to shop around before choosing a doctor. Different medical practices, hospitals may charge different fees and offer a different level of service.
- Visit Your Benefits Resources, available through My Total Compensation and Benefits, to access the Medical Expense Estimator.
- Use the Health Advocate Health Cost Estimator+ (HCE+) tool to compare the costs of dozens of common health care services and procedures by zip code. A personal Health Advocate representative will research the service you need and provide a personalized report.*
Manage a Chronic Illness
If you or your family member has a chronic condition, such as diabetes, asthma or lower back pain, it’s very important to follow through on the course of treatment. If you are invited to participate in the Live Well Chronic Condition Management Programs, a health care professional will partner with you to help you better manage any chronic conditions and potentially lead a healthier life. You can also earn Live Well Rewards for participating.
Save Money with a Health Savings Account (HSA)
The HSA is available to employees who participate in the High Deductible Plan with HSA. It allows you to pay for eligible health care expenses, including your deductible, with tax-free dollars — and Citi will contribute money into your HSA each year that you are eligible to help cover out of pocket expenses. Citi will contribute to your HSA up to $500 for individual coverage or up to $1,000 for any other coverage level.
Take Advantage of Fertility Support
If you are enrolled in a Citi medical plan option, you have access to fertility support benefits through Aetna and Anthem. For more information, visit the Fertility Support page.
Receive Care from a Center of Excellence
Use a Center of Excellence (COE) if you or a covered family member is faced with needing a bariatric, cardiac or transplant procedure. To learn more, review the Benefits Handbook.
New Protections Against Surprise Medical Bills
Effective January 1, 2022, the No Surprises Act provides new protections against surprise billing, or balance billing, under medical plans, such as those offered by Citi. This legislation prohibits medical providers from sending surprise bills for most emergency and some non-emergency out-of-network care. For example, if you visit an in-network facility for emergency services, you may see providers, such as specialists like an anesthesiologist, who don't participate in Citi's medical plan network. The No Surprises Act now protects you from charges and balance bills for these additional services.
You can find more information from your Citi medical plan carrier here and learn more about your rights under the No Surprises Act here.
Transparency in Coverage Rules
The federal Transparency in Coverage Rules require certain group health plans to publicly disclose price and cost-sharing information. This information includes in-network provider rates as well as historical out-of-network allowed amounts and billed charges for covered items and services, which is to be shared via two separate machine-readable files (MRFs). The machine-readable files are formatted to allow researchers, regulators and application developers to more easily access and analyze data. The MRFs for each of Citi's medical plan carriers can be found below:
*All personal information, including protected health information (as defined by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), as amended, privacy and security rules) provided to personal Health Advocates is maintained in a manner to ensure that it is protected and secure, in accordance with HIPAA’s requirements.