Overview
Accidental injuries, serious illnesses and hospitalizations can happen unexpectedly. And when they do, they may have a significant financial impact on your family, even with comprehensive medical coverage. This is where supplemental health benefits can help.
How Do Supplemental Health Benefits Work?
While your medical coverage pays doctors and hospitals directly for costs related to your care, supplemental health benefits pay cash benefits directly to you — you can use this money however you want. For example, you may choose to spend it on:
- Any expenses not paid by your medical plan, such as a deductible, coinsurance or copays
- Medication or pharmacy supplies
- Services that will make your diagnosis and treatment less stressful, including transportation assistance, childcare or housekeeping help
- Things that will make your life easier or more enjoyable, such as a new appliance, a weekend getaway or a pet
- Everyday living expenses, including mortgage, rent, utility bills, car payments and more
You don’t need to account for how the money is spent — it’s your decision!
Who Can Enroll?
These benefits are available to you regardless of your medical coverage — you can choose supplemental health benefits whether you have a Citi medical plan through Aetna, Anthem, an HMO — or even if you have no Citi medical coverage at all.
Key Features at a Glance
Aetna’s supplemental health benefits provide:
Relatively low-cost coverage
(as little as $2 a paycheck in some cases) that provides significant financial protection against the high costs often associated with accidental injuries, a serious illness or a hospital stay.
Fast, easy online claim submission
through the Aetna Simplified Claims Experience ™.
Cash benefits
that are paid directly to you and are independent from your primary medical coverage.
Flexibility
to spend your benefit payment on whatever costs you’re facing, including medical bills, transportation costs, car repairs, child care fees and daily living expenses.
Access to Aetna Discount Programs,
including blood pressure monitors, weight-loss programs and meal plans, books and magazine subscriptions, gym memberships, health and wellness products, hearing and dental products, eye care and more.
Keep in Mind
- On their own, supplemental health plan options don’t provide medical coverage for day-to-day health care needs. Rather, they’re intended to supplement the coverage provided by your primary medical plan.
- These plans can be paired with any medical coverage — whether it’s Aetna, Anthem, an HMO, or coverage you have outside of Citi.
- You pay for supplemental health insurance through after-tax paycheck deductions.
Accident Insurance
Accident insurance pays cash benefits when you or a covered family member get treatment for a covered accidental injury. You can use this money to help pay for expenses not paid by your medical plan (such as your deductible, coinsurance or copays) or anything else.
Accident Insurance Benefits
In the event of a covered accident, benefits are paid for initial treatment, follow-up care, hospitalizations, fractures and dislocations and more. For example:
| Type of Treatment or Injury | Benefit Payment |
|---|---|
| Ambulance | $300 |
| Emergency room | $200 |
| X-ray | $150 |
| Fractured leg | $3,750 |
| Second degree burn | $1,500 |
| Hospitalization | Non-ICU: $2,000 admission + $200/day
ICU: $4,000 admission + $400/day |
| Inpatient surgery | $500 |
| Follow-up doctor’s office visit | $100 |
Is Accident Insurance Right for You?
To help you decide, think about these questions:
- Do you or a family member play sports that could result in an injury?
- How much of your doctor, hospital or ambulance bills does your medical plan cover?
- Would you find it hard to pay your portion of the medical bills associated with an accident?
Accident insurance rates vary by who you cover (just yourself or family members).
Critical Illness Insurance
Critical illness coverage pays cash benefits when you or a covered family member are diagnosed with a covered illness or condition, such as a heart attack, cancer or stroke. The cash benefit payment you receive can be used to help cover expenses for your treatment that are not covered by your primary medical plan. You also can use the money to pay for any other expenses related to your illness or to help cover everyday bills.
In addition, you and any other insured member under your critical illness insurance plan will earn a $50 wellness benefit for completing a health screening during the year.
Choose from Two Coverage Options that Pay a Maximum Benefit Per Diagnosis of:
- $15,000 or
- $30,000
Critical Illness Insurance Benefits
Benefits are paid upon diagnosis of a covered illness or condition, and may be paid more than once if the illness recurs or if a different diagnosis is made. Examples include:
| Illness or Condition | Percentage of Benefit Amount |
|---|---|
| Heart attack | 100% |
| Coronary artery condition requiring bypass surgery | 50% |
| Invasive cancer | 100% |
| Major organ failure | 100% |
| Huntington’s disease | 100% |
| Stroke | 100% |
| HIV | 25% |
| Pneumonia | 25% |
| Coronavirus (must be hospitalized for 5 days or more) | 100% |
| Lyme disease | 25% |
Is Critical Illness Insurance Right for You?
To help you decide, think about these questions:
- Are you at risk of getting critically ill from an infectious disease like the coronavirus, Hepatitis or HIV?
- Do you have a family history of cardiac issues, cancer or Alzheimer’s disease?
- Would you find it hard to keep up with your financial responsibilities if you or a family member became seriously ill?
Critical illness insurance rates vary by age, tobacco use, the benefit level you select and if you cover just yourself or family members. If you buy coverage for yourself, you can cover your children at no additional cost. Note: Covered children receive 50% of your benefit amount
Hospital Indemnity Insurance
Hospital indemnity coverage provides cash payments to help offset your share of the costs associated with an expected or unexpected covered inpatient hospital stay. You receive lump-sum payments for your initial hospital admission, plus daily benefits throughout your hospitalization (up to annual plan limits). The plan also pays a daily benefit for inpatient rehabilitation, substance abuse and mental health stays.
Hospital Indemnity Benefits
Examples include:
| Type of Hospitalization | Benefit Payment |
|---|---|
| Hospital admission* | $1,000 |
| Hospital stay (per day) | $250 |
| ICU stay (per day) | $500 |
| Substance abuse stay (per day) | $125 |
| Rehabilitation unit stay (per day) | $50 |
| Mental health stay (per day) | $100 |
*Up to four admissions per year, with at least 30 days between hospital stays. Daily benefits for each hospitalization are paid up to annual plan limits.
Is Hospital Indemnity Insurance Right for You?
To help you decide, think about these questions:
- Are you planning a medically necessary surgery or expect to be hospitalized in the future?
- Are you thinking of having a baby and may need a hospital stay to give birth?
- Would you find it hard to pay for the hospital costs not paid by your primary medical plan (such as deductible, coinsurance or copays)?
Hospital Indemnity insurance rates vary by who you cover (just yourself or family members).
Federally Required Compliance Notice About Hospital Indemnity Insurance
IMPORTANT: This is a fixed indemnity policy, NOT health insurance. This fixed indemnity policy may pay you a limited dollar amount if you're sick or hospitalized. You're still responsible for paying the cost of your care.
- The payment you get isn't based on the size of your medical bill.
- There might be a limit on how much this policy will pay each year.
- This policy isn't a substitute for comprehensive health insurance.
- Since this policy isn't health insurance, it doesn't have to include most Federal consumer protections that apply to health insurance.
Looking for comprehensive health insurance?
- Visit HealthCare.gov or call 1-800-318-2596 (TTY: 1-855-889-4325) to find health coverage options.
- To find out if you can get health insurance through your job, or a family member's job, contact the employer.
Questions about this policy?
- For questions or complaints about this policy, contact your State Department of Insurance. Find their number on the National Association of Insurance Commissioners' website (naic.org) under "Insurance Departments."
- If you have this policy through your job, or a family member's job, contact the employer.
Submitting Claims
Submitting claims for your supplemental health benefits is designed to be easy, but you do need to file your own claim, separate from any medical plan claims — your doctor or medical plan will not submit a claim for you (even if you have medical coverage with Aetna).
To be eligible for supplemental health benefits, you must file a claim with Aetna.
Through the Aetna Simplified Claims Experience, you can file a claim on the mobile app or member portal. Just provide answers to a few questions and you’re on your way to receiving cash benefit payments.
Learn More
For more information about these benefits, visit Aetna’s Supplemental Health Resource website. You can also call Aetna at 1 (800) 607-3366 to speak with a customer service representative.