Citi Benefits Handbook
Centers of Excellence (COEs)
Centers of Excellence (COE) are top-rated facilities that meet or exceed rigorous, evidence-based criteria established in collaboration with expert physicians and medical organizations. These facilities demonstrate a history of achieving faster recovery times and better expected outcomes. Because facilities must reapply for the designation on a regular basis, you can be sure they provide consistently high-quality care. And high-quality care is more cost-effective care, because you'll experience fewer complications from your treatment.
Centers of Excellence are equipped to deliver complex medical care in specialties such as bariatric, orthopedic and transplant services. Due to the recognition of the importance of having certain specialized procedures performed only at top-rated facilities with a history of achieving faster recovery times and better-than-expected outcomes, the Citigroup Health Benefits Plan includes the following requirements:
- Bariatric procedures will only be covered when performed at a COE.
- Orthopedic and transplant procedures will be covered at the out-of-network level when received outside of a COE.
If you enroll in a medical plan through Aetna, Anthem BlueCross BlueShield or Oxford, you'll have access to Centers of Excellence for certain conditions.
Travel and Lodging Expenses
When available, the plan will assist the patient and family with travel and lodging arrangements when a qualified transplant, bariatric or orthopedic procedure is medically necessary and performed at a designated center of excellence facility. Expenses for travel and lodging for the recipient and a companion are available as follows:
- Transportation, including expenses for personal car mileage at the current federal rate of reimbursement, of the patient and one companion who is traveling on the same day(s) to and/or from the site of the transplant, bariatric, or orthopedic procedure for an evaluation, the procedure, or necessary post-discharge follow-up;
- Reasonable and necessary expenses for lodging for the patient (while not confined) and one companion. Benefits are paid at a per-diem rate of $50 for one person or $100 a day for two people (a maximum of $50 per person — $100 for patient and companion combined — per night is paid toward lodging expenses; meals are not covered);
- Travel and lodging expenses are available only if the transplant, bariatric, or orthopedic recipient resides more than 75 miles from the designated facility for Aetna, BlueCross BlueShield plans or Oxford plans (Note: Oxford does not have an Orthopedic COE);
- If the patient is a covered dependent minor child, the transportation expenses of two companions will be covered; lodging expenses will be reimbursed at the $100 per-diem rate;
- A combined overall lifetime maximum of $10,000 per covered person, per occurrence, for all transportation and lodging expenses incurred by the transplant, bariatric or orthopedic recipient and companion (companions, if the covered dependent is a minor) and reimbursed under the plan in connection with all transplant, bariatric, or orthopedic procedures.