Citi Benefits Handbook
Rules and Features
General Rules about Expenses
Most health care expenses that the IRS considers deductible on your federal income tax return are eligible for reimbursement from the HCSA, provided the expenses are not reimbursed from any other source.
You can be reimbursed for your expenses or those incurred by anyone you can claim as a dependent on your federal tax return, regardless of whether you or your dependent is covered under any Citi medical, dental, or vision plan. Be sure to save your receipts in case you are required at a later date to substantiate that your expense was eligible for reimbursement under the Plan.
Estimate expenses conservatively. You cannot receive a refund for contributions intended to reimburse yourself for a surgery or procedure that is later canceled.
Examples of Eligible Health Care Expenses
- Your share of expenses that are not paid by your medical, dental, and/or vision plan, such as deductibles, coinsurance, and copayments;
- Other charges that exceed what your medical, dental, and/or vision plan will pay, such as charges above maximum allowed amounts or other plan limits;
- Vision care expenses, such as exams, prescription eyeglasses and sunglasses, prescription contact lenses, and laser surgery, that are not covered by your medical or vision plan;
- Hearing care expenses, such as exams, hearing aids, and hearing aid batteries that are not covered by your medical plan;
- Certain equipment and training for disabled individuals;
- Childbirth classes, such as Lamaze, for up to two people;
- Chiropractic care that is not covered by your medical plan;
- Physical therapy, psychiatric therapy, and counseling that are not covered by your medical plan;
- Cholesterol tests, vaccines, and immunizations that are not covered by your medical plan;
- Prescription contraceptives and infertility treatments that are not covered by your medical plan;
- Smoking cessation programs;
- Certain over-the-counter (OTC) drugs, medicines, and biologicals for which you have a receipt and a prescription (see eligibility requirements below);
- Medicines prescribed by a physician that your medical plan or prescription drug program does not cover; and
- Transportation necessary to obtain certain health care services.
OTC Drugs, Medicines, and Biologicals
You may only be reimbursed for over-the-counter medicines and biologicals through your HCSA in instances when a doctor has prescribed the medicine or biologicals or if the medicine is insulin.
Note: You cannot use the CYC payment card to pay for these items. You will need to pay out of pocket and then submit a paper claim along with your receipt and prescription.
Examples of Ineligible Health Care Expenses
- Expenses for which you have been reimbursed from another source, such as Citi's or another employer's medical, dental, and/or vision plan, Medicare, or Medicaid;
- Elective cosmetic surgery or cosmetic dental work;
- Vitamins or minerals taken for general health purposes, including those recommended by your physician;
- Maternity clothes or diaper services;
- Nursing services to care for a healthy newborn;
- Household help or custodial care at home or in an institution, even if recommended by your physician;
- Health club fees, exercise classes, or weight-loss programs for general health purposes, even if recommended by your physician;
- Cosmetics, toiletries, or toothpaste;
- Amounts you pay for medical and dental insurance premiums;
- Over-the-counter items and biologicals for which you do not have a physician's prescription; and
- Long-term care services including insurance premiums for long-term care insurance.
Special Rule for Orthodontia Claims
Generally, a health care service must be provided during the plan year in order for a claim to be incurred and subject to reimbursement. Orthodontic work usually involves a course of treatment that occurs over a number of plan years. In connection with payments made for orthodontic work, IRS guidance provides that if the actual payment is made in advance of a course of orthodontic treatment, the claim is deemed to be incurred at the time of the advance payment and subject to reimbursement at the time the payment is made without regard to when the actual treatment is provided. If the actual payment is not made in advance, the claim is incurred when the services are provided.
For More Information
For more information about eligible expenses, see IRS Publication 502: Medical and Dental Expenses at www.irs.gov or contact your tax adviser. You can also call the IRS at 1 (800) 829-1040.
Note: The IRS publication is a guideline for use in preparing tax returns; it is not a description of the Citi Plan.