Citi Benefits Handbook
Medically Necessary
The Claims Administrator will help you and your physician determine the best course of treatment based on your diagnosis and acceptable medical practice. The Claims Administrator will determine whether certain covered services and supplies are medically necessary solely for purposes of determining what the medical plans will reimburse. No benefits are payable unless the Claims Administrator determines that the covered services and supplies are medically necessary. Please refer to the Glossary section for the definition of medical necessity.
For more information about what your plan covers, see "Covered Services and Supplies". You may also contact your plan directly to confirm coverage of a particular service or supply and to find out what limits may apply.