Citi Benefits Handbook
In-Network Benefits
In-network benefits include:
- Routine eye exam: one eye exam, including dilation, when professionally indicated; each calendar year covered at 100%;
- Frame and spectacle lenses: one pair of eyeglasses each calendar year; frame allowance of $150 per calendar year; members pay 20% of the balance over this allowance;
- Progressive lenses: $0 copay for standard, $20 copay for premium Tier 1, $30 copay for premium Tier 2, $45 copay for premium Tier 3 and $120 Plan allowance for premium Tier 4;
- Anti-reflective coating: $0 copay for standard, $15 copay for premium Tier 1, $30 copay for premium Tier 2 and $110 copay for premium Tier 3;
- Hi-index lenses: $30 copay;
- Contact lenses in lieu of eyeglasses: $130 allowance per calendar year and a 15% discount over the allowance for conventional contact lenses; and
- Up to a 40% discount on additional pairs of glasses at most network providers.
The following products are covered at 100%: plastic lenses (single, bifocal or trifocal); all prescription ranges, including post-cataract lenses; tinting of plastic lenses; standard progressive addition multifocals; polycarbonate lenses; oversize lenses; ultraviolet coating; blended segment lenses; PGX (sun-sensitive) glass lenses; scratch-resistant coating; intermediate-vision lenses; and polarized lenses.
Note: Some brand exceptions may apply and may require a copay.