Citi Benefits Handbook
Paying for Your Expenses Out of Pocket
You can submit claims for certain expenses under the following plans:
  • High Deductible Plan with HSA (preventive care only);
  • Dental; and
  • Vision.
You can use the Optum Financial payment card to pay for eligible expenses. Alternatively, you may pay for eligible expenses out of pocket and submit qualified expenses for reimbursement using the HCSA/LPSA Claim Form. You can submit a claim: (i) online on the Optum Financial website, available through My Total Compensation and Benefits at; (ii) through the Optum Financial mobile app, or: (iii) you can submit a paper claim to Optum Financial using the Optum Financial Manual Claim Form. The claim-filing instructions are on the Optum Financial website, as well as on the Manual Claim Form (available on the Optum Financial website).