Health

Any questions regarding your

international health insurance?
AXA will answer them quickly
and clearly.

Handbook
FlexMed Global DB E&C/
FlexMed Global RK Premium DB E&C
Valid from 1st January 2018
Contents.

I. Welcome to AXA Krankenversicherung. 3

II. You can reach AXA at any time. 5

III. FAQs concerning your international health insurance. 6

IV. Reimbursement FlexMed Global DB E&C 9

1. Direct settlement option 9
2. Reimbursement of costs paid by patients 9

V. Your insurance cover. 10

1. General information 10
1.1. Scope 10
1.2. Doctor and hospital selection 10
1.3. Medical necessity 10
1.4. Advance confirmation of assumption of costs 10
1.5. Previous illnesses 10
1.6. General terms and conditions 11
2. Tariff benefits covered by FlexMed Global DB E&C/ FlexMed Global RK Premium DB E&C 12
2.1. Scope of cover 12
2.2. Outpatient treatment 13
2.3. Inpatient treatment 14
2.4. Supplementary benefits for a parent or guardian accompanying children receiving
inpatient treatment 14
2.5. Dental treatment and prosthesis 14
2.6. Medical evacuation 14
2.7. Repatriation costs 15
2.8. Evacuation of additionally insured children 15
2.9. Additional benefits
2.10. Additional Assistance services 15

3. Exclusions 16

4. Particularities of the residual cost tariff FlexMed Global RK Premium DB E&C 17

5. Particularities of the daily sickness benefit tariff FlexMed Global Cash 17

2
I. Welcome to
AXA Krankenversicherung.
Welcome to AXA, one of the world‘s leading
providers of insurance and financial services!
In the event of illness, international health insurance
by AXA means that you and your family can count on
receiving the best possible international medical care
worldwide.
Some facts at a glance:
n AXA Krankenversicherung is one of the largest
health insurance providers in Germany and is the
pioneer in the field of active health management.
n The FlexMed Global tariff range provides you
with global access to the best medical care and an
around-the-clock service in the event of an
emergency.
n The comprehensive benefits package for outpatient,
inpatient and dental treatment is perfected by special
Assistance Services.
n Numerous best ratings confirm the quality of our
products.
A partnership that pays off for you.
You are insured by AXA Krankenversicherung
and services are provided by multiple-award-winning
AXA PPP International.
This unique partnership not only offers you access
to a worldwide network of medical providers, it also
provides you with an excellent multi-lingual 24/7
customer service and comprehensive online services.
This handbook is an important document and it
provides information regarding the tariff benefits,
special services, assistance and support and on how
to submit claims and how invoices are reimbursed.
In addition to this handbook, you will find a separate
description of the Customer Online portal which you can
use to manage your insurance matters comfortably and
conveniently wherever you are.
If you require further information
or have any questions concerning your
insurance, please contact us at any time
under Tel. 0049 221 148-39728 or via
the Customer Online portal:
www.axa.de/expat-service.

*
Valid as of: 07.2016
AXA Krankenversicherung AG

AXA Krankenversicherung is a member of the inter-

national AXA Group. The ensuing capital strength offers
extraordinary security to customers and business
partners.

This is also confirmed by independent rating agencies:

Standard & Poor´s rates „excellent“ (AA-) and
Fitch rates „Very strong“ (AA-).

* Information regarding the latest rating is available on the Internet under www.standardandpoors.com or by telephone under +44 (0) 20 71 76 38 00.
Ratings are neither a guarantee of financial strength nor an insurance company recommendation.

3
4
II. You can reach AXA at any time.
How to manage your insurance online
You can reach us any time:
Using our customer portal Customer Online:
www.axa.de/expat-service Our Customer Online portal is the swiftest
and simplest way to submit an application for
This service will be made available to you immediately insurance. You can, of course, contact us using
upon registration, as soon as your employer has alternative channels:
registered you with us and you have received the policy
number and your customer number, you can use the By e-mail:
following functions available in our Internet portal: expat@axa.de

n Communicate with AXA in a secure way By telephone:

n View your data easily and comprehensively 0049 221 148-39728

n Conveniently submit your bills and request You will receive swift and reliable assistance in
pre-authorisations more than 30 languages, 24 hours a day, 7 days
a week. Our emergency service help desk can
n Send us your banking details also be reached on this number.
It‘s simple and quick and available any time and
anywhere. By post:
AXA Krankenversicherung AG
Expat Claims
Postfach 1320
65003 Wiesbaden
Germany

AXA PPP International has been operating in the field of Expat business for more than 40 years now and it looks after
employees seconded all over the world. The service centre is available around the clock, providing assistance to all
expatriates insured by AXA Krankenversicherung. We are delighted that our work has been acknowledged by numerous
awards over the past few years (please also refer to www.axapppinternational.com).

5
III. FAQs concerning your
international health insurance
1. In the beginning
Where do I find my customer number
[Customer number]?
You will find your customer number in your welcome
letter and on your insurance card. If you have already
registered on our „Customer Online“ portal, you can call
up your entire policy details under the heading [Policy
information].
What do I do with unpaid bills from a previous
insurer?
If you have undergone treatment and have claimed
medical treatment costs before the date of inception of
your AXA insurance cover, please send the correspon-
ding invoices for such treatment to your previous insurer
as you did in the past. You can send us bills for treat-
ment after the commencement of your AXA cover in the
following ways:
n Online: after your registration via the Customer
Online portal www.axa.de/expat-service
n By e-mail: expat@axa.de
nBy post:
AXA Krankenversicherung AG
Expat Claims
Postfach 1320
65003 Wiesbaden
Germany
If you are unsure what to do with an invoice, please
contact us for assistance. We will be happy to provide
you with immediate help and advice.
6
2. In the event of illness
What should I do in a medical emergency?
AXA will provide you with swift assistance in medical
emergencies, simply call 0049 221 148-39728.
This service is available around the clock and includes
comprehensive support such as arranging medical
evacuation or clarification of the possibility to settle
directly.
Which doctors or medical establishments
can I visit?
You are, of course, free to select a doctor or hospital of
your choice. However, the global presence of the AXA
Group also enables you to fall back on a global network of
medical service providers and hence also on so-called
AXA partner hospitals. Direct settlement is possible with
the providers included in our network. Please contact us
accordingly if you cannot find your preferred doctor or hos-
pital in our MyGlobe network portal, which can be started
in our Customer Online portal. We will be happy to provide
you with prior authorisation of your treatment and will try
to arrange direct settlement with the selected service
provider.
Where do I find a list of AXA partner hospitals?
You can call up a list of these hospitals under the
MyGlobe application which you can start via the
Customer Online portal. We are, of course, also happy
to provide information regarding our partner hospitals
over the telephone, simply call 0049 221 148-39728.
What should I do if I need to be hospitalised?
Please inform us as soon as possible if you have to
seek treatment in a hospital or clinic. In most cases
this will allow us to make payment arrangements
with the hospital to settle claims directly. This means
that, in most cases, you will not have to pay in advance
and swift processing of your claim is also guaranteed.
We can also help you to find a suitable hospital.
In medical emergencies the hospitals and clinics can
also contact us directly using the details on your
membership card.
When do I need to obtain prior confirmation
of the assumption of costs?
As a rule, you are free to choose the doctor or hospital
and are eligible for any medically necessary treatment
covered by the tariff benefits – in most cases even
without prior confirmation of assumption of costs (for
exceptions please refer to Chapter V. 2 „Tariff Benefits“)
If you have already planned to undergo medical
treatment, then obtaining prior confirmation of the
assumption of costs does have many advantages:
n We will contact the hospital and ensure that your
admission to hospital is simple and smooth. Where
possible, we will arrange for direct settlement of
the costs with the hospital, so that you will not need
to make an advance payment.
n Our medical specialists will oversee your treatment.
n In the event of evacuation or repatriation, we will
make the necessary arrangements.
If you require confirmation of the assumption of costs,
please simply call us any time of day or night on
0049 221 148-39728 or e-mail us at expat@axa.de
3. Reimbursement of costs
How can I have a claim settled as quickly as
possible?
Please note the particularities of the FlexMed Global RK
Premium DB E&C tariff in chapter 4. If you are covered
by FlexMed Global DB E&C, there are two ways of reim-
bursing costs in the event of a claim:
1) AXA reimburses the service provider directly
(so-called direct settlement): If you have informed
us in advance on 0049 221 148-39728 regarding
your treatment, our service team will contact the clinic/
doctor administering the treatment directly and shall
agree, wherever possible, direct payment of the medical
treatment costs. This means that you can undergo
treatment without requiring cash and you do not have
to settle with AXA. The selection of one of our partner
hospitals from the global AXA network also allows for
direct settlement which means that you are not required
to effect payment in advance.
2) AXA reimburses your own expenses:
If you have paid for services yourself, simply send
us your receipts, either via „Customer Online“
by e-mail (expat@axa.de) or by post
(AXA Krankenversicherung AG, Expat Claims,
Postfach 1320, 65003 Wiesbaden, Germany).
Our service team will contact you if any further
information is required. As a rule, presented invoices
are promptly reimbursed by AXA provided that the
information they contain is complete.
If the treatment is in the future and you require confir-
mation that the costs will be assumed, please call us
on 0049 221 148-39728. Also please inform us under
this number if you have any questions regarding ongoing
or completed treatment. Our service team will take you
through the necessary steps.
What should be observed when presenting
invoices? What details must bills and receipts
contain?
Invoices can be submitted easily and via different
channels. The most secure way is to upload the
document via Customer Online. In addition, you can
send us your documents also by e-mail or by post.
Please ensure when submitting documents that they
contain the following information:
n Name, address and telephone number of the
treatment provider,
n Name, address and date of birth of the patient,
n Name/description of the illness, nature of treatment
and date(s) of treatment and
n desired method of payment for the reimbursement
of costs.
Prescriptions must clearly contain the following
information:
n The medicine(s) prescribed.
n The price of the medicine(s).
n Payment confirmation.
In the case of dental treatment, the documents must
contain the following information:
n Description of the treated teeth.
n Details of the treatment performed.
Payments paid or rejected by other insurance carriers
must be substantiated.
Important information:
Please note that in some countries (e.g. Japan, Belgium
or Italy) not all of the information we require is noted on
the documents. In such cases you can send a covering
letter to AXA Krankenversicherung AG,
Expat Claims, Postfach 1320, 65003 Wiesbaden,
Germany, or an e-mail to expat@axa.de with the
exact details of the illness and the type of treatment
received. Upon request we will be happy to provide you
with a special self-certification form for this purpose,
which you can submit together with the invoice.
By when must I submit my bills?
Your bills should reach AXA within 6 months of
treatment.
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How will my costs be reimbursed?
All eligible costs you incur during medical treatment will
be refunded to a bank account of your choice. Please
call either our helpline on 0049 221 148-39728 and
give us the bank account details or simply attach the
details when you send us your bills. If we do not have
your bank details, we will issue a cheque and send it
by post. Please used the secured connection in the
Customer Online portal to provide us with your personal
account details. Following reimbursement of your costs
you will receive an e-mail informing you that you can
call up the benefit statement in the Customer Online
portal. This document provides you with a clear overview
of the payments made to date. Please note that the
reimbursement of costs by transfer to some countries
(e.g. USA) may be subject to charges imposed by the
receiving bank which, unfortunately, we cannot foresee
and which we will also not reimburse. In such cases
please arrange to be sent a cheque or use the direct
settlement option.
In what currency are costs reimbursed?
Depending on the type of account, refunds to you
can be made in all major currencies. In the case of
out-patient treatment, the exchange rate on the day of
treatment and in the case of in-patient treatment the
exchange rate on the day of admission shall apply.
4. Changes to your insurance details
How do I change my contact data?
Your contact data are communicated to us by your
employer. Should you need to change them, please
contact your HR Department directly
What happens if I move to another country?
Your employer will also let us know directly if you are
seconded to another country. Should you notice
anything in your details which is no longer up-to-date,
please contact your HR Department directly.
How can I add another member of the family to
the insurance cover?
Insurance of other members of your family is also
managed by your employer. Please contact your
HR Department without delay.
8
5. Complaints
Who can I turn to if I have a complaint?
Satisfied customers, top service and high-quality
international health cover are what we aim for. If you
are dissatisfied with our service or the benefits
provided by your insurance cover, please call us on
0049 221 148-39728. We will deal with your
complaint swiftly and without red tape. Please also feel
free to use the e-mail address: expat@axa.de.
If you would like to contact us by post please write to:
AXA Krankenversicherung AG, Expat Claims,
Postfach 1320, 65003 Wiesbaden, Germany.
You, as the policyholder, can contact the ombudsman
for private health and long-term care insurance to settle
any disputes arising from the insurance policy out of
court.
OMBUDSMANN
Private Kranken- und Pflegeversicherung
Postfach 06 02 22
10052 Berlin
www.pkv-ombudsmann.de
AXA Krankenversicherung participates in the procedure
with the ombudsman for private health and long-term
care insurance.
In addition, in the event of a complaint, you can also
contact the German insurance arbitration service
(Ombudsman) or the supervisory authority:
Bundesanstalt für Finanzdienstleistungsaufsicht (BaFin)
Postfach 1253
53002 Bonn
6. General information
The protection of your personal data is very important
to us. It therefore goes without saying that all data are
subject to the prescribed data protection guidelines.
IV. Reimbursement FlexMed Global DB E&C
1. Direct settlement option
The global presence of the AXA Group enables us to
provide you with access to a global network of selected
medical service providers. This shall, of course, not
preclude your right to select the doctor and hospital of
your choice.
In the event of inpatient hospital treatment we shall
always endeavour to arrange direct settlement in ad-
vance by issuing a cost assumption guarantee so that
you shall not be required to pay the comparatively high
hospital costs upfront. Accordingly, it is important that
you inform us of any planned treatment in good time.
2. Reimbursement of costs paid by patients
If you have paid for the services yourself, please submit
your invoices as quickly as possible (within 6 months
at the latest), preferably directly via the Customer Online
portal. For swift and orderly processing of your
supporting documents please ensure that the following
information is contained in the bill(s):
n Name, address and telephone number of the treat-
ment provider,
n Name, address and date of birth of the patient,
n Name/description of the illness, nature of treatment
and date(s) of treatment and
n desired method of payment for the reimbursement
of costs.
Prescriptions must clearly contain the following
information:
n The medicine(s) prescribed.
n The price of the medicine(s).
n Payment confirmation.
In the case of dental treatment, the documents
must contain the following information:
n Description of the treated teeth.
n Details of the treatment performed.
Payments paid or rejected by other insurance carriers
must be substantiated.
Please call us at any time on
0049 221 148-39728, send us an e-mail to
expat@axa.de or use our Customer Online portal:
www.axa.de/expat-service.
You can access the list of hospitals and treatment pro-
viders included in our AXA network using the MyGlobe
application which can be started in the Customer
Online portal. If you choose to receive treatment at the
facilities within our network, all you will need to do is
present your personal insurance card and you will be
assured of receiving qualified treatment – we will take
care of everything else.
Important information:
Please note that in some countries (e.g. Japan, Belgium
or Italy) not all of the information we require is noted
on the documents. In such cases you can send a
covering letter to AXA Krankenversicherung AG,
Expat Claims, Postfach 1320, 65003 Wiesbaden,
Germany, or an e-mail to expat@axa.de with the
exact details of the illness and the type of treatment
received. Upon request we will be happy to provide you
with a special self-certification form for this purpose,
which you can submit together with the invoice.
Our service team will examine the submitted invoices
and instruct the subsequent reimbursement of costs. If
any requisite information is missing, we will contact you
in the short term.
Please use the Customer Online portal to provide us
with the bank account details to which we should reim-
burse costs. If we do not have your bank account details
we will send you a cheque by post. We recommend the
latter especially in cases where your bank charges fees
for the receipt of payments from abroad.
In the event of an emergency
please contact our 24/7 hotline on
0049 221 148-39728 as quickly as possible,
which guarantees you swift assistance in
medical emergencies.
9
V. Your insurance cover.
1. General information
1.1. Scope
AXA offers you insurance coverage abroad for illnesses,
accident or other defined events. The scope of the
insurance cover is defined in the Group Insurance Policy,
the General Terms and Conditions (Parts I and II) and,
where applicable, in special agreements, and according
to the statutory provisions in Germany.
1.2. Doctor and hospital selection
As the Insured you are free to choose, worldwide,
among doctors and dentists, midwives, child delivery
attendants and members of state-recognised
medical assistance occupations (medical and medical
assistance professions) who are authorised to provide
medical treatment according to the law of the respec-
tive country of temporary residence.
For alternative healing methods (cures) it is also
possible to call on the services of other treatment
providers who are licensed locally and who have under-
gone recognised training.
If no doctor or dentist is available to provide medically
necessary treatment at the place of temporary
residence or within a reasonable distance, in a case of
medical emergency the costs of services provided by
other treatment providers are refundable.
In the case of medically necessary day care treatment
and inpatient treatment, you are free to choose among
public and private hospitals provided that these are
permanently supervised by doctors, they have sufficient
diagnostic and therapeutic facilities and also keep
medical records.
1.3. Medical necessity
A precondition for a claim to an insurance benefit is that
the respective examination or treatment, including any
prescribed medicines, remedies and medical devices are
medically necessary. Medical necessity must be traceable
on the basis of objective criteria (e.g. in the form of
medical diagnoses, laboratory results, X-rays, models).
10
1.4. Advance confirmation of assumption
of costs
We recommend that you contact us in advance if you
are planning medical treatment, especially if you are
planning to stay in hospital. In this case you may benefit
from the following advantages:
n We can confirm to you whether the hospital/the
person administering treatment is included in the AXA
network. In the case of our selected contract partners,
all you will need to do is present your insurance card
and you will be assured of receiving qualified treatment
- we will take care of everything else.
n We can also be of assistance even if you visit an
establishment which is not included in our network.
We will contact the hospital and ensure that your
admission to hospital is simple and smooth. Where
possible, we will arrange for direct settlement of the
costs with the hospital, so that you will not need to
make an advance payment.
n If you have to be admitted to hospital at short notice
or if you have had an accident, contacting us later
will also be helpful. We shall strive to arrange direct
settlement with the hospital also in such cases.
n Our medical specialists will oversee your treatment.
n In the event of evacuation or repatriation, we will
make the necessary arrangements.
In addition, all of the benefits, services and treatment
which require advance confirmation of the assumption
of costs are listed in detail in Chapter 2 „Tariff Benefits“.
1.5. Pre-existing conditions
Pre-existing conditions are conditions suffered prior to
the inception of our insurance cover, i.e. before the
application was accepted. All pre-existing conditions
are included in your insurance cover.
1.6. General Terms and Conditions
1.6.1. Person insured
Your employer has registered you as a seconded
employee to be covered by AXA‘s international health
insurance. Other persons covered may be your spouse,
partner and your children who accompany during your
period spent abroad.

1.6.2. Date of inception

Your insurance cover commences at the time your
employer specifies your cover to commence when you
are registered. The date is specified in your welcome
letter or you can enquire directly with the HR depart-
ment of your employer. You will receive the welcome
letter immediately after you have been registered. We
will also promptly send you your individual insurance
card. You will find the most important information con-
cerning your insurance cover (policy number, customer
number) on your insurance card, as well as the different
ways to contact AXA. Should you require short-term
confirmation of coverage after your insurance cover
has started, please e-mail us at expat@axa.de or,
alternatively, call our hotline on 0049 221 148-39728.
Our staff are available around the clock to provide assis-
tance.

1.6.3. Termination of insurance cover

Insurance cover shall end with the termination of
the insurance agreement, i.e. as soon as your employer
notifies us of your departure from the plan. This regu-
lation also applies to pending claims.

1.6.4. Reimbursement of costs

In the event of medical treatment or other measures
for which benefits are agreed, reimbursement shall
essentially be limited to the local assessment basis.
Individual cases are examined separately.

In this case you will benefit from the advance confir-

mation of the assumption of costs as AXA contacts the
hospitals and doctors outside of its own global network
in order to negotiate costs and agree direct settlement
where possible.

11
2. Tariff benefits under FlexMed Global DB E&C/
FlexMed Global RK Premium DB E&C
2.1. Scope of cover
2.1.1. Validity of the insurance cover
Please refer to the tariff option applicable to you.
You can call up the tariff for which your employer has
registered you with us in our Customer Online portal by
clicking on [Policy information]. Here you can also see,
if you have worldwide insurance cover including USA
(Region 1) or excluding USA (Region 2).
As a rule, you enjoy worldwide insurance cover also
outside the country to which you are seconded. The
only exceptions are periods spent in your home country
(see above) and in the USA. If you enjoy insurance cover
in Region 1 (worldwide incl. USA), then you are fully
insured in the USA as well. Persons insured in Region 2
(worldwide excluding the USA) are covered for medical
emergencies in the USA for up to 6 weeks per stay.
Travels to the USA for the purpose of medical treatment
are not covered. Please inform us via your HR depart-
ment urgently and in advance if you plan to stay outside
of the country you are seconded to for longer than three
months.
12
2.1.2 Insurance cover in your country of usual
residence
You will be covered for a total period of up to three
months per insurance year during temporary periods
spent in the country you have left or will leave for your
secondment on behalf of your employer. The only
exception applies to home leaves for USA nationals/
residents: If you enjoy insurance cover in Region 1
(worldwide including the USA), you are fully insured
during a home leave for a period of up to 3 months also
in the USA. Persons insured in Region 2 (worldwide
excluding the USA) are covered for medical emergencies
in the USA for up to 6 weeks per stay.
Please note: We deem an emergen-
cy to be the sudden, acute occurrence of
an illness or the acute deterioration of health
which constitutes an immediate threat to
health.
2.2. Outpatient treatment
Reimbursement of costs:
n 100 % of the invoice amount for medically necessary
outpatient treatment, including medicines and
dressings prescribed due to illness, an accident, preg-
nancy or delivery.
Medicines must be obtained from a pharmacy or from
an alternative officially authorised dispensary.
In the case of pregnancy and childbirth all medically
necessary costs will be assumed including the costs
of specialists, antenatal and postnatal care of the
mother and the care of newborn babies. This includes
routine ultrasound scans (up to 3 times) and consul-
tancy.
n 100 % for remedies
Inhalations, physiotherapy, physical exercises, mud
wraps, hydrotherapy, baths, massages, speech
therapy, ergotherapy, electrotherapy, light therapy and
podological therapy are classified as remedies. These
remedies have to be prescribed.
n 100 % for medical aids following advance confirma-
tion of assumption of costs by the insurer.
Only the following aids are classed as medical aids
(incl. the repair thereof) under both tariff alternatives:
– Electronic reading devices, hearing aids including
otoplasty and initial equipment with batteries,
speech aids including initial equipment with
batteries;
– Orthopaedic made-to-measure shoes, orthopaedic
shoe fittings, orthopaedic shoe insoles, orthesis,
bandages;
– Replacement body parts (e.g. prostheses, epithesis),
pacemakers, walking aids and surgical hose, wigs
following chemotherapy and in the case of Alopecia
totalis, scars caused by an accident, radiation or
surgical scarring;
– Stomaostomy, tracheostomy and incontinence
articles, breast pumps, enteral feeding and
accessories;
– Provision of oxygen with oxygen concentrators, liquid
oxygen, oxygen bottles, respiration equipment;
– Monitoring equipment (e.g. pulse oximeters, heart
monitors), insulin-, infusion- and pain pumps, inhalers,
infusion and inhalation apparatus, aspiration and
suction equipment as well as sleep apnea therapy
equipment (CPAP), iontophoresis apparatus,
coagulation monitors (Coagu Check), blood
sugar measuring devices, blood pressure measuring
devices;
– Wheelchairs, walking frames, home dialysis
equipment, special bedclothes for allergic persons
(= encasings), white canes, procurement and
training – but not the upkeep – of a guide dog;
– CPM devices.
The listed medical devices have to be prescribed by a
doctor and they must not be considered to be general
consumer goods.
n 100 % for optical aids (spectacles, lenses and
contact lenses) up to 200 Euro per insurance year.
n 100 % for alternative treatment methods by alter-
native practitioners, acupuncture (needle technique),
homoeopathy, osteopathy and chiropractic.
Expenses for alternative treatments are only reim-
bursable if they are administered by doctors or other
medical care providers who can prove that they have
had relevant training recognised in the country of
treatment and are licensed or authorised to provide
such treatment there. For example, in Germany these
would be alternative medical practitioners as defined
by the German Alternative Medical Practitioners Act
(Heilpraktikergesetz).
n 100 % for medical consultation and diagnosis,
including pathology, radiology, computer tomography
(CAT scans), magnetic resonance tomography (MRT),
positron emission tomography (PET) and
n 100 % for psychotherapy up to a maximum of 20
sessions per insurance year.
n 100 % for preventive check-ups (screening)
n 100 % for vaccinations recommended by the World
Health Organisation.
n 500 Euro for giving birth as an outpatient, even
with no proof of actual costs, upon presentation
of the birth certificate and subject to waiver of reim-
bursement of actual costs.
13
2.3. Inpatient treatment
n 100 % of the invoice amount for the costs of
inpatient treatment due to illness, an accident,
pregnancy or delivery.
Cover is granted for the costs of:
n Hospital care
n Board and accommodation in a single or twin room
n Private medical treatment
n Operations and anaesthetics
n Medicines and dressings
n Medical consultation and diagnosis, including
pathology, radiology, computer tomography
(CAT scans), magnetic resonance tomography (MRT),
positron emission tomography (PET)
n Midwives
n Complications in connection with pregnancy or
childbirth such as, for example, premature birth, mis-
carriage, ectopic pregnancy
n Psychotherapy
n Medically necessary costs of transportation to or from
the nearest suitable hospital
n Transportations which are necessary for medical
reasons and prescribed by a doctor, provided that an
appropriate means of transport is used. In this case a
doctor‘s certificate must be submitted confirming the
medical necessity
n Inpatient follow-up rehabilitation
The costs of subsequent inpatient rehabilitation
measures are reimbursable if and to the extent to
which the insurer has agreed to accept such costs in
writing prior to commencement of the subsequent
rehabilitation measures and provided that no other
cost carrier assumes these costs.
2.4. Supplementary benefits for a parent
or guardian accompanying children receiving
inpatient treatment
Costs incurred for the accommodation of an adult
accompanying a child are covered by the child’s
insurance. This shall only apply in the case of children
under the age of 16.
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2.5. Dental treatment and prosthesis
Reimbursement of costs:
n 100 % of the invoice amount for medically necessary
outpatient dental treatment
n 100 % for professional dental cleaning, up to
100 Euro per insurance year
n With the insurer’s prior written declaration of
assumption of costs, 50 % for dental prosthesis
including:
– prosthetic dentistry, e.g. bridges, prosthetics
– crowns and partial crowns, also in the case of
treatment of an individual tooth
– implants
– functional analysis costs within the scope of a
dental prosthesis measure
– functional therapeutic costs
n 100 % for dental prosthesis due to an accident
n 100 % for orthodontic treatment if the treatment
commenced before the insured person reaches
the age of 19 – up to 1,500 Euro per insurance year
n 100 % for orthodontic treatment due to an
accident
Particularly in the event of treatment involving dental
prosthesis, inlays, implants, periodontal treatment and
orthodontic measures it is always wise to send us the
dentist‘s treatment plan and cost estimate together with
the cost estimate from the dental laboratory.
2.6. Evacuation
n 100 % reimbursement of the costs of medically
necessary or sensible evacuation to the country
from which the principal insured departed on an
assignment for the policyholder or to the home
country of the insured person or to the nearest
suitable hospital.
Medically sensible is a return transport in the following
cases when
n a medically best possible treatment in the country of
residence is not guaranteed, and/or
n the healing process can be remarkably improved by
returning.
Any evacuation must be prescribed by a doctor, or-
ganised by the insurer and be carried out with the
insurer‘s prior written approval. An evacuation can also
be organised by an Assistance Provider commissioned
by your employer.
As far as a separate preauthorisation is issued for the
following, the insurer furthermore pays up to 100 % for:
n the return travel costs of all covered family members.
n accommodation expenses and return travel costs of
an accompanying person (over 18 years) on return of
an insured person under age (under 18 years).
2.7. Repatriation costs
n 100 % reimbursement of the direct costs of
repatriation incurred upon the death of an
insured person, only if repatriation is organised by
the insurer or an Assistance Provider commissioned
by your employer.
Repatriation shall be to the country from which the
principal insured person departed on an assignment for
the policyholder.
2.8. Evacuation of additionally insured
children
n 100 % of the necessary costs of returning
additionally insured children under the age of 18
home, provided that the principal member and all
additionally insured adults were or are to be evacuated
or are deceased.
2.9. Additional benefits
n 100% reimbursement of deductibles according
to Section 61, clauses 1 and 3, SGB V (Deduct-
ibles for Medicines and Remedies) and according to
Section 61, clause 2, SGB V (Hospital Deductibles)
up to 280 Euro per year under the FlexMed Global RK
Premium DB E&C tariff.
2.10. Additional Assistance Services
Insurance cover is more than merely the reimbursement
of costs in the event of illness. The numerous Assistance
Services provided by AXA are a very helpful complement
available to you around the clock. Costs which we incur
with third parties within the scope of Assistance services
are not covered under your tariff benefits. In this case
we shall inform you in good time.
Our Assistance Services at a glance:
n Information on the best medical care available
on location.
AXA Assistance helps you to select the best medical
service provider (doctor, hospital, pharmacy) in his
immediate vicinity.
n Organisation of an early return journey home
If you have to return to your usual country of
residence earlier than planned, AXA will help you to
make the travel preparations.
n Assistance in the case of lost documents
AXA Assistance will assist you abroad to obtain
replacement travel documents.
n Informing relatives in the event of illness
If, in the event of an emergency, you are unable to
contact your relatives, AXA Assistance shall help
by communicating important information and shall
keep the family duly informed of all developments.
n Wheelchair and luggage assistance
If a wheelchair is required when travelling, AXA will
ensure that a wheelchair is available at the airports of
departure and arrival and it will organise transpor-
tation of luggage.
n Translations
AXA Assistance will support you with the translation –
oral and written – of medical documents.
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3. Exclusions
With AXA‘s international health insurance you will enjoy
comprehensive insurance cover for medically necessary
treatment which applies worldwide.
However, within the scope of your cover, the insurer‘s
shall not be liable to pay claims:
1. for illnesses – including their consequences – or for
consequences of accidents or occurrences of death
which were caused by warlike events, civil commo-
tion or civil war. This exclusion shall not apply if the
insured person staying outside of Germany does
not actively participate in the warlike event, civil
commotion or a civil war;
2. for illnesses – including their consequences – or for
consequences of accidents or occurences of death
which were caused through active participation in
acts of terrorism;
3. for illnesses and accidents caused deliberately,
including their consequences, or for the treatment
of addictions;
4. for illnesses and accidents that the insured person
has sustained in a crime committed by him/her
such as murder, manslaughter or rape;
5. for health resort and sanatorium treatment and for
rehabilitation measures of statutory rehabilitation
carriers;
6. for outpatient medical treatment in a spa or health
resort. This limitation shall not apply if, during a
period of temporary residence, medical treatment
becomes necessary due to the manifestation of an
illness not connected to the purpose of the period
of temporary residence or due to an accident;
7. for treatment administered by the spouse, civil
partner, parents or children; material costs are reim-
bursed;
8. for accommodation due to an insured person
requiring nursing care or custody;
9. for treatment due to the unfulfilled wish to have
own children (artificial insemination);
10. for cosmetic/plastic surgery which does not
constitute medically necessary treatment;
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11. for abortion with the exception of the following
three events:
a) due to a medical indication – danger to the life
or the health of the expectant mother.
b) due to a eugenic indication – danger of a physical
or mental impairment of the child – possibility to
abort in the first 22 weeks with exemption from
punishment.
c) due to ethnic (criminological) indication –
pregnancy caused by rape;
12. for remedies, even if they are prescribed as re-
medies, if their composition is not revealed, food
supplements, tonics, cosmetics, mineral waters and
bath salts and oils, potency enhancement remedies,
contraceptives (unless an underlying illness exists),
hair restorers and over-the-counter aids to slimming
and laxatives;
13. for treatment or pharmacotherapies which do not
conform to generally accepted medical practice or
which are deemed to be of an experimental nature;
14. In addition, under the FlexMed Global tariff the insu-
rer is not obliged to pay for illnesses and their con-
sequences and for the consequences of accidents
or death caused by nuclear, biological or chemical
contamination.
Further benefit limitations
Should medical treatment or an alternative measure,
for which benefits have been agreed, exceed the amount
of treatment deemed medically necessary or if the
fee charged is inappropriate, we shall be entitled to
reduce our payments to an acceptable amount. Where
expenses for medical treatment or other services are
strikingly disproportionate to the services provided, we
shall not be obliged to perform in this respect.
Other claims for reimbursement
In the event also of any claim to benefits from a
statutory accident insurance or from a statutory pension
insurance provider or a claim to statutory medical care
or accident care, these must be called upon first.
If the insured is entitled to claim against several
entities liable to pay compensation for the same insured
event, then total reimbursement must not exceed total
expenditure.
4. Particularities of the residual cost
tariff FlexMed Global RK Premium DB E&C
If your statutory health insurance (SHI) remains in For additional information please contact us via e-mail
effect in Germany and your employer has taken out at expat@axa.de or by telephone under the number
private residual cost insurance for you and for the family 0049 221 148-39728.
members accompanying you for illnesses suffered
The General Terms and Conditions (here: AVB-E) of the FlexMed
during your secondment abroad, a separate rule shall Global RK Premium DB E&C tariff apply.
apply to the reimbursement of costs. We have briefly
summarised the necessary steps which enable the
simple settlement of reimbursable costs in a separate
information sheet. These will be provided via the
Customer Online Tool.

5. Particularities of the daily

sickness benefit tariff FlexMed Global Cash

If your employer has taken out the FlexMed Global
Cash tariff you can claim globally applicable daily sick-
ness benefits in the event of an incapacity to work for
a maximum period of 78 weeks (including the selected
qualifying period of 42, 91 or 182 days).
As the daily sickness benefit tariff is only valid in connec-
tion with a FlexMed Global full cost insurance policy, this
cover shall also lapse when the insurance expires.
Further explanations regarding, for example, the scope of insurance
cover and the limitation of the duty to indemnify are set down in
the General Terms and Conditions (AVB-E KT) of the FlexMed Global
Cash tariff. Your employer will be happy to provide you with these
upon request.

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 AXA Krankenversicherung AG, 50592 Köln
www.AXA.de
(1.18)