Your Catalogue of Benefits in case of illness during your assignment abroad. Helpline

Transcription

1 Your Catalogue of Benefits in case of illness during your assignment abroad

2 We look after your health anywhere in the world Welcome to caregroup the global service of Volkswagen Group Services GmbH Being a full subsidiary of Volkswagen AG, the global service of Volkswagen Group Services GmbH supports you in all health matters anytime and anywhere in the world. As an employee of the Volkswagen Group, you are entitled to special care. This is also one of the reasons why the global player is one of the most attractive employers in the world. This Catalogue of Benefits provides you with an overview of our scope of services and also answers all the questions you might have in this regard. We hope you have a successful and healthy time abroad. Yours sincerely, your caregroup team the Global Service of Volkswagen Group Services GmbH In cooperation with your employer, we have compiled a health coverage package for you which is optimized to your needs. Furthermore, you profit from our close cooperation with the Volkswagen medical service as well as the Audi BKK. It is of special importance to us that you and your family can face the challenges of your deployment abroad free from worry. For this purpose, you will receive the best possible health care in the event of illness. This is what we offer and this is also reflected in this guide. 2

3 04 What you should now in advance 06 Services PRIOR TO YOUR MEMBERSHIP 08 Our services 19 What is not covered by caregroup 22 What to do in case of need 27 FAQ 29 Definitions 37 Contact details 39 Imprint 3

4 What you should know in advance A stay abroad always means making new exciting experiences with the people and cultures in other countries, but unfortunately illnesses and accidents can never be ruled out entirely. In order to protect you from unpleasant surprises and protect you in the best possible way, caregroup the global service of Volkswagen Group Services GmbH has developed a high quality service package for you and your family in cooperation with Volkswagen AG. Insurance protection is provided by Volkswagen Insurance Company DAC (VICO). However, our competent and reliable international service will be your exclusive contact for all health issues and matters concerning your benefits during your assignment abroad. Furthermore, we will handle the settlement and reimbursement for the medical services provided abroad. You are in good hands during your stay abroad. The entitlement to benefits is only valid for the period of your assignment abroad. Continued membership after assignment ends is not possible. Membership of your existing health insurance in your home country will be maintained either actively or passively. This makes it possible for you to return to your health insurer afterwards without any problems. 4

5 What you should know in advance Active health insurance If you keep the health insurance coverage in your home country active, you are to turn in all claims resulting from visits to the doctor, dentist or hospital in your home country to your health insurance in your home country. Caregroup will only be liable for the medical expenses which arise in your host country. Passive health insurance (prospective entitlement) If you cannot remain in your health insurance of your home country, then it is possible, that we cover medical expenses for your home country as well. The Human Resources Department of your employer will decide, based on social insurance regulations, if you keep an active form of your labor contract. If you are staying in a third country during your assignment abroad (e.g. while on holiday or business trip), an international benefit coverage valid for up to six weeks is given through caregroup in the case of emergencies (e.g. heart attack or traffic accident). Only exception are the countries for which you have an active health insurance. 5

6 Services prior to your membership We at caregroup the global service of Volkswagen Group Services GmbH act reliably, flexibly and always responsibly. Our service starts long before your deployment abroad; in this way, you will have received all important documents by the time your membership begins. Thus, you can look forward to your new challenges abroad free from worry. You are in good hands with us! 6

7 Services prior to your membership Registration process If you are going to be assigned abroad, the Human Resources representative responsible for you at your home company will register you with us. Subsequently, we will send you a welcome with important information and access to the following linked documents: catalogue of benefits as reference manual refund form for the reimbursement process overview of the international direct billing partners information about invoicing and reimbursement process Your member card The member card will be sent to each registered person by post mail or through the Human Resources department. The member card enables access to selected service providers and offers you two significant advantages: It serves as identification when dealing with medical service providers, e.g. medical practitioners, pharmacists or hospitals. The most important telephone numbers and the data for treatment in the case of illness are all found at a glance. If you misplace your card, we will provide you a new one 7

8 Our services No prior medical examination which implies a risk premium. The treatment of pre-existing illnesses and chronic illnesses is covered as specified in this service catalogue. Reimbursement for the medical services in Germany is based on the medical fee schedules (GOÄ/ GOZ). Medical services will be reimbursed up to the respective maximum rate of 2.3 or 3.5 with appropriate explanation. Your benefits base on the scope of the statutory health insurance in Germany however, you are entitled to very much more. In an uncomplicated way, you will receive customer-oriented services and benefits normally only offered by private insurers. The scope of benefits and services offered by caregroup contains the following additional services ¹: caregroup the global service of Volkswagen Group Services GmbH is a partner you can rely on in health matters. Please find an overview of our extensive range of services below. Treatment by a chief physician and single room accommodation Treatments by chiropractors and osteopaths Coverage for medication without a price limit Inlays and dental implants International emergency treatment and medical evacuation to the home country 24-hour/7-day service ¹ Please take into consideration page 29 and ff. 8

9 Overview of our benefits Outpatient treatment We cover among other services outpatient treatments, diagnostic tests and prescribed medical aids when medically necessary. The specific benefits can be found in the following list: Outpatient treatment Scope of coverage per year of membership* Preauthorization Prescription Medical treatment with free choice of doctor (general practitioner, specialist) Outpatient surgery (see def. 2, page 29) Full reimbursement Full reimbursement Indicated laboratory services (see def. 25, page 32) Full reimbursement x (if above 200 ) X-ray, medically indicated magnetic resonance imaging (MRI), CT (computer tomography) and ET (positron emission tomography) Full reimbursement Chemotherapy, Radiotherapy Full reimbursement x Alternative medicine (see def. 1, page 29) max. 750 Prescribed physiotherapy (see def. 32, page 34) max. 12 sessions x Prescribed Speech-language therapy max. 10 sessions x Psychotherapy (see def. 34, page 34) max x x x x *Please refer to the pages 15, 16 and 17. 9

10 Overview of our benefits Outpatient treatment Scope of coverage per year of membership* Preauthorization Prescription Rehabilitation (see def. 35, page 29 and 34) max x x Medical aids (see def. 27, page 33) max x x Medicine (see def. 4 and 8, pages 29 and 30) Full reimbursement x 10

11 Overview of our benefits Inpatient treatment Inpatient or partial inpatient treatment in a hospital, costs for surgery and anaesthesiology, diagnostic tests, physiotherapy or rehabilitation measures. The detailed benefits can be found in the following listing: Inpatient treatment Scope of coverage per year of membership* Preauthorization Prescription Hospital accommodation (one bed room and chief physician treatment). (Definition 22, page 31) Full reimbursement Hospitalization due to pregnancy and childbirth (one bed room and chief physician treatment) planned/unplanned caesarean section (see def. 22, page 31) Full reimbursement Day clinic and inpatient treatment Full reimbursement Costs for a parent accompanying a registered child with a maximum age of 16 years receiving inpatient treatment max x Surgical fees incl. doctor s fee, costs for anaesthesiology and surgery Full reimbursement Indicated laboratory services Full reimbursement *Please refer to the pages 19, 20 and

12 Overview of our benefits Inpatient treatment Scope of coverage per year of membership* Preauthorization Prescription X- ray, MRI (magnetic resonance imaging), CT (computer tomography), PET (positron emission tomography) Medicine (see def. 4 and 8, pages 29 and 30) Full reimbursement Full reimbursement Rehabilitation measures (see def. 35, page 34 Full reimbursement x x Bone marrow and organ transplants (see def. 20, page 31) Full reimbursement x Radiotherapy and chemotherapy Full reimbursement *Please refer to the pages 19, 20 and

13 Overview of our benefits Additional benefits and services Additional benefits such as, for example, vaccinations, home-care or ambulance services are also covered by caregroup. The specific benefits can be found in the following list: Additional benefits and services Scope of coverage per year of membership* Preauthorization Prescription Vaccinations and prophylaxes within the defined scope of application (see def. 18, page 31) Medically recommended preventive check-ups (see def. 26, page 31) Full reimbursement Full reimbursement Medical check-ups (see def. 10, page 30) max. 800 every 2 years only Prevention courses on health topics as nutrition, exercises, addictive substances, stimulants and drugs e.g. cardio training; confirmation of participation (see def. 33, page 34) for a minimum participation of 80% up to max. 90 per course; up to two courses per year of membership 13

14 Overview of our benefits Additional benefits and services Scope of coverage per year of membership* Preauthorization Prescription Home-Care and domestic services immediately following an inpatient treatment or if an inpatient treatment is not possible or necessary for certain reasons (see def. 11, page 30) max X X Prescribed domestic services (see def. 41, page 35) Full reimbursement X X Pre- and aftercare examinations in case of pregnancy ¹ Pregnancy courses (see def. 36, page 34) Full reimbursement 100% of the costs up to max. 400 Home birth up to max. 1,000 per home birth Midwife services (see def. 12, page 30) Full reimbursement Artificial insemination incl. laboratory and medicine (see def. 24, page 32) 4 attempts 50% max. 4,000 per attempt x x ¹ Please refer to our pregnancy brochure for detailed information on your benefits during pregnancy * Please refer to the pages 19, 20 and

15 Overview of our benefits Additional benefits and services Scope of coverage per year of membership* Preauthorization Prescription Prescribed contraceptives (see def. 42, page 35) full reimbursement up to completion of the age of 21 years Ambulance service (see def. 23, page 32) Full reimbursement x Necessary medical return transfer to the home country (see def. 29, page 33) Full reimbursement x x International emergency treatment in the countries without an acitve health insurance, valid for up to six weeks (see def. 31, page 33) Full reimbursement Transfer in the event of death (see def. 40, page 35) max x Visual aid (see def. 37, page 34) max. 200 x 15

16 Overview of our benefits Dental benefits and services You will be reimbursed for the costs of dental treatment (100%), e.g. preventive measures as well as for indicated artificial denture (80% - up to max. 3,000 in the first year of membership, max. 4,000 in total in the first and second year of membership, and from the third year of membership onwards up to 4,000 euros per year). The detailed services can be found in the following listing: Dental benefits and services Scope of coverage per year of membership* Preauthorization Prescription Dental treatment including x-ray Full reimbursement Surgical treatment, e.g. removal of the tooth, root canal treatment Full reimbursement Professional tooth cleaning once per year of membership, full reimbursement Treatment of periodontitis, oral mucosa disorders and periodontal disorders/periodontal surgery 80% up to max. 3,000 x Occlusal splints, incl. material costs 100% up to max. 1,500 * Please refer to the pages 19, 20 and

17 Overview of our benefits Artificial denture Artificial denture Scope of coverage per year of membership* Preauthorization Prescription Prosthetic services, e.g. dental bridges, dental crowns, inlays, onlays, dental implants, prostheses, dental laboratory work and materials, function-analytical and functiontherapeutic services. During the first 15 months from the beginning of the membership on you are actually entitled to acute situations or emergency treatments only. (see def. 46, page 36) 80% up to max. 3,000 in the first year of membership,up to 4,000 in total in the first and second year, and from the third year onwards up to 4,000 per year x * Please refer to the pages Scope - up to the respective maximum rate of 2.3 or 3.5 times the rate 17

18 Overview of our benefits Orthodontic treatment Orthodontic treatment Scope of coverage per year of membership* Preauthorization Prescription Corrective measures for tooth and jaw misalignment for children and young people with a maximum age of 18 years (treatment plan and cost estimate, see def. 14, and def. 19, page 30 and 31) Full reimbursement x All the maximum amounts listed in the overview of benefits and services (see definition no. 17, page 31) apply for each member and per year of membership (see definition no. 30, page 33) * Please refer to the pages 19, 20 and

19 What is not covered by caregroup caregroup the global service of Volkswagen Group Services GmbH offers a comprehensive scope of benefits and services. Nevertheless, a health care provider cannot cover every treatment without exception. For this reason, the following treatments, medical findings, procedures and compounds are not reimbursable: Elective, non-medically indicated surgeries and/or cosmetic/plastic surgery (see definition no. 21, page 31), as far as the last one does not serve the purpose of restoring the function or outward appearance after an accident or as part of a surgical treatment related to a tumor disease. Treatments which are offered outside the countries of coverage, i.e. outside of the home country and host country. The only exception counts for emergencies during trips with a duration of up to six weeks. Treatments in the home country if you have an active membership in a health insurance there Terminations of pregnancy with the exception of a medically or criminologically indicated abortion (see definition no. 28, page 33). Treatments of sexual dysfunction, sterilization, refertilization or contraception. Sex transformation surgery Stay in a health resort, spa or wellness facility,, nursing home, recreation home or sanatorium, even if this has been prescribed. Drug and alcohol rehabilitation program (amongst others pharmacological smoking withdrawal) as well as treatment of deliberately induced illnesses and injuries. Treatment of illnesses or injuries resulting from active participation in war, riots or civil war. Consultations carried out by your spouse, parents or children. The costs for medically necessary treatments which are carried out by family members are not refundable (even if these family members are medically qualified). Treatment of illnesses or injuries resulting from participation in occupational sporting activities. 19

20 What is not covered by caregroup Any type of experimental or untested treatments which do not correspond to the generally accepted ones (e.g. shock wave therapy, hyaluronic acid). Treatment of overweight, apart from pathological obesity. Non-prescribed medication and medication available over the counter (OTC), regenerative supplements, nutritional supplements, care products, contraceptives and erectile dysfunction treatment medications. Treatment of hair loss, unless the hair loss is a result of tumor therapy. Laser surgery/treatment, e.g. eye surgery/laser surgery for the treatment of visual performance. Cosmetic dental treatment, e.g. veneers, partial crowns in front part, bleaching as well as providing milk teeth with high-quality composite fillings (inserts). Sealing of teeth from the age of 18 years onwards and sealing of milk teeth and frontal teeth and premolar area. Orthodontic treatments with the Aligner Therapy (e.g. Invisalign) and orthodontic treatment for adults. Dental veneers by dental prosthesis (from 6th tooth of the upper jaw and from the 5th tooth of the lower jaw onwards). Please note as well the definition 45 (artificial denture) on page 36. Costs due to a doctor s fee agreement and optional services incl. laboratory. Costs which exceed the reimbursable maximum rates (2.3 to 3.5). Caregroup will not reimburse penalties for late payments by the responsible member. These charges must be paid by the member himself. Air purifier, air humidifier and accessories even if prescribed by a doctor. Transfer of all benefits and services, e.g. maximum amount. Individual health benefits (IGel: Individuelle Gesundheitsleistungen) medical services that are excluded from the caregroup benefits. 20

21 What is not covered by caregroup Ozone therapy Phototherapy X-ray or ultrasound in 3D/4D Couple therapy or marriage counselling Parking fees and banking charges Travel and accommodation costs, even if they are related to a medical treatment. 21

22 What to do in case of need In order to ensure that you are aware of the procedures in advance and do not need to deal with unnecessary paperwork in case of illness; the following illustrations of the operational procedures will help you to achieve the fastest possible processing. Please remember to request the original documents (prescriptions or invoices). Copies will not be accepted. As an exception, copies may only be submitted if the original document is no longer available and this is confirmed by you personally and in writing. In order to avoid double payments, the invoices should either be addressed to you (in which case you will be reimbursed) or to Volkswagen Group Services GmbH (in which case direct payment will be done). Please make sure that you have an authorized payment method acceptable for the hospital on the day of discharge. In case of an emergency, you do not require pre-authorization for inpatient treatment. However, the global service of Volkswagen Group Services GmbH must be informed accordingly within 48 hours of admission. 22

23 What to do in case of need Visiting a doctor Before visiting a doctor Before the treatment starts, always check whether the service you want to use is contained in our service catalogue and also if a pre-authorization is. When is a pre-authorization necessary? Preauthorization is always necessary for a predictable inpatient treatment* prior to hospitalization, for patient transfers, for dental prostheses and orthodontic treatment. This also applies for treatments requiring an agreement between medical practitioner and caregroup about treatment procedures, the number of proposed treatments or procedures and costs. In order to be able to issue a guarantee of payment, we need the following documents from your doctor: treatment plan and cost estimate (see definition no. 14, page 30) x-ray, in case of dental treatment medical reports in case of inpatient treatment* This treatment plan and cost estimate will be checked by caregroup the global service of Volkswagen Group Services GmbH in order to enable the fastest possible treatment guarantee. All treatments requiring pre-authorization are listed on pages 6 to 11. Please note: In case pre-authorization was not requested for an inpatient treatment or other treatment listed in our overview of services, we are not obliged to cover the costs. If a subsequent assessment confirms the medical necessity for the treatment, you will, of course, be reimbursed appropriately. With the end of your assignment abroad, your entitlement to benefits automatically ends as well. You are not entitled to any further claims against caregroup the global service of Volkswagen Group Services GmbH. During your visit to the doctor When visiting your doctor, bring with you the following: Member card ID document (ID card or passport) and pre-authorization letter (if for this treatment) * If you receive an inpatient treatment, the treatment plan, has to be submitted to us mandatory four weeks in advance. 23

24 What to do in case of need Settling the payment: Reimbursement In order to be entitled to reimbursement, the treatment must have been made by a legally approved doctor, dentist or other therapist. You need to ensure that you are invoiced for the treatment. The invoice must contain the following information: first and last name date of birth of the member invoice number date of treatment and invoicing the diagnosis (diagnosis/icd code) or a description of the symptoms break down of received treatments, individual prices and total amount in the case of dental treatment, the affected and replaced teeth as well as the carried out treatments must be indicated Direct billing Direct billing ensues if the invoice is addressed directly to Volkswagen Group Services GmbH instead of you. You have the option to have the treatment costs billed directly to caregroup - the global service of Volkswagen Group Services GmbH - by the medical service provider. Please refer to our direct payment list to find out for which service providers direct billing is currently possible. An overview of our international direct billing partners can also be found on our website under: Direct billing with hospitals, medical practices and other service providers If the provider agrees in a cooperation with us, we will settle the bill directly with the hospital. In this case, you are not to pay in advance. To be on the safe side, find out whether such an agreement has been made before checking out of the hospital and if the check-out staff of the hospital is aware that you are not to make any cash payments. Please inform us in case the service provider you have selected is not listed on the direct billing list. We will gladly contact him on your behalf. Direct billing is the quickest and easiest method of payment for all parties involved. 24

25 What to do in case of need Reimbursement procedure caregroup - the global service of Volkswagen Group Services - is committed to reimburse you as quickly as possible for advance payments. How to claim reimbursement: Duly fill the refund request which we have sent to you or which you can find under including your IBAN and BIC/SWIFT and add the date and your personal signature to the document. Please use a separate form for each covered person. Attach all the original documents such as doctors bills, invoices, prescriptions for medicine, invoices for laboratory tests etc. to your refund request and send these documents to the following address: Volkswagen Group Services GmbH caregroup / Auslandsservice Major-Hirst-Straße 11 D Wolfsburg GERMANY You can also send the refund request via Werkspost (company mail) to: name: Volkswagen Group Services GmbH caregroup location code: 951 postbox: initials: A-GKPA Please note Reimbursement applications must be submitted within six months (ultimo) to the end of the calendar year at the latest. The year in which the service was provided or the invoice was issued counts. Any applications submitted at a later date will not be considered. Our advice: submitting applications at yearend or in mid-year may lead to longer processing times. For this reason, we recommend that applications are submitted as soon as possible. 25

26 What to do in case of need Processing of your refund request by caregroup of Volkswagen Group Services GmbH As soon as your refund request has been received on time, you will receive a confirmation via . Subsequently, we will process your claim as quickly as possible. Reimbursement currency Reimbursements are paid out directly to you. Reimbursements are either paid out in EUR or in the currency of the invoices. The following currencies are not reimbursable: CNY/RMB, MYR, THB, TWD, TRY, and CLP. Payments by cheque are not possible. Please indicate your currency of choice on the refund request. The exchange rate used will be the rate of the first trading day of the month in which the invoice or receipt was issued. Reimbursements will be transferred; free of charge (see definition no. 38, page 35), to the bank account you specified for your home country or host country (see definition no. 38, page 35). The credit is made via the Volkswagen Global Treasury Platform (GTP). 26

27 FAQ Now you know which services we provide. Here you will find answers to the most frequently asked questions. How can I get enrolled in the global service of caregroup? The Human Resources Department of your employer in the home country will register you automatically with caregroup - the global service of Volkswagen Group Services GmbH - before your assignment abroad starts. Are additional costs such as e.g. parking fees during doctors visits also reimbursed on top of the medical fees? No, additional costs cannot be reimbursed by us. We offer you a comprehensive scope of services, which focus on the essentials: the medical services. What happens if I am in a hospital or medical facility and am to pay a large sum for the treatment in advance? In this case, please call us. If no direct billing agreement exists, we will fax a confirmation of the covered range of benefits to the hospital or medical facility. In most cases, this will result in you not needing to pay any fees in advance. On our website you will find a complete list of all the medical service providers with whom we have reached a direct billing agreement. Which bank account should be specified for reimbursement payments: the bank account in the home country or the account in the host country? You can choose either of the two. If you decide to use your German account, the bank transfer normally take less time. However, please keep in mind that some additional costs may arise when you access the money from the host country e.g. by withdrawal or transfer. Can I submit copies of the invoices when applying for reimbursement? You are to submit the original invoices by mail along with the refund request. Otherwise we will have to decline the reimbursement request. Do I still need my national or private health insurance? Or can I cancel it when I go abroad? There is no general answer to this question. It depends on the respective home country/host country combination as well as your personal family situation. Please ask the Human Resources Department of your company and your local health insurer. 27

28 FAQ My address has changed. How should I proceed? It is in your own interest to immediately inform us, in writing, of any changes to your correspondence address as well as your address and telephone number auslandsservice@volkswagen-groupservices.com with your membership number. Which address should I choose for communication? In some host countries, mail deliveries may pose a problem. Please specify an address on your refund request which is safe to use in order to ensure that you will receive our correspondence. Please also specify your telephone number and address on the forms so that we can reach you if we have any questions. What happens in the case of changes to the family status (birth, marriage etc.)? Please inform your Human Resources Department and immediately send them a copy of the respective certificate. Can I remain a caregroup member when I return from my assignment abroad or if I leave the Volkswagen Group? No, the caregroup benefits are only available for active members of the Volkswagen Group during their assignment abroad. Insofar as you were insured with a statutory or private health insurer before your assignment abroad, you should contact this insurer in order to find out what your options for continued insurance are. How do I cancel the membership once I have returned permanently from my assignment abroad? As your Human Resources Department has only arranged the membership for a limited period anyway, the membership will end without you needing to cancel it. If your assignment abroad is extended or shortened, the Human Resources Department of your company will automatically contact and inform caregroup - the global service of Volkswagen Group Services GmbH. In case of illness, you will profit from our comprehensive knowledge of national and international medical service structures. Do you have any questions? Call us we are looking forward to help you. We are at your service. Helpline:

29 Definitions In order to clarify and avoid misunderstandings, the meanings of the terms used in this guidebook are defined as follows: 1. Alternative medicine is defined as methods of treatment and diagnostic concepts, alternatively or in addition to the conventional medicine. These include naturopathy, osteopathy, acupuncture, TCM and homeopathy (only prescribed globules are refundable). Alternative medicine can be refunded within the maximum value of 750 but only if performed by a medical specialist with an additional qualification in naturopathy or homeopathy. 2. Outpatient surgery, also known as ambulatory surgery, is a surgical procedure that is performed inside a medical practice, an ambulatory department of a hospital or a day centre. From a medical perspective it is not for the patient to stay overnight. This corresponds to the German statutory health insurance regulations. 3. Relatives or accompanying family members are those family members or companions who accompany you during your assignment abroad and share your household. This does not include relatives visiting you from your home country or country of origin. 4. Medicine drugs are substances and preparation of substances to cure, mitigate or prevent diseases applied to the patient or restore, correct or influence functions in the body. Covered by caregroup are generally only prescription drugs that are covered by the statutory health insurance in Germany as a standard benefit. Please note that prescription drugs are only refundable together with the original prescription showing the diagnosis. Non-prescription medicines are only available in pharmacies but without a prescription. Therefore, they are also called OTC products ( over the counter = over the counter selling). Please note that OTC drugs and so called Life-Style-Products are not refundable, even when they are prescribed by a physician. Products classified as vitamins or minerals, food, diet products, tonic as well as cosmetic products or ones for the prevention or used habitually are not refundable. Even if they are medically recognized, recommended or prescribed. Also not refundable are detergents such as lens cleaning tissues, moisturizing drops, contact lens care products, cases, normal bandages, such as children patches. 29

30 Definitions 5. A doctor is a medical practitioner (general practitioner or specialist) or holder of a medical degree/diploma which is officially recognized and who may legally practice medicine in the country of treatment. Any doctor meeting these requirements may be selected. 6. A treatment is any medical procedure for healing or relieving illnesses or injuries. 7. A third country is the country to which the caregroup member travels during his assignment abroad, e.g. for the purpose of a holiday or business trip. It does not refer to the home country or country of origin. 8. Over-the-counter medication refers to medicine which may be sold in other shops besides pharmacies (e.g. supermarkets and drugstores) and are available without prescription but not refundable. 9. The host country is the country of residence and work of you and your family during your deployment abroad. 10. Medical check-ups Health check-up (for employees from 18 years onwards) should preferably be carried out in health department of the host company or during the home leave in the health department of the home company. The usual checkup intervals of the respective companies apply. If this is not possible (employees and family members from the age of 18) the examinations can be done at a service provider of your choice. The usual checkup intervals of the respective companies apply as well. In these case the maximum amount covered is Home-care refers to the medical services of a nurse or person with similar training which have been prescribed by a doctor. The prerequisite is that this will prevent, shorten or replace hospitalization which would otherwise be. A preauthorization is. 12. Midwife services: caregroup members are entitled to make use of the services of a midwife prior to, during and after the delivery in accordance with the midwife guidelines of the German Statutory Health Insurance. In the first 10 days after the delivery, one visit per day is reimbursable. From the eleventh day onwards to eight weeks after delivery, up to 30 consultations are reimbursable. More than 30 consultations are only reimbursable if these have been prescribed by a doctor. 13. Healing therapies are diagnostic and therapeutic measures for identifying, relieving or healing disorders, illnesses or injuries. 14. A treatment plan and cost estimate for orthodontic or prosthetic treatment shows the planned treatment and the estimated costs for a 30

31 Definitions patient. In principal, the treatment plan and cost projection has a similar function to the offer of a dentist or another provider and serves to clarify which costs are carried by the patient, caregroup or other carriers. 15. The home country is the country from which you and your accompanying relatives are assigned by the employer. 16. The country of origin refers to your country of birth. 17. The maximum amounts refer to the maximum amounts which are reimbursable. All maximum amounts apply to each registered person and year of membership. 18. Vaccinations and prophylaxes protect against dangerous diseases. The costs for prescribed, medically vaccinations recommended by the German Vaccination Commission (STIKO) and the World Health Organization (WHO) are reimbursable. However, vaccinations and prophylaxes for holiday trips to third countries are excluded. The costs for necessary prophylaxes and vaccinations associated with your host country are reimbursable as far as they are not provided by the corporate medical service as non-cash benefit. Vaccinations have to be carried out by the health centre of your company. Please contact them in order to get more information. Information and contact persons can be found under: and Orthodontic services refer to corrective measures for tooth and jaw malocclusion using of special treatment devices. Treatment should have been initiated before the age of 18. A treatment plan and cost projection for the entire treatment must be submitted before treatment begins. The Aligner therapy is not refundable. 20. Bone marrow and organ transplants refers to the surgical measures for organ and/or tissue transplantations such as e.g. heart, heart valves, lung, liver, pancreas, kidney, bone marrow, parathyroid gland, muscle/skeleton and cornea. 21. Cosmetic/plastic surgery is only refundable in exceptional cases, e.g. surgeries for restoring the function or outward appearance after an accident or as part of a surgical treatment related to a tumor disease. A previous authorization is. 22. A hospital is a medical facility which is officially recognized in its country of operation. In such a facility, the patient is constantly monitored by a doctor. During inpatient treatment in a hospital, the covered member, without any time limit, is entitled to a single room accommodation as well as for 31

32 Definitions the treatment by a chief physician. Recreation homes, nursing homes, health resorts, spas as well as sanatoriums are not considered to be hospitals. Please note that in case of a planned or unplanned caesarean section a medical diagnosis is needed. 23. An ambulance service is a necessary medical transport of a patient for an initial treatment following an accident or emergency. It is performed by an approved emergency service using a proportionate means of transportation and transfers the patient to the closest suitable hospital or medical facility. 24. Artificial insemination is a medical necessary treatment that is applied to induce a pregnancy. Before the start of the treatment a pre- approval is absolutely necessary under submitting medical reports of findings and a treatment plan. This has to contain a maximum of three planned subsequent cycles. Caregroup covers 50 % of the costs up to max per attempt (limited to four attempts) inclusive the costs for laboratory and medication are covered. This service can only be allowed in the case of married couples and only in the homologous system, whose eggs and sperm cells must be only used. The requirements for a covered IUI / IVF or ICSI treatment are that both members are at least 25 years old but not older than 45 (women) or 50 (men). If you are, however, already in the 45th (44 years old woman) or 50th (49 years old man) year of age, only one attempt is refundable. 25. Laboratory services (inpatient and outpatient): All medically necessary tests depending on the diagnosis of the delegating physician are covered. Not refundable are laboratory tests beyond the defined and sufficient measure of an appropriate and economic patient care specified by the Gemeinsamer Bundesausschuss (Federal Joint Committee (G-BA)). Please note that, if the costs for a laboratory treatment are over 200, it will be necessary to issue a pre-authorisation. 26. Medically recommended preventive check-ups help to identify and successfully treat illnesses at an early stage. Medically recommended preventative check-ups for children and adolescents include check-ups U1 to U10 as well as J1 and J2, whose purpose it is to ensure the normal physical and mental development of the child. Recommended check-ups for women include: genital examinations (from the age of 20 years onwards, annually) breast and skin examinations (from the age of 30 years onwards, annually) examinations of the rectum and colon (from the age of 50 years onwards, annually) 32

33 Definitions enteroscopy (from the age of 55 years onwards, every two years) mammography screening (from the age of 50 years to the age of 69 years, every two years) The medically recommended preventative check-ups for men include: prostate, genital and skin examinations (from the age of 45 years onwards, annually) examinations of the rectum and colon (from the age of 50 years onwards, annually) enteroscopy (from the age of 55 years, every two years). 27. Medical aids (according to the Catalogue of auxiliary and non-physician Care) refer to prescribed medical aids (these include prostheses, orthopedic accessories, braces and walking aids, hearing aids, stoma consumables, hernia supports, abdominal bandages, compression stockings) or accessories/ technical products which serve the purpose of transporting medication or other therapeutic preparations for internal use into the body (e.g. injections, inhalation devices and similar application aids). This also includes changes and repairs to these medical devices as well as replacements and the training for their utilization. Medical devices must be prescribed by a doctor and may not be categorized as general materials. 28. Medically or criminologically indicated pregnancy terminations arise when the health of the woman is seriously endangered by the pregnancy or if there are clear grounds for assuming that the pregnancy is a result of a sexual offence (sexual abuse of children and helpless victims, rape or sexual assault). In such a case, medical evidence must be submitted along with the indication and diagnosis as well as a cost estimate. 29. Medically return transportation relates to the medically prescribed return transportation of the covered person into the home country in case of an accident or severe illness which is covered according to our catalogue of benefits and if, from a medical perspective, an unassisted return journey is not possible. The medical necessity for the transportation must be attested by your treating doctor and the transport must be applied for and authorized by caregroup in advance. A signed release of private information must be submitted along with the application and the attestation by the doctor. 30. The membership year starts with the registration of a new assignment in caregroup. The next membership year will begin twelve months after the start date. 31. An emergency refers to an accident or other misfortune, an acute start or an acute worsening of a severe illness which poses an immediate th- 33

34 Definitions reat to the inflicted person s health and, therefore, requires immediate medical attention. 32. Physiotherapeutic measures include the following physical-medical services: inhalations, physiotherapy and physical exercises, massages, medical packs and medicinal baths, thermal treatment, occupational therapy (OT), manual therapy (MT), lymphatic drainage, and electrotherapy. These treatments must be performed by a doctor in his own practice or by a holder of an officially recognized diploma for assistance medical professions (massage therapist, certified masseur and balneotherapist, physiotherapist) with an own practice and must have been prescribed by a doctor. The prescription must have been issued prior to the treatment date and contain the diagnosis, type and number of treatments. 33. Within the health subject of prevention course you will receive the following range of services starting 2018: For at least 80% of participation we are refunding a maximum of 90 Euro per training for up to two courses per membership year 34. Psychiatric treatment/psychotherapy refers to the treatment of a clinically significant psychological or psychiatric disorder, which causes a considerable impairment of the personal capabilities in important life functions (e.g. ability to work). The disorders must be classifiable according to the criteria of a recognized classification system (e.g. ICD-10). Not refundable are couple therapies. 35. Rehabilitation is the specific treatment inside a recognized rehabilitation facility following acute injury or illness where the emphasis is on the recovery of the normal function and/or form of a part of the body and/or organ. This includes, among others, physiotherapy, massages, medical packs, thermal therapy and electrotherapy. Pre-authorization is for rehabilitation measures. Applications may only be submitted if no other carrier (e.g. statutory pension insurance) is responsible for this. The letter of rejection by the other carrier must be submitted along with the cost estimate. 36. Pregnancy courses refer exclusively to prenatal classes and postnatal exercises for women. A certificate of attendance of the facility must be submitted along with an indication of the total costs for the course. 37. A visual aid is an optical device used for compensating defective vision or improving the visual performance. These primarily include glasses and contact lenses. Please note that we are only allowed to accept invoices proceeding from a land with an active coverage with caregroup (at your home and/or host land). 34

35 Definitions 38. In this context, free of charge means that no bank fees are charged for the transfer of the reimbursement amount. 39. Outpatient clinic or partial inpatient treatment refers to a treatment carried out in a hospital or a day center during the day. The caregroup member is entitled to a single room and treatment by a chief physician. An overnight stay of the patient is not or no longer medically. 40. A transfer in the event of death refers to the return of a deceased person from a foreign country to the home country. Funeral expenses are excluded. 41. Domestic services will be reimbursed in following the cases: If and as long as the covered member is not capable of keeping his household running due to illness an according to a medical prescription If there is no other member in the household who can assume this task And if there is a child in this household which is either younger than 14 years or disabled and in need of support. Domestic services are only approved for a period of 20 workdays and a maximum of 8 hours per day and per illness case (in well-justified exceptional cases for an additional 10 working). No costs are reimbursed for relatives and persons related by marriage to the second degree. The prices will be considered according to the local fees. 42. Prescribed oral contraceptives are reimbursable for female members up to completion of the age of 20 years. Not refundable is the application of an intrauterine device. 43. Prescribed speech therapy serves the treatment of a diagnosed impairment such as e.g. nasal obstruction, neurological disorders (lingual paresis, brain damage etc.) or articulation disorders due to anatomical deformities of the mouth (e.g. cleft palate). In the case of speech impairments, speech disorders and voice disorders, we will assume the reimbursable costs for exercise treatments if prescribed by a paediatrician or an otolaryngologist in as far as these are performed by a doctor or speech therapist. 44. Pre-authorization means that prior approval by caregroup the global service of Volkswagen Group Services GmbH is for the assumption of costs before the treatment can begin. Please refer to the paragraph Our services to gain an overview of the treatments requiring pre- authorization. 35

36 Definitions 45. Dental treatment refers to medical dental treatment indicated in the overview of dental services. Treatments of milk teeth using high-quality composite fillings (insert) are excluded of the coverage. 46. Artificial denture refers to prosthetic services such as e.g. dental crowns, inlays, onlays, dental implants or dental bridges. All additional dental services associated with dental prosthetic treatment are also included in this definition (e.g. laboratory and material costs). Orthodontic treatments that could be related to a subsequent prosthetic treatment are excluded from the coverage. Please note that there is no entitlement to prosthetic services of missing teeth or not durable fixed artificial tooth at the moment of the beginning of the assignment. During the first 15 months from the beginning of the membership on you are actually entitled to acute situations or emergency treatments only. In order to check and approve a prosthetic treatment, we need the following documents in advance: treatment and cost plan x-ray Please read at this regard the pages 16 and ff. 36

37 Contact details Do you have any questions about your benefits and our services? The team of the Global Service of Volkswagen Group Services GmbH places its services at your disposal to answer questions you might have concerning the range of benefits. You can call us: Mondays to Thursdays From 8 a.m. - 6 p.m. (CET/CEST) Fridays: From 8 a.m. - 5 p.m. (CET/CEST) Telephone In case of a medical emergency, you can also call us around the clock from anywhere in the world under this number. Or you can send us an auslandsservice@volkswagen-groupservices.com Of course, you are also welcome to visit us personally: Volkswagen Group Services GmbH caregroup/auslandsservice Braunschweiger Straße 101/Burgwall 17 D Wolfsburg 37

38 For Members who are living and working in the USA and Mexico: We have a separate information booklet for you and will gladly advise you before your departure. Please keep in mind that, in the USA, direct billings as well as pre-authorizations are handled by our partner Olympus Managed Health Care and in Mexico by our partner CNI - Choicenet International. Only reimbursement applications have to be sent to us directly. For questions and information in the USA: Olympus Managed Health Care Hotline: oder toll-free (USA/Kanada; 24 h) olympus@omhc.com USA: Chattanooga: For questions and information in Mexico: CNI Choicenet International toll-free 01 (800) (786) CNIteam@choicenet.mx 38

39 Postal adress: Volkswagen Group Services GmbH caregroup/auslandsservice Major-Hirst-Straße 11 D Wolfsburg Publisher: Volkswagen Group Services GmbH Project management: Julia Rösler Visiting adress: Volkswagen Group Services GmbH caregroup/auslandsservice Braunschweiger Straße 101/ Entrance Burgwall 17 D Wolfsburg Impressum Set & Layout: Marketing Services - Creative Group (MSCG) Status: January 2018 Tel Fax auslandsservice@volkswagen-groupservices.com 39