Services brochure 2018 Stay healthy. Get well. Be provided for.

Transcription

1 Services brochure 2018 Stay healthy. Get well. Be provided for.

2 We are close at hand. Find your local customer center. Berlin Daimlerstrasse 112 Phone: +49 (0) Fax: +49 (0) Berlin-Friedrichshain Mühlenstrasse 30 Phone: +49 (0) Fax: +49 (0) Bremen Mercedesstrasse 1 Phone: +49 (0) Fax: +49 (0) bremen@daimler-bkk.com Düsseldorf Rather Strasse 51/Bldg. 104 Phone: +49 (0) Fax: +49 (0) duesseldorf@daimler-bkk.com Esslingen-Mettingen Emil-Kessler-Strasse 4 Gate 1/Bldg. 1 Phone: +49 (0) Fax: +49 (0) stuttgart@daimler-bkk.com Germersheim Mercedes-Benz-Strasse 1 Gate 1, room E.07 Phone: +49 (0) Fax: +49 (0) germersheim@daimler-bkk.com Hamburg Am Radeland 125 Phone: +49 (0) Fax: +49 (0) hamburg@daimler-bkk.com Hannover Mercedesstrasse 9 Phone: +49 (0) Fax: +49 (0) hannover@daimler-bkk.com Kassel Mercedesplatz 1 Phone: +49 (0) Fax: +49 (0) kassel@daimler-bkk.com Ludwigsfelde Industriepark Phone: +49 (0) Fax: +49 (0) berlin@daimler-bkk.com Mannheim Hanns-Martin-Schleyer- Strasse Phone: +49 (0) Fax: +49 (0) mannheim@daimler-bkk.com Neu-Ulm Carl-Zeiss-Strasse 2 Phone: +49 (0) Fax: +49 (0) neu-ulm@daimler-bkk.com Rastatt Mercedesstrasse 1 Gate 3/Bldg. ATZ Phone: +49 (0) Fax: +49 (0) rastatt@daimler-bkk.com Sindelfingen Tübinger Allee, Gate 80, Bldg. 551, ground floor Phone: +49 (0) Fax: +49 (0) sindelfingen@daimler-bkk.com with customer centers located in Bldg. 50/1, entrance D, level 0, Bldg. 44/6, Room 409 Stuttgart-Möhringen Epplestrasse 225/Bldg. 6 Phone: +49 (0) Fax: +49 (0) stuttgart@daimler-bkk.com Stuttgart-Untertürkheim Mercedesstrasse 132 Bldg. 132, ground floor Phone: +49 (0) Fax: +49 (0) stuttgart@daimler-bkk.com Wörth Daimlerstrasse 1 Phone: +49 (0) Fax: +49 (0) woerth@daimler-bkk.com Gaggenau Hauptstrasse 107/Gate 1/Bldg. 34 Phone: +49 (0) Fax: +49 (0) gaggenau@daimler-bkk.com Postal address Daimler BKK Bremen Central phone number Phone +49 (0)

3 We offer you a service provided by colleagues. No other health insurance fund can be as close to its members as the Daimler health insurance scheme (BKK). As a health insurance fund exclusive to Daimler AG and affiliated companies, we can tailor our package of services to the needs of the company s staff and their families. Because we are employed by the company ourselves, we are well acquainted with the situation in each workplace and with the working environment at each site.

4 We live service. We offer a simple, straightforward service with a number of extras. Judge us on the basis of our service promises Attractive reward schemes Make the most of workplace health promotion offers or take part in the popular 100 PRO AKTIV reward scheme. You can gain a bonus of up to 100 if you complete various healthy-living measures and activities within one calendar year (proof required). Alliances with professional service providers No matter whether you re young or old, at home or at work, we want to support you through everything that life throws at you and that s why we are working in partnership with experts. Which means better service and greater peace of mind for you. Tariff options It s important that your healthcare benefits are flexible, so that you re not paying more than you have to, while also ensuring you have the best cover. Turn to page 52 for our tariff options. Supplementary insurance Need additional cover for glasses or alternative medical treatments? Daimler Vorsorge und Versicherungsdienst (Daimler VVD) knows the insurance market inside out and will find the right supplementary insurance for you. Always there for you We are always there whenever you need us, offering round-the-clock opening hours, fixed appointments with an advisor and much more besides. We are flexible and tailor our service to your individual requirements. Close at hand We are always on hand not only at all the main Daimler plants where we have customer centers. We also come to you wherever you are at home, in the workplace, or in the hospital. Simply tell us what you need and we will arrange an appointment for you within three working days. An appointment as soon as possible Time is precious. We don t expect you to waste it waiting around. If you would like an appointment with an advisor at your customer center, we guarantee you won t have to wait long. Colleagues looking after colleagues As your colleagues, we know how things operate at Daimler. We are well acquainted with the situation in each workplace and with the working environment at each site. No other health insurance fund is as close to its members. We take care of your concerns as if they were our own. We have our finger on the pulse We will always keep you fully informed. We keep you up to date with all the latest developments relating to health insurance and health & safety policy. Our extras * We delight our customers with the services we provide. The majority of our services are statutory obligations but we have the opportunity to offer a number of extras in addition to the standard services in many areas. These extras include: online customer center attractive reward schemes alliances with professional service providers tariff options supplementary insurance Daimler BKK app Assistance in any situation Special circumstances require a special kind of support. We have a wealth of expertise and we are happy to give you the benefit of our experience whether it s relating to nutrition, travel, private health insurance abroad, retirement pension, psychological problems, or private supplementary insurance. We help keep you fit We encourage you to take preventive action: health courses, activity weeks, health centers on site, etc. Our range of services is comprehensive. Round-the-clock peace of mind We move with the times. Our online customer center at is open 24 hours a day. Need an additional service? If you require a specific service, just let us know. We take your needs seriously and will do our utmost to meet them wherever possible and desirable. Please us at wirlebenservice@daimler-bkk.com. They are marked with an asterisk. *

5 Daimler BKK is online. Website and app. Our smart media makes it easier for you. Our website Your benefits Become a member, learn about Daimler BKK services and receive health tips and much more information all with a click of the mouse. Receive our most up-to-date offers at any time by visiting our website at We are providing all important documents and forms that you will need to do so here. It s worth it to take a look over and over again. Online customer center At our online customer center you can get instant answers to many questions at any time of day! Have you moved house and want to update your address details with us? Do you need a membership certificate? Do you want to find out what excess you d have to pay for dental prostheses? These are just some of the many useful services available from our online customer center. It s well worth taking a moment to register. web code 165 The new Daimler BKK app with even more convenience It s fast, easy to use and practical. By using the Daimler BKK app, you will always have access to our service at your fingertips, which helps you save a lot of time and money. You can find all important information regarding your Daimler BKK insurance in the app. The app continues to expand with new services for your convenience. Sending us your sickness notification Infected with the flu? Have a torn ligament? Starting now, you can take a picture of your sickness notification (disability certificate) with the new Daimler BKK app and send it to us. Our tip: Even if you are rarely sick, it s a good idea to download the Daimler BKK app right away and apply for your login. It will be mailed to you within a few days. Got everything together? Then you can use the app immediately in case there s an emergency, and save precious time. In just a few seconds, you can send your illness report to us and then focus on getting healthy again. Quick clarification of family insurance We must have your Questionnaire on reviewing family insurance in order to keep our insurance information up to date. If you have family members that are insured with us, we will regularly need to request some important details from you either using our website or with the Daimler BKK app. You can now comfortably fill out the questionnaire online with just a few clicks. Other benefits By using the Daimler BKK app, you always have contact information for our customer centers and can reach us directly via the app. Would you like to change the information provided on your bank account? The app lets you do that quickly and easily, and your data will be transmitted securely. Downloading the Daimler BKK app The Daimler BKK app is available free of charge in the Google Play Store and the Apple App Store. One-time registration in our online customer center is needed to use some of the services in the app. All app functions are explained in a video on our website at: web code 4830

6 We re not here for everyone only for you Our exclusive range of services. Our health insurance fund covers Daimler AG and a number of other affiliated companies; we would be pleased to send you a list of these firms on request. If you work for one of these companies, you and your family members can obtain insurance from us. Who can become a member? Employees of Daimler AG or other affiliated companies, unless they have private health insurance Employees who are returning from an assignment abroad and are (re)employed in a role covered by the BKK Pension claimants and retirees who used to be employed by one of the named companies Spouses and life partners (as defined by the German law on life partnerships) of our members who are insured through another statutory health insurance fund Who can remain a member? Members who switch to another job within the Daimler Group or to another employer Members who take part-time phased early retirement Members who take (early) retirement Students and interns who were previously covered through family insurance Children who were previously covered through family insurance Spouses and life partners (as defined by the German law on life partnerships) of our members who were covered through family insurance Employees of the Daimler Group who are not covered while on an assignment abroad but would like to be covered once they return to Germany Who is covered by family insurance? We provide health insurance cover for your entire family: spouses, life partners (as defined by the German law on life partnerships), and children of our members are also insured without having to pay any additional premiums, provided their monthly income does not exceed certain statutory limits. We would be pleased to inform you of the current income thresholds. If one parent is not insured through a statutory health insurance fund, special terms and conditions apply to the children. We would also be pleased to advise you on this matter. When are children covered by your insurance? Usually up to their 18th birthday Up to their 23rd birthday if they are not in employment Up to their 25th birthday if they are still in full-time education or are completing a year of voluntary social/environmental work; periods of voluntary military service or recognized voluntary community service extend their entitlement to insurance cover by one year Indefinitely if they cannot support themselves financially due to disability

7 Stay healthy 08 Get well 24 Be provided for 34 Premiums and additional payments 42 Tariff options 44 Our services (A Z) 46 N.B.: For ease of reading we have chosen to use the masculine pronoun throughout. Naturally, this always refers to both men and women. This brochure provides you with a summary of Daimler s healthcare benefits. Only the applicable laws and our articles of incorporation are legally binding. Should you have any queries, please do not hesitate to contact us.

8 Stay healthy Keep fit! At work, in everyday life, or within the family with our targeted service and many free extras, we help you to look after and improve your health. 01 Stay healthy at work 01.1 Tips from the professionals 01.2 Courses in the workplace and nearby 01.3 Tips, advice and assistance 02 Stay healthy in everyday life Getting off to a good start 02.2 Looking after your health and having fun 02.3 Health checks for your own peace of mind 02.4 Extra check-ups for him and her 02.5 Not giving infectious diseases a chance

9 02.6 Looking after your teeth 02.7 Keeping your vision clear with glasses and contact lenses 02.8 Rewarding health-conscious employees 03 Stay healthy within the family Pregnancy and check-ups 03.2 Supporting you through childbirth 03.3 For the healthy development of your child 03.4 When someone is ill at home 03.5 Health cures for mothers, fathers and children 03.6 Health pays for the whole family 04 Stay healthy on vacation Plan before you set off 04.2 Medical care on vacation 05 Stay healthy as you get older Early detection and check-ups 05.2 It pays to exercise 05.3 Information when you need it

10 01 Stay healthy at work. Doing something for your own health in the workplace? We promote the development of specific programs. Daimler BKK and our colleagues on the ground feel a special sense of responsibility for all issues relating to workplace health promotion. In conjunction with Daimler AG s health management team, we support the health promotion measures and activities at the sites and offer exclusive benefits for our members. Good for maintaining your health long term Tips from the professionals Workplace health promotion We see the promotion of healthcare within the company as a longterm, systematic process. Using our tools for promoting health in the workplace, we work together with Daimler AG s health management team to achieve Daimler s ultimate goal of having healthy employees in a healthy company. Health reports Our health reports offer an informative analysis tool for calculating the sickness figures at the sites. These analyses enable us to derive targeted measures for all employees at Daimler AG and our members, such as the development of needs-based courses. Workplace health promotion bonus model * Maintaining and improving the health of the workforce: this was the purpose behind the development of our scientifically supported workplace health promotion bonus model. It rewards outstanding commitment at Daimler Group plants, sales and service outlets, and logistics centers with bonus payments. All of the money is used for workplace health promotion initiatives at the sites. This ensures that all employees at Daimler AG benefit from the funds, and that workplace health promotion is strengthened over the long term. Together with the Health & Safety department, we have continued developing the workplace health promotion bonus model over the years. The working relationship with the individual sites plays a major part in the success of the model. Free use of the company medical service * In an emergency, our members who are Daimler employees can use the company medical service (CMS) at the company sites free of charge. If you require any medication or vaccinations as part of this first-aid treatment, the company s medical service will charge these costs to us. Flu vaccination * Active Daimler employees can be given this vaccination by the company medical service at a number of Daimler Group sites. Employees are notified of vaccination appointments via the portals and notice boards Courses in the workplace and nearby RückenPlus * Move around again without pain with a scientifically tested training program for the back, shoulders, hips, and knees. The RückenPlus program is aimed at Daimler employees with recurring back problems. The first step is an examination by the company doctor to verify that you have a medical need. The training itself takes place in small groups of up to eight people and is held in modern facilities near your place of work. Specialist trainers lead the 30 to 36 training sessions and provide personalized exercise plans for you to follow at home. How you benefit: hassle-free access following referral by the company doctor detailed initial analysis and final analysis to provide a comparison training in small groups under expert leadership use of high-quality medical training equipment personalized exercise program to follow at home and accompanying workbook Cost coverage for the RückenPlus program The program starts with six to twelve units, the costs of which are settled on the basis of a physiotherapy prescription. This gives you an introduction to the physiotherapy content of the program. You pay the statutory contribution of 10 percent. For twelve training sessions, this amounts to approximately 50. We will reimburse the full cost of the subsequent 24 training sessions if you take part in the program regularly. Programs for trainees Trainees and apprentices at our sites have the opportunity to attend exclusive quality-assured courses on prevention and healthcare, which are specially tailored to the needs of those who are just starting out on their career path. In relation to these measures too, we act as a cooperation partner for the Health & Safety unit in many cases, helping to support health promotion activities for trainees in the Daimler Group. 10 STAY HEALTHY

11 Healthcare courses held near the workplace In collaboration with the health centers and SG Stern Germany, we provide quality-certified healthcare courses that are tailored to the personal needs of our members. For maximum convenience, the courses are held near members workplaces often at in-house health centers. We pay 90 percent of the course fees (up to a maximum of 150). We offer members subsidies on up to two healthcare courses per calendar year Tips, advice, and assistance Balancing a career and a family The professional demands placed on employees continue to increase and we spend a large part of our day at work. Because of this, it is not always easy to reconcile work responsibilities with family obligations. It is important to achieve a balance between the different areas of your life. A wealth of tips and information on how to successfully combine work and family life can be found on our website: web code 1512 Shift work Shift workers are subjected to high levels of stress. Their daily rhythm is completely disrupted. It is therefore all the more important to look out for their health. We offer good tips on adequate periods of rest and recuperation. These can be found on our website. Health risks in the workplace Smoking, alcohol, bullying, or workaholism none of these is acceptable in the workplace. We provide information and advice on these issues. By creating awareness we help to improve your personal health and that of your colleagues. Further information on this matter can be found on our website. Our service Health coaching Fitness advice online with: Abreathing coaching breathe deeply again office fitness coaching get fit at your desk back coaching we ll help you protect your back web code 4810 Online customer center A 24-hour online service, not just for shift workers: all you need is your insurance number and a password, and you can access exclusive information, functions, and services. Personal advice at your workplace We come to you. On request, we can visit you in your place of work, at home, or in the hospital. Brochures and information sheets Information materials on the RückenPlus back program are available from your local customer center. Keeping fit at your desk and PC Our website has a section entitled Keeping fit at your desk and PC which contains information about posture, eye relaxation techniques, and many other tips on working in front of the screen: web code 195 Psychosomatic intervention * Swift and professional help for psychosomatic problems: you can attend up to eight personal appointments at recognized psychosomatic medicine institutions as an outpatient following a referral from the company doctor, from the Daimler AG counselor, or directly from us. The aim is to increase your quality of life, enable you to continue working, and avoid any risk of becoming incapacitated. The appointments are of course voluntary, confidential, and subject to legal duties of nondisclosure. We cover the costs. * Extra services offered by Daimler BKK STAY HEALTHY 11

12 02 Stay healthy in everyday life by looking after yourself and being active. Not easy, but far easier with the right packages. Our health is dependent on a wide range of factors that we are not always able to influence ourselves. To a certain extent, however, every individual can actively do something for their health in their day-to-day lives. Lifestyle and nutrition play a major role here. Our services and packages are designed to help you to lead a healthy life. After all, prevention is better than cure and it improves your quality of life Getting off to a good start Trainees and newcomers welcome! Trainees and newcomers can take full advantage of Daimler BKK s services. These are available to all those who start their careers in the Daimler group. They can even keep their membership going if they later change employer. What s more, the children of Daimler BKK members have the unique opportunity to keep their Daimler BKK policy when they begin their training, irrespective of where they start their traineeship. We are not just like every other health insurance fund. We offer many extras that others do not, including lots of tips and a helping hand for trainees starting out. Simply visit our website to browse our varied range of services. Programs for trainees at Daimler At some Daimler sites, our trainees and apprentices have the opportunity to take part in exclusive prevention and healthcare courses that are specially tailored to the needs of those who are just starting out on their career path. As a cooperation partner for the Health & Safety unit, we support health promotion activities for trainees and young employees in the Daimler Group Looking after your health and having fun Prevention courses from Daimler BKK We want our members to stay fit and healthy that s why we actively help them by subsidizing two prevention courses each year with a focus on the following areas: exercise nutrition stress relief/relaxation addiction and substance abuse Appointments with specialists If you think you need an appointment with a specialist, you already have a referral but do not know which specialist to contact, or you need an earlier appointment with a specialist due to illness, our appointment service is here to help. Appointment service of the Associations of Statutory Health Insurance Physicians The regional appointment service guarantees a maximum waiting time of four weeks for a specialist appointment. With the exception of ophthalmologists and gynecologists, this requires you to have been referred to a specialist. Our website contains all of the telephone numbers for the Associations of Statutory Health Insurance Physicians sorted by German federal state. web code 4958 BKK activity weeks * These healthcare programs are especially popular because they are both enjoyable and useful. Our activity weeks are fun and beneficial to your health. We offer a variety of programs for every stage and situation in life. And best of all, we cover the full cost of these programs; all you have to pay for is your accommodation and meals. web code 364 Well-Aktiv * Well-Aktiv is the title of our compact course for improving your health in beautifully scenic surroundings: over the course of four or five days, we invite you to take preventive action to look after and improve your health. As with the BKK activity weeks, we cover the cost of the program itself; all you have to pay for is your accommodation and meals. web code 543 Healthy backs Exercise and sport strengthen all of your back muscles. Walking, swimming (on your back), cycling, and cross-country skiing massage the spinal column and help to keep it supple. There are two ways in which we support your participation in expert back-strengthening classes: we offer subsidies for quality-assured training courses and participation counts toward our 100 PRO AKTIV reward scheme. You can also find a wealth of handy tips on our website for keeping your back strong. web code 4571 You can also find all our subsidized courses online in our healthcare course database. web code STAY HEALTHY

13 02.3 Health checks for your own peace of mind Check-ups for women Women can have screening to enable the early detection of cancer from the age of 20. The nature of these medical check-ups vary with age and the associated risk factors. The following regular medical check-ups for women are covered by the health insurance scheme: cancer screening from the age of 20 check-ups from the age of 35 to enable the early detection of cardiovascular and renal disorders, diabetes and skin cancer early detection of bowel cancer from the age of 50 mammography screening between the ages of 50 and 69 two colonoscopies from the age of 55, alternatively fecal occult blood test Reimbursement of costs for courses on breast self-examination * Daimler BKK reimburses the full cost of courses offered by midwives, pro familia e.v., and gynecologists on the early detection of breast cancer through self-examination. Check-ups for men * People who look after their bodies and make use of the free regular medical check-ups know how to play it safe. An appointment with your doctor can be arranged quickly and easily. For every stage in life, there are various medical check-ups men can have to detect illness early on: check-ups from the age of 35 to enable the early detection of cardiovascular and renal disorders, diabetes and skin cancer early detection of prostate and genital cancer from the age of 45 early detection of bowel cancer from the age of 50 two colonoscopies from the age of 55, alternatively fecal occult blood test Prostate cancer test for men from the age of 20 * The PSA test (prostate specific antigen test) is used for the early detection of prostate cancer. We recommend a thorough consultation with the doctor who is conducting the test. We also cover the costs of the test up to a maximum of 20 per year for men with particular risk factors for this illness. Cancer screening for men under 45 * Men under 45 are now also eligible for examinations to detect cancers. We refund the costs up to a maximum of 15 per year, if there are particular risk factors present for cancer. Our service Health online Our free initial online consultation for all your health-related issues. Whether it s life coaching, expert consultations or local healthcare courses you re looking for, you ll find it here. Sign up for our Daimler BKK newsletter Services, medical facts, changes to laws no matter what the news is: You will hear about it straight away with our Daimler BKK newsletter. Go to and simply enter web code 5666 in the search field to register for the monthly newsletter. web code 5666 Daimler BKK app Are you an active person and always on the go? No problem. With the Daimler BKK app, you can always access our exclusive services no matter where you are. More information at: web code 4830 INFOMED healthcare hotline: +49 (0) The independent guide that will help you find your way through the healthcare jungle. Brochures and information sheets Information materials on the following topics are available from your local customer center: prevention healthcare 100 PRO AKTIV reward scheme dental prostheses (incl. supplementary insurance) BKK Activity Weeks and Well-Aktiv programs * Extra services offered by Daimler BKK STAY HEALTHY 13

14 02.4 Check-up extras for him and her Check-up for under-35s * You re never too young to have a check-up! This medical examination checks for signs of high blood pressure, cardiovascular disease, diabetes and kidney damage. Every other year we will refund costs up to a maximum of 30, if there are particular risk factors present for an illness. Skin cancer screening and reflected light microscopy * Malignant skin tumors can be detected at an early stage through skin cancer screening and also by using reflected light microscopy. This simple examination method uses a microscope to examine the deep layers of the skin. Once a year we will reimburse costs for skin cancer screening and reflected light microscopy up to a maximum of 25. For reflected light microscopy only, we cover the costs up to a maximum of 10 per year, if there are particular risk factors for this illness. Health comes first check-up service * The reminder service provided by your Daimler BKK: we will write to you ahead of any medical check-ups that you are entitled to to ensure they do not get forgotten. The earlier a disease is detected, the better the chance of overcoming it Not giving infectious diseases a chance Vaccinations * Vaccinations are among the most effective and important prevention measures for our health. They offer the best and simplest method of protecting against dangerous infectious diseases. We will cover the cost of any vaccinations recommended by a doctor in Germany. We will also pay the cost of any vaccinations you may need if you are traveling abroad on business. Flu vaccination * A genuine flu virus is no laughing matter. You can protect yourself against such viruses by being vaccinated in the autumn, and we ll cover the cost. And to make things even easier for you, many workplaces within the Daimler Group provide vaccination appointments Looking after your teeth Individual prophylaxis and regular check-ups * From the age of six to 17, children should attend six-monthly dental check-ups, known as individual prophylaxis, to prevent dental diseases. 14 STAY HEALTHY

15 This covers the following: assessment of oral hygiene status advice on dental care and nutrition plaque removal fluoridation of teeth and sealing of fissures on the large, permanent molars Our tip: make a note in your bonus booklet of regular check-ups and the date of your oral hygiene status check in order to save on subsequent treatment costs or the cost of dental prostheses. It is also important that young children have dental check-ups. If children do not attend a group check-up at their school or kindergarten, they need to have three dental check-ups between their third and sixth birthdays in order to detect any problems at an early stage. Pediatricians often carry out these check-ups. Members aged 18 or over are entitled to an annual dental check-up. Dental treatment Daimler BKK will bear the cost of medically recommended and necessary treatment. Under certain conditions, this may cover orthodontic treatment, periodontal treatment, and fillings. Further information about cost coverage and contributions can be found on our website under Teeth. Dental prostheses The following applies to all health insurance funds: the allowance for your dental prosthesis is based on the problem, i.e. the diagnosis. In practice, this means that all members are awarded the same amount for the same diagnosis. Depending on the diagnosis (for example, missing tooth), we will pay you individually calculated amounts. The fixed subsidies cover 50 percent of the specified amounts for the standard treatment. The fixed subsidy may be increased by 20 to 30 percent if you present your dental care bonus booklet. Private supplementary dental insurance * Moderate insurance premiums, high level of service that s what you can expect from supplementary dental insurance tailored to your individual needs. We offer various types of supplementary dental insurance for dental treatment and dental prostheses through Daimler Vorsorge- und Versicherungsdienst (Daimler VVD). Daimler VVD ensures you receive high-quality treatment in return for reasonable insurance premiums. For more information on tariffs and services, please get in direct contact with our colleagues at Daimler Vorsorge- und Versicherungsdienst (Daimler VVD). Getting a second opinion free of charge * The patient advice centers of the German Dental Association (BZÄK) and the regional Associations of Statutory Health Insurance Dentists (KZVs) provide professional advice on all aspects of dental care Keeping your vision clear with glasses and contact lenses Glasses For children and teenagers aged 18 or under and members with seriously impaired vision, we will pay the agreed fixed contribution toward lenses prescribed by an ophthalmologist, provided the type chosen is covered by our contract. Frames are not included in this service. Multifocal lenses and contact lenses Where necessary, we will subsidize the cost of multifocal lenses and in certain circumstances contact lenses and plastic spectacle lenses for children and teenagers aged 18 or under. For safety reasons, plastic lenses are always recommended for children aged 14 or under and we will, of course, subsidize these. All healthcare insurance schemes base these subsidies on binding reference prices for optical aids. Private supplementary insurance: glasses and contact lenses * Could you use a little extra assistance to help you see more clearly? If so, our private supplementary insurance for spectacles and contact lenses could be of interest to you. Our colleagues at Daimler Vorsorgeund Versicherungsdienst (Daimler VVD) will be happy to advise you on tariffs and services Rewarding health-conscious employees 100 PRO AKTIV reward scheme * 100 PRO AKTIV is the name of our reward scheme for healthconscious employees. Children aged 6 to 17 and adults aged 18 and over can get involved and collect points toward cash bonuses. We award children a maximum of 30 for taking part in programs, while adults can earn up to 100 per year by participating in health programs (proof required): check-ups that are absolutely necessary from a medical point of view for example cancer screening or general medical examinations challenges that, above all, reward physical activity for example healthcare courses, BKK activity weeks taking initiative with own healthcare, such as getting additional vaccinations You benefit from: free advice a second opinion from another dentist explanation of issues relating to your cost and treatment plan or private invoice * Extra services offered by Daimler BKK STAY HEALTHY 15

16 03 Stay healthy within the family. Living with children and taking responsibility for their health we can help you with this. A new life is being brought into the world, and this brings with it added responsibility and challenges for the parents. We want you to be able to enjoy life with your children from the very first moments. We therefore offer you advice and cover the cost of check-ups and other services tailored to your needs Pregnancy and check-ups Conceiving through fertility treatment * Many couples and women who want children make use of fertility treatment. We offer more than just the legally required cost contribution: we cover additional costs arising from the treatment plan, so long as both partners are insured with us. Healthy pregnancy * We offer an additional care service for mothers-to-be: Healthy pregnancy. Participation is voluntary and free of charge; all you need is for your gynecologist to be participating in the service. They will use a questionnaire to assess your individual risk of premature birth and provide comprehensive advice on personal risk factors. During early pregnancy (before the start of the ninth week), a vaginal ultrasound scan can be conducted to confirm that the pregnancy is intact and help ensure that potential complications are identified at an early stage. Your gynecologist can also use supplementary laboratory tests between the 16th and 24th week to identify hidden infections that could trigger premature birth at an early stage. Antenatal care As soon as you become pregnant you are entitled to receive antenatal care, which you should take advantage of in the interest of your own health and that of your baby. You are entitled to be screened for gestational diabetes (glucose tolerance test) between the 24th and 28th weeks of pregnancy. As of July 1, 2013 this is charged to your electronic health card (Gesundheitskarte). You are entitled to two check-ups after your baby has been born. A detailed overview is provided in our brochure on check-ups. You can also use our service for advice on health insurance during maternity leave and parental leave. Simply inquire at your customer center. Enhanced ultrasound examination During the course of their pregnancy, women are generally given three basic ultrasound examinations. At the second ultrasound (at between 19 and 22 weeks), expectant mothers can choose between a basic examination and an enhanced ultrasound examination that can identify potential abnormalities. Your doctor will charge this service to us using your health card. Ultrasound examination in early pregnancy * We will cover the cost of an ultrasound examination during the early stages of pregnancy (between four and nine weeks) up to a maximum of 35. Toxoplasmosis test * We reimburse the cost of a toxoplasmosis test to check for immune protection during the early stages of pregnancy. If there is no sign of immune protection, we will also carry the cost of another two tests at up to 30 per test. Nuchal translucency (NT) scan * We will cover the costs of an NT scan, including laboratory services, up to a maximum of 180. Medication for pregnant women * We cover pregnant members for the cost of non-prescription proprietary medicines containing the active ingredients iron, magnesium and folic acid (as separate or combination drugs) that are available only from pharmacies, if recommended by a doctor. Please contact us to find out the exact requirements for reimbursement of costs. Stiftung Warentest information * Information on screening and its benefits can be requested from the Stiftung Warentest product-testing foundation via the online customer center on our website a service that is available free of charge to our members: web code 242 BabyCare * This program, which we provide free of charge, supports women through their pregnancy and during the first few weeks following the birth. Women are given a handbook containing all the important information relating to pregnancy and birth, a brochure full of recipes for a healthy diet, a diary for important dates such as gynecological appointments and questionnaires for identifying individual risks particular to them. The aim is to prevent premature births. 16 STAY HEALTHY

17 03.2 Supporting you through childbirth Maternity assistance Well looked after right from day one. Our maternity assistance covers treatment by a doctor and assistance from a midwife, as well as nursing care in a hospital or dedicated maternity facility and help at home. Please contact us to find out the exact services and terms. We will be happy to advise you. Midwife call-out service * Midwives are invaluable in all aspects of birthing. Women nearing their due date are glad to have support they can count on day and night. We will refund the costs of a call-out service in the final weeks of pregnancy (generally 38 to 42 weeks) up to a maximum 250 per pregnancy. The midwife must be self-employed and fully registered. Antenatal classes for her and him * One of the many advantages of antenatal classes is that they provide a good opportunity to familiarize yourself with the maternity hospital or birthing center. We will cover the cost of antenatal classes offered by registered providers: 6.80 per hour (in groups of up to 10 expectant mothers for a maximum of 14 hours) 8.83 for individual classes prescribed by a doctor (for a maximum of 28 classes lasting 15 minutes) Besides subsidizing the classes for pregnant women, Daimler BKK will reimburse up to 50 per year for their partners to take part, so long as they are also insured with us. Postnatal exercise classes We will cover the cost of postnatal exercise classes offered by registered providers: 6.80 per hour (up to 10 new mothers per group for a maximum of 10 hours) Maternity pay for women in employment Maternity pay is designed to offer the financial means to enable women in employment to prepare for the forthcoming birth of their child. The amount women receive is dependent on their net earnings, but the maximum amount paid by the health insurance fund is currently 13 per day. If your net earnings are higher, the difference will be paid by your employer. Maternity pay is generally paid for six weeks prior to delivery and eight weeks after the birth of your child. Our service Online portal Fit from an early age Our free online portal with suggested games and tips for parents: web code 1576 Online questionnaire for family insurance Website or app? You can now fill out the questionnaire more conveniently online and send it to us. More information at: web code 4830 Family hotline: +49 (0) The trained staff at our partner INFOMED will answer your health questions: pregnancy hotline baby hotline youth hotline parent hotline Brochures and information sheets Specialist information sheets for you, available from your local customer center: full protection for your family healthcare: keeping you healthy BabyCare pregnancy care package healthy pregnancy * Extra services offered by Daimler BKK STAY HEALTHY 17

18 03.3 For the healthy development of your child Sight tests for little ones * Two sight tests are carried out between 5 and 14 months and between 20 and 50 months to screen for amblyopia. Amblyopia is a sight condition also known as lazy eye. Early diagnosis and treatment prevents permanent loss of vision and blindness. Daimler BKK covers the cost of this screening up to a maximum of 20 per test. Check-ups from birth to five and a half years The sooner the better: for children, healthcare begins when they are a newborn in the hospital, where parents are given an examination booklet outlining exactly which examinations are due when. There are exactly ten in the first five years. The first takes place immediately after the birth. This is followed by nine further check-ups (U1 to U9). More check-ups for your child in elementary school * Two additional medical check-ups (U10, U11) are recommended when your child attends elementary school. Sometimes children need targeted support, especially in their first few years at school. The U10 check-up is for children aged between seven and eight. It is used to identify any developmental and behavioral problems and to initiate treatment where necessary. The U11 check-up for children aged between nine and ten seeks to identify any problems with performance at school, socialization and behavioral issues, dental, oral and maxillary abnormalities, as well as media use that could be damaging to their health, and to initiate the relevant treatment. Adolescent check-up for 12 to 14 year olds (J1) The onset of puberty brings with it a number of significant challenges for children and their parents. It is important that the adolescent check-up (J1) is carried out to prevent risks. The check-up focuses on the early detection of illnesses that could affect physical, mental, or social development. Adolescent check-up for 16 to 17 year olds (J2) * A J2 examination is recommended to monitor ongoing health developments in young adults. Physicians check for (and discuss) puberty problems, abnormal posture, eating, digestive and metabolic disorders, and other conditions. We refund the cost of this examination up to a maximum of 50. In some states in Germany, it is sufficient to present the health insurance certificate, provided there is a family-doctor agreement in place. We refund the costs for J2 if there are particular risk factors for an illness. Our Health comes first check-up service * Our Health comes first campaign reminds mothers and fathers in writing about their child s next medical check-ups this service is free. Full coverage of costs for vaccinations * Vaccination is one of the most effective and important prevention measures for our health. It protects against infectious diseases, some of which can have very severe consequences. For some of these diseases, no effective treatment has yet been developed. So do not put yourself and your loved ones at risk. Keep up to date with your vaccinations! From flu vaccinations for adults to jabs against polio and other diseases for children: we will cover the cost of any doctor-recommended vaccinations for Germany and for travel abroad. Dental sealant * Dental sealant for the milk molars and permanent molars is available for children aged between six and 17 as a form of protection from an early age. We reimburse up to 7.50 per sealed tooth. Orthodontic services For children and adolescents who are under the age of 18 when treatment starts, we will pay 80 percent of the cost of any medically necessary orthodontic treatment. If several children are being treated at the same time, we will bear 90 percent of the costs for the second child and each subsequent child When someone is ill at home Help at home * Too ill to run the household on your own for the time being? Members can apply to Daimler BKK for help with the cost of a home help, if they are unable to run their household because of serious illness. We offer far more than the legal minimum in this respect. Speak to us for advice so that we can suggest the best solution for your situation. We help make arrangements or discuss with you the possibility of someone you trust acting as a home help. Child sickness benefit You will be eligible to receive sickness benefit for a sick child if you are unable to work because you have to look after or nurse the child. This is provided that the child is covered by statutory health insurance, is under the age of 12 or has a disability and is reliant on the help of others, and that no one else in the household can take on this responsibility. We will be happy to answer any questions you have about the exact rules. 18 STAY HEALTHY

19 03.5 Health cures for mothers, fathers, and children Get the information, then the cure In today s society, mothers, fathers, and children are all under a great deal of pressure. Stress, exhaustion, and chronic illness increasingly require specific medical intervention. Prevention-oriented health cures can help to protect against impending illnesses or undesirable developments (especially in children). They can also show people how to adopt a healthier lifestyle. If the treatment you are currently receiving locally has proven insufficient and your doctor believes a health cure is necessary, we would be pleased to help you. We offer advice on outpatient and inpatient health cures, health cures for children, and health cures for mothers or fathers and their children. Through our collaboration with a number of quality-certified health-cure establishments, we can help you to find the one that is right for you. Full cost coverage for health cures for children We will cover the full cost of health cures for children. In the case of children aged eight and under, we will also pay for the mother or father to accompany the child Health pays for the whole family 100 PRO AKTIV reward scheme * Our tried-and-tested reward scheme, 100 PRO AKTIV, is entering its next stage and is making it even easier for children and adults to take part in activities that promote a healthy lifestyle. Children aged 6 to 17 and adults aged 18 and over can get involved. Check-ups and sports, healthy eating and consultations the more involvement and dedication members can prove, the better. We award children a maximum of 30 for taking part in programs, while adults can be awarded up to 100. Bonus cards for you and any spouse or children insured with Daimler BKK can be ordered by phone, in person at your local customer center, or online at: web code 4520 Pediatric day surgery * Pediatric day surgery is beneficial because it uses less invasive surgical methods and avoids long stays in the hospital, which can be very stressful for children. We will cover the costs, including appointments immediately before and after the hospital visit, as well as anesthesia, and material costs. * Extra services offered by Daimler BKK STAY HEALTHY 19

20 04 Stay healthy on vacation. We offer service and peace of mind, so you can relax and enjoy your vacation. It s vacation time at last. Your bags are packed and off you go. But have you considered all eventualities? We want you to be able to really relax during your precious time off. We therefore offer tips on how to prepare for your holiday along with a comprehensive international service. Everything to keep you healthy before, during, and after your vacation Plan before you set off Health insurance for travel abroad Receiving good treatment if the worst happens while you are abroad we believe it is our duty to give you this peace of mind. While traveling in EU countries and Switzerland you are covered by health insurance and can obtain treatment in an emergency. A foreign healthcare certificate or European Health Insurance Card (EHIC) is indispensable for travelers. However, your statutory entitlements while abroad are not as extensive as those covered by private health insurance for travel abroad. Even if you have a foreign healthcare certificate or EHIC, there may be situations in which a doctor will only treat you if you pay upfront. Depending on the country, we are permitted to reimburse only some or even none of the costs. Statutory health insurance funds are not permitted to cover the cost of transporting you back home. We therefore recommend that you take out private health insurance for travel abroad.

21 Private health insurance for travel abroad * By taking out private health insurance for travel abroad, you are playing it safe. It offers the most extensive cover, and includes return transport home for example. Daimler Vorsorge- und Versicherungsdienst (Daimler VVD) recommends premium products for private health travel insurance. Please contact us. We will be happy to advise you. German-/English-speaking doctors abroad * Before you set off, you can contact INFOMED for addresses and information on doctors in the area who speak German and/or English. Call the health hotline at any time on +49 (0) Reimbursement of costs for travel vaccinations * Different countries, different diseases. However, you can protect yourself against most infectious diseases through vaccination. We will cover the cost of all vaccinations recommended by your doctor. You get the vaccinations done, submit the prescription and invoice to us, and we will reimburse you for the full cost Medical care on vacation Visiting a doctor in Germany If you are vacationing at home, there s no change: you can get medical and dental treatment wherever you are in Germany. You just need to take your health card (Gesundheitskarte) with you to the doctor s and you will receive treatment straight away. Our service Vacation preparations and travel first aid kits Look online for useful tips and checklists to help get your vacation off to a good start: web code 4975 Fact sheets for around 40 holiday destinations Comprehensive information about services and rules relating to the reimbursement of treatment costs in different countries. It s quick and easy to download from the website: web code 448 Brochures and information sheets Specialist information sheets for you, available from your local customer center: vacation guide private health insurance for travel abroad Visiting a doctor abroad You must take your health card (Gesundheitskarte) with you if you travel to a country in the European Union (EU) or the European Economic Area (EEA), which includes Norway, Iceland, and Liechtenstein, or to Serbia, Montenegro, Macedonia, or Switzerland. The reverse of the card incorporates the European Health Insurance Card (EHIC). You can obtain treatment by simply showing the doctor your EHIC together with your ID card or passport. Exception for Serbia: Here you must present your EHIC to the local health insurance company, which will give you a certificate showing your entitlement to treatment. Germany has social insurance agreements with Bosnia and Herzegovina, Tunisia, and Turkey. We can provide you with a special certificate of entitlement to treatment in these countries. You can also download information sheets about your destination from our website. The certificates of entitlement give you access to services in accordance with the locally applicable laws. You need to take out private health insurance for travel to countries in which neither the EHIC nor any social insurance agreement is valid. * Extra services offered by Daimler BKK STAY HEALTHY 21

22 05 Stay healthy as you get older. We are all getting older but that doesn t mean we can t stay healthy by keeping physically and mentally active. Age needs to be redefined in our society. For a long time now, being a member of the older generation has no longer been seen as a disadvantage. Overall, the health and fitness of senior citizens has improved considerably. We can also help you to stay fit for a long time to come Early detection and check-ups Skin cancer screening and reflected light microscopy * The earlier malignant skin tumors are detected, the better the chances of recovery. We reimburse the costs of annual skin cancer screening with reflected light microscopy up to a maximum of 25. Reflected light microscopy is a simple examination method, whereby the deep layers of the skin are viewed through a microscope. For reflected light microscopy only, we will pay costs up to a maximum of 10 per year. In individual cases, we will refund the costs for both check-ups when there are particular risk factors for skin cancer. Colon cancer screening from age 50 As part of the regular medical check-up for colon cancer, a doctor or specialist carries out a digital rectal examination. Patients up to the age of 55 also undergo fecal occult blood testing on their stool. We will cover the cost of an annual check-up. From the age of 55 upwards, members are entitled to regular screening for colon cancer in the form of two colonoscopies. There must be at least ten years between the first and second examinations. If you choose not to have a colonoscopy, you can have your stool tested for occult blood every two years. Whether you are male or female, you should take advantage of this preventive screening for your own peace of mind. Breast cancer screening for women from age 50 Women aged between 50 and 69 are entitled to mammography screening for the early detection of breast cancer. Mammography screening involves taking an x-ray of the breasts. The aim of this screening program is to detect breast cancer as early as possible so that it can be successfully treated with minimum invasiveness. Courses on breast self-examination * Courses on breast self-examination are a good way of enabling women to spot any early signs of breast cancer. These courses are offered by gynecologists, midwives, hospitals, women s health centers, pro familia e.v., and similar organizations. We will reimburse the full cost of such courses. Flu vaccination * Flu vaccination is recommended and offers effective protection in particular for the over-60s. We also recommend the vaccination for people with cardiovascular diseases or a weak immune system. We will cover the cost of the vaccination. Ultrasound examination of the abdominal aorta from the age of 65 Abdominal aortic aneurysms can develop in old age. During an ultrasound examination, the diameter of the abdominal aorta is measured once to determine the possible presence of bulging and decide on a treatment. We offer this screening to all men ages 65 and above It pays to exercise Activity weeks * Our BKK activity weeks keep you fit. After all, prevention is better than cure. Together with like-minded individuals, you can attend selected health resorts to discover how being healthy can be fun. Specific topics include: relaxation training orthopedic back exercises Nordic walking hiking ergometer training The relevant catalogs are available from our customer centers. Alternatively, you can view all packages and register online at. web code Plus activity weeks * At Daimler BKK we focus on prevention. We will subsidize costs up to 160 when you take part in a BKK activity week that is tailored specifically to the needs and capabilities of people aged 60 and over. What you can expect: six-day prevention program packages in selected spa resorts throughout Germany healthcare programs on exercise, relaxation and diet continuous in-house quality management 22 STAY HEALTHY

23 100 PRO AKTIV reward scheme * If you keep yourself fit and healthy, we will reward you with a bonus of up to 100. Whether it s active involvement in a sports club, a flu vaccine or colon cancer screening, we recognize your efforts with a bonus each year. Further information can be found on our website. Alternatively, you can simply request your bonus card from your local customer center web code 4507 Information when you need it Over-50s healthcare hotline * The over-50s healthcare hotline from INFOMED is the healthcare hotline service for our more mature members. Here, specialists can answer any questions relating to issues that crop up more often in your later years. Simply call +49 (0) if you have questions on topics such as: finding the right type of sport for more physical activity as you get older avoiding injury not putting on weight when you retire keeping memory loss at bay correcting failing eyesight anti-aging and what s behind it hearing problems and hearing devices Our service Staying active as you get older Your comprehensive online guide to the health of women and men in the second half of their lives. Key words are menopause, screening, etc.: web code 4572 Memory trainer A host of memory exercises at the click of a mouse. Simply visit our website and train your mind and your brain: web code 67 Over-50s healthcare hotline: +49 (0) Independent doctors and medically trained staff at our partner INFOMED will answer your questions. Brochures and information sheets Specialist information sheets for you, available from your local customer center: Activity week and Well-Aktiv catalogs prevention check-ups * Extra services offered by Daimler BKK STAY HEALTHY 23

24 Get well When you are sick you need the best possible support. We are always there to offer practical assistance: from advice on treatment and therapy options to covering costs and offering our own range of courses. We want your treatment to be successful.

25 06 Get well with rapid assistance Going into hospital 06.2 Additional cover 06.3 Going to the doctor 06.4 A linked network for successful treatment 06.5 Getting help and guidance 07 Get well with medication and physical aids Good information and advice 07.2 Complete overview of the costs 07.3 Adapting to physical restrictions 08 Get well with health cures, therapies, etc The right health cure for me 08.2 The right treatment for your symptoms 08.3 Getting the right treatment 08.4 Getting you back on form 08.5 Finding your feet again once you return to work

26 06 Get well with rapid assistance. Working together with doctors and hospitals to ensure the best care that is our goal. If you fall ill, you can expect us to deliver a fully comprehensive, high-quality service. By working closely with doctors and hospitals, we make sure that you receive the best-possible treatment and benefit from the full range of facilities offered by the healthcare system. This way we can manage cases individually and professionally for your benefit and for your speedy recovery Going into hospital Getting to the hospital We will cover the cost of: your journey to and from hospital for inpatient treatment or to and from a health resort ambulance journeys to hospital (even if these are not followed by inpatient treatment) journeys that require an ambulance for medical reasons journeys to receive outpatient treatment if hospital treatment is thereby avoided or shortened Patients are required by law to pay 10 percent of the transportation costs themselves; this charge will be at least 5 but no more than 10. This additional charge does not apply to patients undergoing rehabilitation. We can only pay the cost of journeys to receive outpatient treatment in exceptional cases that have been approved beforehand; we would be pleased to provide further details upon request. Benefits during a hospital stay We will cover the cost of a medically required hospital stay. This includes food and accommodation as well as medical treatment, surgery, medication, and nursing. We will also pay for any transportation required for medical reasons. Adults (aged 18 or over) must pay 10 for every day they stay in hospital. This additional payment is limited to a maximum of 28 days in any one year. Continued payment of salary and sickness benefit If you are unable to work due to illness or because you are attending a recognized health cure, your employer will continue to pay your salary for up to six weeks. The same applies if you are unable to work due to termination of pregnancy (within the scope of the law) or an organ donation. You will be eligible for sickness benefit once your salary or wages cease to be paid while you are unable to work, while you are in hospital, or during a residential health cure paid for by us. You will be paid 70 percent of your standard remuneration (basic pay). The level of basic pay used to calculate sickness benefit will be no more than the statutory income threshold (2018: 4,425 per month, or a maximum of 147,50 per day; so sickness benefit at 70 percent comes to ). Sickness benefit must not exceed 90 percent of your net earnings. In principle there is no limit on how long you can receive sickness benefit; for one and the same illness, however, you will be paid this benefit for no more than 78 weeks within any three-year period. Help at home * Generally we will pay the cost of a home help if children need to be looked after during a period of illness, a hospital stay or a health cure treatment, and there is no one else in the household who can take on this responsibility. Even if there are no children in the household and a home help is required, you can still request one. We offer far more than the legal minimum in this respect. Speak to us for advice so that we can suggest the best solution for your situation Additional cover Private supplementary insurance: hospital * If you have to stay in hospital, Daimler BKK pays for the cost of your inpatient treatment. With private supplementary insurance for the hospital, you can enjoy added benefits and financial security. For example, the costs of the following services are covered: payment of remaining costs in advance by BKK for general hospital services choice of accommodation in a one or two-bed room (depending on member s tariff) as part of the chief physician option, we pay for private medical treatment if you would like to choose your doctor and be treated as a private patient. For more information on this and other possible benefits, please contact the team at Daimler Vorsorge- und Versicherungsdienst (Daimler VVD) to arrange a personal consultation. 26 GET WELL

27 Per diem sickness benefit insurance from Daimler VVD Sickness benefit is lower than your standard earnings: it is 70 percent of gross income or a maximum of 90 percent of net income. For 2018 the upper limit, determined by the income threshold, is 4,425 per month. If earnings exceed the monthly income threshold, the payment is calculated as 70 percent of 4,425 only, i.e. a maximum of 3, gross per month. Because of this reduced income, it can be difficult to meet your ongoing costs, especially in the case of a long-term illness. Per diem sickness benefit insurance helps to bridge the gap. For this purpose, Daimler Vorsorge- und Versicherungsdienst (Daimler VVD) offers supplementary insurance with attractive benefits: safeguarding the net income not covered by BKK sickness benefit after 42 days of illness, payment of an agreed per diem amount for every further day you are unable to work payment of per diem sickness benefit, even on Sundays and public holidays If you are interested in this private supplementary insurance, simply inquire at your BKK customer center. We would be delighted to give you more information and refer you to Daimler VVD Going to the doctor Medical and dental treatment Our members have unlimited access to treatment by any doctor, dentist or psychotherapist who is licensed for statutory health insurance funds provided they use modern, recognized methods of treatment. You are free to choose any of the doctors and dentists in Germany with whom we have a contract. Supplementary insurance: outpatient add-on * With its outpatient add-on service, our partner Daimler VVD offers comprehensive supplementary insurance cover with fair terms and conditions. Here are just some examples of what this add-on can be used for: corrective lenses (spectacles, lenses, contact lenses) additional payments for non-physician treatments (massages, mud packs, physiotherapy, medicinal baths) additional payment for medication, surgical dressings, and physical aids alternative remedies, including prescribed medication worldwide health insurance cover for travel for up to eight weeks (doctor, medication, hospital, transport home in the event of illness including by chartered air ambulance) Identifying good doctor s practices * A good doctor s practice can be identified based on a series of objective criteria. We have put together a checklist of the standards you can expect and demand from doctors and practices on our website at: web code 1124 Our service Finding a hospital Finding a suitable hospital for upcoming treatment: hospital quality reports, information on the number of operations carried out at each hospital, and more can be found at: web code 376 Integrated healthcare agreements Our website lists doctors in your region who work together with other specialists to offer integrated healthcare. web code 48 Sickness benefit calculator Greater transparency and the ability to plan with the online sickness benefit calculator. This enables you to see whether per diem sickness benefit insurance is worthwhile for you. Sickness notifications with the app With the new Daimler app on your smartphone, you can take a picture of your sickness notification (disability certificate) and send it to us. In this way, you save time and postage costs. It doesn t get any easier than that! INFOMED doctor s appointment service: +49 (0) Advice and information on any queries you may have about a doctor s appointment: Do I need an appointment with a specialist? Which specialists can I be referred to? How do I get an earlier appointment with a specialist for a speedier diagnosis? * Extra services offered by Daimler BKK GET WELL 27

28 06.4 A linked network for successful treatment Integrated healthcare * In order to facilitate and maintain a one-stop healthcare service for our members, we have contracts in place with specialists, hospitals, and rehab clinics to ensure close cooperation. At regional level, we have signed a wide range of contracts in areas such as surgery, orthopedics, cardiology, and psychiatry. Coordinated collaboration between practices and clinics helps to ensure a more successful treatment outcome. This means unnecessary waiting times and duplication of medical examinations can be avoided. Pediatric surgery * In the area of pediatric surgery, we have extended the principle of integrated care to cover the whole of Germany. The advantage for you is that recognized specialists work hand in hand to avoid examinations being repeated unnecessarily and to ensure the best possible care before and after the operation. Long stays in the hospital, which can be very stressful for children, are avoided as far as possible and less invasive surgical methods are used. Inquire in your Daimler BKK customer center about the options near you for integrated healthcare for your child. Family-doctor-based healthcare The aim of family-doctor-based healthcare is to reinforce the family doctor s central role as your first point of contact for any health-related issues. The family doctor coordinates all treatments and can therefore improve the quality of healthcare. Among other things, this means that the duplication of medical examinations is avoided and drug prescriptions from different specialists are coordinated more effectively. Find out from your local customer center which family doctors are offering family-doctor-based care Getting help and guidance Advice for hospital patients * Specialist advice throughout the entire treatment: our regional hospital advisors are there to support you if you suffer a serious illness (such as a heart attack, cancer, stroke, or psychological illness) and will help you with all aspects of your stay in hospital. This gives customers suffering from acute or chronic neurological illnesses access to a very special level of treatment: our specialist consultants are there for you throughout the whole treatment process, from your stay in hospital to rehabilitation and right up until discharge. This customized care package should ensure that your treatment runs smoothly and that interfaces are optimally linked, enabling you to recuperate and hopefully regain full fitness as soon as possible Support in the event of incorrect medical treatment * Talk to us if you suspect that you have received incorrect medical treatment from a doctor. We can advise you on how to proceed in such cases and offer you extensive support and information.

29 07 Get well with medication and physical aids. Be able to choose the right medication for you. We ensure the necessary transparency Cost transparency, ability to make comparisons, and discounts on certain medications these are the ways in which we can contain the cost of medication. This ensures you receive the best healthcare without undue expense Good information and advice Stiftung Warentest medication database * Our online customer center gives you access to this comprehensive database. This is a convenient way of finding detailed information about medication, its active ingredients, and the illnesses for which it can be used. We will cover the cost of this service. Medication for cancer treatment * The medication database also contains the 80 most important active ingredients with descriptions and an overview of the latest study results. The information is designed to help cancer patients to make an informed and conscious decision for or against a specific course of medication together with their supervising doctor Complete overview of the costs Medication and surgical dressings We will cover the cost of medication and surgical dressings prescribed by a doctor. We are only permitted by law to bear the cost of non-prescription medication for children aged 12 or under, with a few legally stipulated exceptions. Adults aged 18 or over are required by law to pay 10 percent of the costs themselves (at least 5 but no more than 10). Homeopathic remedies and naturopathic treatment * With us, you can get homeopathy remedies simply by using your health card (Gesundheitskarte). We will reimburse up to a total of 100 per year for many non-prescription proprietary drugs used in homeopathy, phytotherapy, and anthroposophy that are only available from pharmacies, provided these have been recommended by a doctor. Further information can be found on our website. Discount agreements for medication We help you save money! As a patient, you can assume that your doctor will have an interest in prescribing you cost-effective medications as he is trying to keep within his budget. He will therefore often prescribe you an active ingredient rather than a specific medication. In this case, the pharmacist decides which drug to give you. If there is a discount agreement for this active ingredient with Daimler BKK, then he must give you a medication that is covered by the agreement, as long as it is available. If it is not available or there is no discount agreement, then he is obliged to give you one of the three cheapest drugs. Pharmacists are automatically informed about any discount agreements in place. The current list of drugs manufacturers who have signed a discount agreement with Daimler BKK can be found on our website: web code 630 Optional medication Pharmacists are always obliged to give you one of the three most affordable drugs. However, when handing in a prescription, you can also choose to have another drug. In this case, members are liable to pay the additional costs which are often considerable. If you would like to find out more about how these additional costs are calculated, we will be happy to advise you. Medication exempt from additional payments For certain groups of medication, you do not have to pay any additional costs. We can help you decide which one to choose. Information about medication which is free to you can be found on our website at: web code 462 Exemption from additional payments In order to ensure that you do not have to pay amounts you cannot afford, the law stipulates that any additional payments you are required to make must not exceed 2 percent of your annual gross earnings. For some groups of people, such as people receiving income support or a basic pension, special rules apply in relation to determining gross earnings. People who are undergoing ongoing treatment for a chronic illness can apply to have their additional payments reduced to 1 percent of their annual gross earnings. Our website contains a calculator that you can use to work out whether your additional payments have reached these limits. * Extra services offered by Daimler BKK GET WELL 29

30 Our service Stiftung Warentest medication database Free use of the impartial, wellregarded medication database via our online customer center: web code 242 Guidance on medication costs and additional payments At the Daimler BKK online customer center, our members will find a wealth of useful services: lists of additional payments and discount arrangements calculator for working out whether your payments have reached your annual limits online application service for exemption from additional payments : web code 4400 Daimler BKK discounts Go online to see which medications are available at a discounted price for Daimler BKK members: web code 630 INFOMED health hotline: +49 (0) The INFOMED team can help you in your choice of products which are free to you. Reimbursement of additional payments You can avoid expensive additional payments for medication, surgical dressings, and physical aids by taking out the outpatient add-on supplementary insurance. Additional payments are reimbursed in full on two insurance tariffs offered through Daimler Vorsorge- und Versicherungsdienst (Daimler VVD) Adapting to physical restrictions Physical aids Physical aids help you recover more quickly or help you adapt to a physical restriction. Speak to your doctor about whether you need a physical aid, and if so, which type. If an aid is necessary, the doctor will issue you the necessary prescription (health insurance prescription, pink form). If you fulfill the medical criteria, we will bear the cost of the approved physical aid up to the value of the reference price or the price stipulated in the agreement (if applicable). Our care package also includes information about how to use the aid, as well as any adjustments, repairs or replacements that may be required. Members are legally required to make a payment toward the cost of each physical aid. This is normally 10 percent of the final price (at least 5 but no more than 10). An exception applies for consumable aids. In this case, the payment is set at 10 percent of each consumable, but no more than 10 per month. Medication plan Mistakes when taking medication can intensify or impair the effectiveness of individual drugs and damage your health as a result. Since October 1, 2016, you are entitled to a personal medication plan issued by your attending physician in order to help prevent such mistakes. Participation is subject to a few conditions: You are using at least three drugs stated on your statutory health insurance prescription The drugs must all be systemic, i.e. they work in the body The drugs are intended to be taken for at least four weeks 30 GET WELL

31 08 Get well with health cures, therapies, etc. We are there to help you get back to your normal life and return to work. Getting back to everyday life after an injury or serious illness often requires a whole series of measures. We provide support with health cures, therapies and specific rehabilitation measures. Providing all the important information about this and the straightforward payment of costs is all part of our service The right health cure for me Health cures A health cure is a specific course of health treatment that only succeeds if you yourself make an active contribution. Rehabilitation-oriented health cures can help to permanently overcome past illnesses. They can also show people how to adopt a healthier lifestyle. If the treatment you are currently receiving locally has proven insufficient and your doctor believes a health cure is necessary, we would be pleased to help you. Non-residential health cures We will pay the following costs for non-residential health cures taken in approved health resorts: treatment by specially qualified doctors health cure treatments (medicinal baths, massages, etc.) In addition, you will receive an allowance of 13 per day ( 21 for children with chronic illnesses) toward the cost of your food and accommodation, resort tax, and travel. Simply keep hold of your hotel or guesthouse bill and present it to us as proof. Members aged 18 and above are required by law to pay 10 percent of the cost of health cure treatments themselves, plus 10 per doctor s prescription. Residential health cures If a non-residential health cure does not meet your needs or is inappropriate for any other reasons, you will be eligible for a residential health cure in a clinic. Members aged 18 and above are required by law to pay 10 per day toward the cost. We will cover the remaining costs of: treatment by doctors health cure treatments (medicinal baths, massages, etc.) resort tax food and accommodation travel The pension insurance fund generally pays the cost of residential rehabilitation health cures. We will be pleased to advise you. You will only have to pay these costs for a maximum of 28 days for subsequent rehabilitation and in the case of certain medical indications. Health cures for children We will cover the full cost of health cures for children. In the case of children aged eight and under, we will also pay for the mother or father to accompany the child. Health cures for mothers and fathers We will pay the cost of health cures in selected quality-certified health-cure establishments excluding a member contribution of 10 per calendar day. Choice of health-cure establishments * When it comes to choosing where to take a health cure, we have a variety of quality-assured establishments for you to choose from. We help you to select the most suitable place, taking into consideration your illness, where you live, and other criteria. Our members constantly tell us how satisfactory they find this procedure The right treatment for your symptoms Support with ADHD * Attention deficit hyperactivity disorder (ADHD) is one of the most frequent psychological illnesses among children and young people. Symptoms include a poor attention span and lack of concentration, distinctive fidgeting and a strong desire to move around, as well as impulsive and erratic behavior. In Baden-Württemberg we offer special treatment for children and young people aged between 4 and 17 affected by ADHD, ranging from quality-assured diagnosis and treatment through to parental training on ADHD. Further information on this matter can be obtained at your local customer center. Personal nutritional advice * The food we eat has an impact on virtually every aspect of our lives. By eating a healthy, balanced diet we can prevent many illnesses. If your doctor recommends a consultation, please contact us directly. Whether you re traveling to a check-up or for rehabilitation treatment, we will cover your travel costs within a clearly defined scope. To find out which costs we refund for trips made using private cars or public transport, speak to your local customer center. * Extra services offered by Daimler BKK GET WELL 31

32 Obesity programs * We offer special programs for children, young people, and adults who are clinically obese (adiposity). These include Kinderleicht, M.O.B.I.L.I.S., and Optifast. Ask at your local customer center about suitable programs, the exact terms, and cost contributions. Bone density scans * Bone density scanning is a statutory service available for suspected cases of osteoporosis, provided a course of drug treatment is planned. This test can be repeated every five years or sooner if new findings emerge to indicate that the therapy should be optimized Getting the right treatment Non-physician treatments * Whether you have been prescribed massages, physiotherapy, or medicinal baths, we will cover the cost of these treatments according to a table of rates. Members are required to pay some of the cost themselves. Members aged 18 and over pay 10 percent of the costs plus 10 per doctor s prescription. This rate also applies if you undergo outpatient treatment in a hospital or health-cure establishment. Alternative remedies and homeopathy * Natural treatments and healing methods are becoming increasingly popular. If you are interested in alternative remedies, then we have just the service for you. We have expanded our extensive range of free extras to include homeopathy. With many doctors you can access homeopathic services very easily using your health card (Gesundheitskarte). Naturally, we can help you find a suitable doctor. Simply contact your local customer center. Covering the cost of osteopathy * Using the power of the hands to make a manual diagnosis and provide therapy, blockages in the body are released and balance is restored to the body s systems. We will cover 80 percent of the costs for up to six quality-assured osteopathy sessions (maximum of 60 per treatment) per calendar year. Please inquire in the customer center before undergoing this treatment. Search online for qualified therapists at: 08.4 Getting you back on form Rehabilitation Following a serious illness, it s not always easy to step back into everyday life. Lasting impairments can sometimes make it hard for people to get back in to their old routine at work and at home. We are on hand to support members throughout their rehabilitation as they brace themselves for the new challenges that daily life presents. Rehabilitation sport and functional training Our complementary rehabilitation services include the following: functional training and sport as rehabilitation training courses for chronically ill patients and their families We will be happy to help you find a suitable provider. If the doctor treating you feels that additional services are necessary from a medical point of view, he will write out a prescription for you that you can simply hand in to your local customer center to have the costs reimbursed. Occupational therapy The aim of occupational therapy is to restore and support restricted physical and mental ability. It is offered during inpatient treatment in the hospital and as part of a rehabilitation program, as well as during outpatient treatment at every stage of the illness. The methods are wide-ranging: self-help training, household training, concentration and stability training, group sessions, and training on how to use physical aids. During the treatment, artistic, craft, manual and intellectual skills are specifically developed and practiced. Depending on the capabilities and limitations of the patient in question, occupational therapy can be conducted in individual one-to-one sessions, in small groups or as group therapy. Patient consultation is also an important part of occupational therapy. Any issues relating to rehabilitation can be discussed with the therapist. web code 4834 Covering the cost of acupuncture We will pay the cost of acupuncture treatment conducted by registered and qualified doctors for chronic pain in the lumbar spine and chronic arthritis of the knee. Payments are made using your health card (Gesundheitskarte). 32 GET WELL

33 08.5 Finding your feet again once you return to work Work capability assessment The possibilities and opportunities for returning to work are determined using work capability assessments, and suggestions are offered on how to resume your career after an illness. The work capability assessment focuses on diagnostic considerations. Work therapy Work therapy is concerned with gradually preparing patients with psychological problems or physical or mental disabilities for the basic requirements of working life. In this case, work is used as a therapeutic measure. If a patient s physical and mental capabilities are affected to the extent that they cannot yet return to work, work therapy measures are used. Covering the costs We will cover the costs of work therapy or a work capability assessment, if another insurance fund is unable to provide this service in accordance with statutory provisions. If the treatment is necessary to maintain or restore your ability to work, you need to contact your pension insurance fund. Workplace-specific rehabilitation * Making it easier for you to return to work. This rehabilitation treatment, which is offered on a regional basis, provides you with therapies that have been tailored to the specific requirements of your job. This makes it much easier for you to return to your day-to-day work. Our service Evaluating alternative remedies Our website provides an overview of all health resorts and the areas in which they specialize: web code 255 Online catalog for non-physician treatments Point of reference for non-physician treatments that can be prescribed for the relevant complaint. You will also find a list of all the changes to the guidelines on non-physician treatments: Stiftung Warentest on non-physician remedies Exclusively for you in our online customer center: free access to the data on remedies published by the Stiftung Warentest product-testing foundation: web code 242 INFOMED health hotline: +49 (0) Objective, independent consumer advice on all issues relating to health cures, therapies, etc. Brochures and information sheets We offer detailed information materials on the following topics. Available from your local customer center: catalog of health cures for mothers/fathers/children guidelines on health cures for mothers/fathers/ children homeopathy health cures and treatments * Extra services offered by Daimler BKK GET WELL 33

34 Be provided for We have the right packages to help you lead a largely independent life in your old age or in the event of chronic illness. We can help with all queries relating to your care. From outpatient support to care provided at home and to inpatients, if the worst comes to the worst you can rely on us.

35 09 Be provided for in the event of chronic illness Success due to networking 09.2 Psychological and emotional support 09.3 Good advice in many areas of life 09.4 Recovery through rehabilitation measures 10 Be provided for when nursing care is required Finding the right care 10.2 Getting care at home 10.3 More care on the ward 10.4 Good short-term care

36 09 Be provided for in the event of chronic illness. You can rest assured you ll receive optimum support. With the right partner, of course. How do you live with a chronic illness? This is the key issue for those affected. We are continually developing our services to make this question easier to answer. The close cooperation between patients, doctors and hospitals, and the application of the latest medical guidelines are designed to improve the healthcare provided to those affected and to enhance their quality of life. A key objective: to empower patients to cope independently with their own illness Success due to networking BKK MedPlus BKK MedPlus is the trademark of our free treatment programs for people with chronic disorders. They are based on sound knowledge of the best treatment and the optimum course of treatment for the relevant illness. The aim of BKK MedPlus is to improve the care that members receive by ensuring a more effective flow of communication and closer cooperation between everyone involved in the treatment process. Therapy measures are coordinated with the help of treatment guidelines based on the latest medical knowledge. As a health insurance fund, we coordinate and accelerate the treatment process in conjunction with the doctor. We offer nationwide programs for the following chronic illnesses: asthma chronic obstructive pulmonary disease (COPD) diabetes mellitus type I and II breast cancer coronary heart disease, including chronic heart failure A program with a guaranteed seal of approval Members who sign up for a BKK MedPlus program are eligible for our optional DMP tariff. DMP stands for Disease Management Program and this is a seal of approval. The quality of the programs and their success rates are continually documented, providing an overview that can be viewed by Daimler BKK members. Integrated healthcare * A number of contracts are in place to ensure that our members can benefit from both outpatient and inpatient care from medical and non-medical service providers who work together closely and effectively. Integrated healthcare is designed to provide patients with coordinated, one-stop treatment. That way, unnecessary and time-consuming repeat examinations can be avoided and you receive the best possible care for a speedy recovery Psychological and emotional support Enjoying good mental health (SeGel) * Daimler BKK is breaking the mold with its innovative integrated healthcare packages for people with chronic mental illness. The comprehensive advice and support that Daimler BKK provides comprises the following: sociotherapy outpatient psychiatric care occupational therapy non-inpatient crisis intervention (refuge rooms) round-the-clock on-call service support from a case manager care at home and in the patient s social environment Sociotherapy Sociotherapy is outpatient care for the severely psychologically ill. It is designed to enable people with psychological illnesses to receive treatment performed or prescribed by a doctor. In addition to training and motivation methods, sociotherapy also covers coordination activities. Those affected need to learn to manage their everyday lives independently and assume responsibility for themselves. We will cover the costs of sociotherapy for up to 120 hours within three years for each incidence of illness. You pay 10 percent of the cost for each calendar day. This charge will be at least 5 per day but no more than Webcode BE PROVIDED FOR

37 Psychosomatic intervention * Swift and professional help for psychosomatic problems: you can attend up to eight personal appointments at recognized psychosomatic medicine institutions as an outpatient following a referral from the company doctor, from the Daimler AG counseling team, or directly from us. The aim is to increase your quality of life, enable you to continue working, and avoid any risk of becoming incapacitated. The appointments are of course voluntary, confidential, and subject to legal duties of nondisclosure. The costs are covered by us Good advice in many areas of life Personal nutritional advice * Typical illnesses that can be alleviated by a change in diet include metabolic diseases such as diabetes as well as rheumatic conditions or renal disorders. We offer special consultancy services for tumor patients, as problems such as malnutrition can often occur during cancer therapy and these can be avoided with the appropriate support. If your doctor recommends a consultation, please contact us directly. Obesity programs * We offer special programs for children, young people, and adults who are clinically obese (adiposity). These include Kinderleicht, M.O.B.I.L.I.S., and Optifast. Ask at your local customer center about suitable programs, the exact terms, and cost contributions. Our service BKK MedPlus All important information about the free voluntary program for people who want to play an active role in the treatment process: Finding local integrated healthcare Find services in your area online by selecting your town/city or entering your postcode: web code 48 Self-help group search You can find a suitable self-help group near you through our cooperation partner NAKOS: web code 1529 INFOMED healthcare hotline: +49 (0) Objective, independent consumer advice on any queries about symptoms and potential treatment. Brochures and information sheets We offer detailed information materials on the following topics. Simply inquire at your customer center: BKK MedPlus RückenPlus INFOMED doctor and appointment service nursing care insurance * Extra services offered by Daimler BKK BE PROVIDED FOR 37

38 09.4 Recovery through rehabilitation measures Rehabilitation sport and functional training If the doctor treating you feels that additional rehabilitation services are necessary from a medical point of view, we will cover the cost of these. Our complementary rehabilitation services include the following: functional training and sport as rehabilitation training courses for chronically ill patients and their families We will be happy to help you find a suitable provider. Find out more from your local customer center. RückenPlus * Move around again without pain with a scientifically tested training program for the back, shoulders, hips, and knees. The RückenPlus program is geared to Daimler employees with recurring back problems. Following an initial examination by the company doctor, the training itself takes place in modern facilities near your place of work in small groups of up to eight people. Specialist trainers lead the 30 to 36 training sessions and provide personalized exercise plans for you to follow at home. Daimler BKK pays the cost of the program except for a 50 contribution that you must pay yourself. Workplace-specific rehabilitation * This rehabilitation treatment, which is offered on a regional basis by Daimler BKK, provides you with therapies that have been tailored to the specific requirements of your job. This makes it much easier for you to return to your day-to-day work. 38 BE PROVIDED FOR