Medical Benefits Guide

with complete Terms and Conditions

Coordination of Benefits

Pre-Certification Requirements

Application Form

Policy Contract and ID Package

Direct Payment

Copayments and Coinsurance

Coverage Areas (in CZ and Shengen, AXA. In U.S., UK, Canada




Pre-Certification Requirements


When seeking Medical Care, in Emergency.............(paste VZPff text here)

Before seeking non-emergency medical care be sure to First

phone the AXA Helpline on your ID card to verify your benefits you may also phone

the AccessHMO Helpline also on the back of your ID card to schedule the next available

doctors appointment at the nearest participating medical providers such as

Narodni Polyclinic in Prague 1 or Canadian Medical centers in Prague 4 and Prague 6


Application Form

We welcome your Doctor to join our Growing Provider Network

Provide us with the name, medical specialty and contact details so we can coordate

Direct Payment of Claims to the Licensed Private Doctor of Your Choice.


Please be sure to enter your tentative schedule of travel dates (arrivals-departures)

on the application form outside of the Czech Republic and Shengen Zone and any scheduled trips to the UK, North America or Asia

to insure you and your family accurately.


COVERAGE AREA and Coordination of Benefits


Czech Republic and Shengen Zone

Before see



Complete Policy legal language