Direct payment - not Scheduled:

Available
In the event of a Medical Emergency and/or Accident, with 24 Hours a day
365 días a year
care in a Network Hospital and Physician.
1. Identify yourself to the Hospital administration as an 800 872 0585
insured with your Medical Expenses credential. [email protected]
2. Each Hospital has an internal policy of requesting a
deposit or signing a promissory note, while the Insurance
Company authorizes the admission.
PCE Technology de Juarez
3. If the insured does not require hospitalization for more

MAYORES
than 24 hours, you will have to settle the account and
process it for reimbursement. Benefit programs
Nuestro
Refund Procedure

• We suggest you observe the following

Insurances
recommendations:
• Fill out the initial major medical expense
reimbursement request form with banking information,
including a copy of the IFE.
Policy number
Contact 2) Alejandro Salcedo
• Fill out the illness or accident notice as clearly and [email protected]
completely as possible.
FK00632A
Móvil. 5579 323460
• Present the doctor's report completed by the treating Contact 3) Gilberto Sanguino
[email protected]
doctor, who should be asked to be as explicit as Movil. 656 3600349
possible when filling out the form.
• Verify that the doctor's fee receipts specify the concept
(surgeon, assistant, anesthetist), mention how many
consultations and that they are issued in accordance
with fiscal requirements.
INSURANCE COMPANY APP:
• Accompany the pharmacy invoices with the medical
prescription and break down each of the medications.
MY AXA MEXICO
• Invoices for x-rays, laboratories, ultrasounds, etc.,
must be accompanied by the results (interpretation)
obtained (definitive diagnosis).
• Gather this documentation and deliver it to Human
Resources and your payment will be received in 8
business days.

HOSPITAL AGREEMENTS:
An important characteristic is that the insurer has direct
payment agreements with the main hospitals throughout
the Mexican Republic.

For the agreement to take effect, it is required:

a) Hospitalization longer than 24 hours.
b) That the illness or accident is covered.
c) Check that you are an active worker
d) Deliver forms to the hospital properly
required. This brochure is descriptive and does not include all the conditions and
restrictions of the policy. Consult your Human Resources area.
On the website, you will find the forms, Network of
Hospitals and Doctors in agreement and other information
of interest to you.
 6. Treatment of baldness, obesity, weight reduction,
OBJETIVO: •Nose and paranasal sinus surgery: 100% coverage for
sterility and birth control.
7. Check-up type exams or rest or rest cures.
accidents and illnesses. Sum insured, deductible and
8. Expenses for attempted suicide or voluntary
Reimburse the insured for major medical expenses incurred coinsurance of the policy.
mutilation.
as a result of illnesses or accidents that occur to him or her or
9. Any complication derived from or that may arise
a member of his or her family (spouse and children included •Involuntary abortion: Deductible Sum Insured and
during or after the treatment of illnesses, injuries,
in the policy). In this way, the company prevents the family coinsurance of the policy.
conditions or interventions expressly excluded in
budget from becoming significantly unbalanced.
the conditions of the Plan.
Likewise, he is given the opportunity to go to the doctors, Hospitalization:
10. Expenses for accidents and illnesses that arise
specialists, laboratories and hospitals that he himself selects. •Private room (standard)
from participating in:
The Major Medical Expense Plan operates under certain • Operating room, healing and recovery
11. a) Military service, acts of war or rebellion
characteristic rules and limitations which are described below. • Intensive therapy
12. b) Criminal acts
• Medical and surgical material
13. c) Quarrels whenever he was the provocateur
One of the most important features of the Plan •Medical and surgeon team fees
14. Injuries suffered by the insured when traveling as
is that it is not necessary to undergo a •Assistant (20% of Surgeon's Fees)
an occupant of any racing vehicle, tests or speed
prior medical examination. •Anesthetist (30% of Surgeon Fees)
contests.
•Consultations, therapies, rehabilitations and nursing
15. Experimental medical or surgical treatment that has
•Orthopedic devices and prostheses up to the insured sum
COVERAGE: of the policy.
not been properly proven effective.
16. Medical or surgical treatments for sterility, infertility,
birth control, sexual impotence and its
Broker: Mercer Marsh Beneficios Expenses Not Covered:
complications, regardless of their causes and/or
Period: December 31, 2023 al 2024 •Sterility treatments, birth control
origins.
Sum Assured : 1,797 UMAM ($5,667,199 MXN) •Cosmetic treatments or plastic surgery
17. Medical treatment as a result of menopause.
Deductible: 1.8 UMAM ($5,676 MXN) •Treatments against baldness, obesity or weight loss
18. Replacement of orthopedic devices or prostheses
Coinsurance: 10% •Treatments resulting from alcoholism and drug addiction
existing on the date of contracting the policy.
• By using an agreement hospital and doctor, the •Professional practice of extreme sports
deductible and coinsurance are eliminated, whether in •Check-ups
•Replacement of appliances and prostheses
direct payment or reimbursement (Coinsurance limit:
•Moles or nevus HOW TO USE MY PLAN:
$30,000.00 MXN)
• Accident Deductible and Coinsurance: Not applicable
What do I need to use the policy?
Direct payment your best option
Maternity: Childbirth $35,000 MXN and Cesarean section • That the treating doctor dictates the definitive diagnosis,
The direct payment system allows the participant to
$60,000 MXN, benefit for the owner and spouse, no whether due to illness or accident.
receive care at any hospital and doctors with
deductible or coinsurance applies. • That the condition is covered by the major medical
whom Grupo Nacional Provincial has established
expenses policy
an agreement. WITHOUT DISbursing the total
UMAM value during 2023: $3,153.70 • AXA Seguros determines whether or not the diagnosis
proceeds according to what was contracted in the policy. cost of the confinement, thus protecting it from an
economic imbalance. (Except when hospitals are
Children born within the term of the policy and the spouses of used in the Border Strip or Abroad.)
people who marry will be considered dependents; However, it EXCLUDED EXPENSES:
is essential to report your discharge to the Human Resources Scheduled direct payment:
Department within 30 days of the event. Hospital and Doctor in agreement.
1. Psychiatric and psychological treatments for states of It is when the participant carries out the procedures in
WHAT DOES MY PLAN COVER? Main coverages mental or nervous depression, hysteria, neurosis or advance of his/her hospitalization to obtain his/her
psychosis. authorization letter for direct payment according to
• Congenital conditions: as long as the mother has been
2. Treatments to correct behavioral and learning disorders the following:
an Insured in the policy for 10 continuous months and the
3. Conditions resulting from alcoholism or drug addiction. 1) Present medical report and clinical history.
Company has been notified no later than 30 days after the
4. Dental, orthodontic and maxillofacial treatments. 2) Request accident or illness notification yourself at
birth.
5. Plastic or aesthetic surgery. Except reconstructive all points.
• Circumcision: As long as it is not for prophylactic
ones as a result of an accident covered by the 3) Attach interpretation of studies carried out.
purposes.
plan. 4) Choose your Agreement Hospital.
• Pre-existence: No waiting period
6. Treatment of baldness, obesity, weight reduction, Deliver the documentation to Human Resources for
• Border Strip: only for reimbursement and applies double
sterility and birth control. the issuance of the pass letter.
deductible and double coinsurance, within 40 km of the
border line 7. Check-up type exams or rest or rest cures.