Elective CS and Insurance?

TX-Bride

Do a typical insurance ploicy pay for elective CS, my dr says they do, although I have not called my own plan/coordinator to find out but I thought they mostly don't pay for elective cs. 

HarrietNJMommy

Check with your insurance company. Most do not cover elective c-sections.

sbartschke

Mine was covered.

thehauffamily

IDK what ins you have but we have BCBS and they cover elective c/s.  Our first was emergency and our second was elective along with this one.  I'm sure my dr worded it so it sounded medically ness. to the ins company, but they are elective and they are covered.  I have to pay more for my deductible because c/s's are more costly, which is why I'm hoping for a VBAC this time around.

kellyjojo

I had an elective with my first and had Aetna as my primary and GHI as my secondary.  Was 100% covered.  Have Unied Health Care now and having another elective.  Again, covered.  You have got to call and see what your specific plan covers. 

emaddock

Yes--a birth is a birth regardless of if you choose to have a csection or have one because of a failed vaginal birth.

Neener73

We have an HMO, and it was covered.  I don't know if my OB had to provide any type of documentation in order for it to be covered. 

Vegasbb

Most of the time this is a non-issue because doctors can word it so it sounds medically "necessary". Mine was technically elective, but baby was breech so my forms all say "medically necessary". If your baby is big, you have high blood pressure, etc, etc these can all be "medically necessary".

If this is 100% elective, I question your desire for a C/S!  

HarrietNJMommy

Most of these situations are not "elective". There is medical reasoning behind them. 

I don't consider any of my c/s "elective". My first 2 kids were breech, so I had a c-section (this is a medical reason for a c-section - no OB around me delivers breech babies). I was NOT allowed to VBAC for #3 or #4, so they were also not "elective".

All 4 have been scheduled c-sections, but I still don't consider them elective. 

To me, the word "elective" means that it is your first baby and you don't want to go through having a vaginal delivery and are "electing" to have a c-section instead. I'm assuming that would NOT be covered by insurance because you just don't feel like trying. A vaginal deliver is in the best interest of the insurance company since it does cost so much less......... 

TX-Bride

Thanks. I need to call the insurance and find out for sure.

thehauffamily

I agree with the other ladies.  Your dr will word it where it will be covered.  Babies aren't allowed to be born via c/s until 39 weeks, but my dr along with me believe 38 weeks is fine, so he said there was "ways around it".  I said so if I'm misserable 38 weeks will be fine? LOL and he said "well we can't word it as "misserable" but yes, if baby is fine we can do it at 38 weeks".  Drs can get around the ins companies.  Just make sure to let your dr know