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Medical insurance and C section

(12 Posts)
Daffodil3003 Thu 23-Jul-15 20:10:52

Hello
I've just found out I need to have a c-section due to past fibroids being removed and also having a previous c-section. My insurance company April UK said that cover "specified obstetric procedures" and wondered if anyone has had a c-section on private insurance and how difficult it is for the insurers to agree to one. Just concerned they may say no as I have had a previous c-section (on NHS). I'm due the second week of Sept which my hospital has said is the busiest time of the whole year, so to have a private c-section would be preferable!
Thanks

cherryade8 Thu 23-Jul-15 22:46:52

Bupa told me that they only pay for sections where a consultant specifies that the mothers life will be in serious danger without one. They don't cover if it is the baby who would be in danger. Despite having had a lot of previous surgery Bupa wouldn't cover one for me, having said that I didn't push it as I was happy with the nhs consultant that i was given and was told that not many consultants are willing to do sections paid for by private medical insurance as the insurers don't pay enough...

Ime you either pay privately yourself or use nhs, I've never found insurance useful in pregnancy but maybe that's just me. Good luck!

Daffodil3003 Fri 24-Jul-15 12:38:53

Thanks cherryade8 for that. Sure April UK will be similar to Bupa. Yes it's not life threatening I have the c-section just an increased risk of uterine abruption.
Did you have your c section at a London hospital as well?

UsernameAlreadyInUse Fri 24-Jul-15 13:11:04

You need to ring the insurance co and see what they say. I have had three c-sections approved (only two deliveries though, my first pregnancy ended early). One by Groupama, one by Aviva and one by AXA PPP. It depends on their policies and I found that even though my condition wasn't on their list (and nor would it have endangered the baby's life) getting cover was no problem. If you speak to someone to make an initial inquiry, concede nothing. Just say your consultant requires you to deliver by section and ask what the procedure is for obtaining cover.

Are you seeing a consultant now and does s/he do private work. I found a letter from my consultant worked wonders, there were no quibbles at all. In terms of going private, the surgical conditions are not really any different but the aftercare is amazing.

Daffodil3003 Fri 24-Jul-15 14:26:46

Thank you so much UserNameAlreadyInUse. Yes I'm going to call them Monday. My consultant does do private work but I've only seen his junior at the moment. I'm 32 weeks now and due to meet again at 36 weeks. Yes the aftercare is what I'm interested in as my midwife has said the hospital in scheduled to go into (Kingston) is very busy the week I'm due in Sept.. I have to have a c section as I have had a past one and the risk of uterine abruption due to past c-section and that is the main reason I believe. Thanks for sharing your experience.

cherryade8 Sun 26-Jul-15 08:28:08

Hi Op by coincidence I'm at Kingston too smile I think there are a couple of consultants who do private obstetrics there (lots do private gynaecology but stopped doing obstetrics for insurance reasons from what I understand). I'm very happy with the consultant I have but can understand wanting private aftercare. I would have pushed to use insurance too if I hadn't been so keen to have my particular consultant, who delivered my last dc too and I think is excellent.

Good luck!

cherryade8 Sun 26-Jul-15 08:29:44

I suspect the reason they are so busy in September is due to all the babies conceived around Christmas, I understand it's always busy in September smile

Daffodil3003 Thu 30-Jul-15 14:02:49

Hi Cherryade that is a coincidence! When are you due?
I have just spoken with April Uk and even though my insurance says it doesn't cover "normal childbirth and pregnancy" a woman I spoke to said "it doesn't cover any childbirth or pregnancy". Im now thinking that maybe best is to speak to the consultant Mr Anim who I think is the only one doing private c-sections at Kingston now and see if having a letter may help my case.
I asked the woman what "specified obstetric procedures" they meant and she said "ectopic pregnancy…etc". Grrrrrrr!
I am currently Mr Chow's care but he doesn't do private work any more supposedly.
Someone has told me that at Kingston you are most likely to get your own room if you have had a c-section and slightly older (over 35). Do you know if this is right?
Thanks for sharing your experience!

UsernameAlreadyInUse Thu 30-Jul-15 15:37:43

That must surely be wrong! Either all pregnancy and childbirth claims are excluded (not unimaginable) or some are included. If the policy indicates the latter by saying 'normal pregnancy and childbirth are not covered' well that is not the same as 'no pregnancy and childbirth'. Sorry, I am sure you have come to the same conclusion yourself, it is just frustrating when insurance companies try to fob you off and make things difficult for you.

Daffodil3003 Thu 30-Jul-15 16:05:52

Yes UsernameAlreadyInUse!
In fact my policy document says I am covered for pregnancy complications but they sent me another document when I came off the phone from them a generic policy document which shows NO pregnancy/childbirth is covered!
So….have written asking to make formal complaint and to get the name of the person I can deal with going forward regarding my claim. Have also booked in with the consultant who will write a letter for me specifying why it is a "pregnancy complication" which for me is risk of uterine abruption which I have been told by a consultant can be life threatening. Hopefully then April UK will allow me to have it done privately. If not will take this further, as clearly been miss-sold my policy and ask for all my contributions made back which may be more than the c-section and hospital charges itself!

cherryade8 Fri 31-Jul-15 11:24:00

Hi daffodil, I'm due very soon in August, so will let you know how I get on! I understand that they are very busy at the hospital at the moment. My first baby was delivered there too, you can ensure that you get a single room by paying c£100 per night I think, or you can chance it and hope smile mine is an elcs, though last time was emcs and I have a long gynaecological history so multiple reasons for elcs. If you go privately I think you'll be in the Coombe Wing following the birth, which I understand is very nice.

Hope your insurance is sorted soon! Bupa told me that my life had to be in danger for them to pay for the birth, apparently uterine rupture doesn't count as this according to them, though as I said I didn't push it as the lovely consultant I have only does private gynaecology, not obstetric. I would have thought uterine rupture should be considered a threat to life tbh.

Daffodil3003 Sat 01-Aug-15 12:51:22

Thanks Cherryade. I had an ELCS there last time round in 2013 and had my own room and so wanted my own room again as I found it so hard to get baby in the night tied up to a catheter. But as it was a private room my husband could stay and that was just fantastic as he could get baby for me in the night to feed. I have heard re the utility rooms where you pay £100 a night but I was told they are the normal rooms and if someone is already them then you have to go in a ward so it wasn't a guarantee. But I think with ELCS you are quite likely to get a room? Is this what the midwife told you too?
I had a wonderful gynaecologist there Mr Morris who doesn't do obstetrics anymore either! Wow I think we will be a month apart. ive recently been researching activities that I can take a 2 year old to and baby, some stay and plays/Baby Rainbows look good for both ages. Thanks again for sharing your experiences x

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