C-section coverage with Aviva

[ghislaine]

I'm hoping someone who's been through this can share her wisdom with me....

I have a gynaecological condition that means I need to have a c-section. In my last pregnancy, my health insurance (Groupama) agreed to cover me. But as I then lost my baby at 14 weeks, I never inquired into the details of what exactly they were prepared to cover. Fast forward a year, and I'm pregnant again but with a new insurance co. When we changed companies to Aviva - (well, my husband's work changed coverage) he range them to say we were TTC and the previous co had covered a section.

So earlier this week, I saw my gynaecologist and as in her words, a VB is "extremely inadvisable", she is writing a letter to Aviva about my need for a section. She's sending the letter to me first, just in case she inadvertently says anything that doesn't help my case. I also have another letter from my first gynae (she's not seeing patients at the moment) who is world expert in my condition, from my first pregnancy.

Does anyone who's had a c-section covered with Aviva have any advice about the process, how difficult it was to get coverage, and also how extensive their coverage is? I'm aware, now being 14 weeks, that I've left it very late to start booking with non-Portland consultants. We can afford some top-up but not a huge amount.

Hi CBC, if you look at my post from 16 Sept, you can see what Aviva have covered/contributed for an ELCS under the Solutions Plus policy. The only thing I haven't mentioned is the contribution of £228 for the anaesthetic.

The main thing is you'll need a consultant to say a CS is medically advisable in your case, and then you need to contact the Women's Health division with the correspondence. They write back with a list of what they will and won't cover. In my case the decision was very quick (three day turnaround) but I don't know how typical that is. They won't cover everything but you will get a significant discount off paying it all yourself.

I'm due to have mine very soon. I'll report back with how the billing went!

interesting fact
Malpresentation is a medical indication for c section. So if you go and see your private consultant for his/her (second) opinion and they say the baby is lying the wrong way IN THEIR OPINION and a c section is advisable, then your insurer will ordinarily cover it because then it's deemed as medically necessary.

Just sayin'

Bumping this with an update as I got my final bill this week.

I was really unsure what it would be, as in the weeks before the section (and even during my stay) we kept getting conflicting messages from Aviva and the Portland as to what would be covered. After numerous phone calls and emails I lost the energy to pursue it and resigned myself to paying around £3000, worst case scenario.

In the end we paid £238 hospital fees, made up of £93 baby hearing check, £45 take home drugs, meals for my husband and other guests, and £100 excess on the policy. This was mitigated a bit by the £100 "baby bonus" we were able to claim. For some reason, even though they said they didn't Aviva paid the paediatrician check, nursery fees, lactation consultant and the anaesthetist in full!

I still have to pay the shortfall with the obstetrician, but I don't expect that to be more than £800 - £900.

So, in the final reckoning, it will be about £1200, which was a lot better than expected, and very good value for money/our premiums.

Hi Ghislaine.

Would you mind telling what kind of cover you had with aviva when you had your baby?

Many thanks.

her kid is 5 now i assume. she may not even be around.