experiences with BUPA for C-sections at Portland please!

[Samvet]

Hello,
After a truely horrifying NHS birth, what I would described as the worst days of my life afterwards in the hell that is St Michael's Bristol and overcoming PTSD I have decided that if I have another baby I will have an ELCS. I am pretty much phobic of the NHS now due to their extreme shitness and have BUPA insurance. They tell me they will cover all bills from the Portland IF a consultant recommends a section for medical reasons. They do not count PTSD as medical reason.
my questions are:
Did BUPA cover everything? Any exclusions?
Has anyone had a section covered by BUPA when an ELCS is your preference but technically you could give birth vaginally (although would likely tear along MASSIVE epi scar)?
Has anyone had an ELCS at the Portland when you live outside London?

thanks very much, not even pregnant yet but will not be so if the NHS or any ripping of my whotzit are involved in the birth.

(PS not debating benefits of VB vs ELCS, understand all that, believe me no one is pulling a massive baby out of me again with forceps that fell on the floor, a ventouse that flew off the babies head and some other thing they found in a cupboard).

People I know who have wanted to use BUPA for ELCS have found that the BUPA covers the cost of the medical side but not the hospitality side. Also, the medical fees are so high somewhere like the Portland that they don't cover all of those fees either - e.g. my consultant at NHS hospital works at the Portland and all of her fees are not covered by BUPA.

You need to speak to them and check your individual policy limits. AXAPPP for example only cover the consultant's fee to £350 which is of course ridiculous. Also, the rate the insurance company pays is not what the hospital lists as its charge - they negotiate a special rate.

There's no substitute for calling BUPA to see what's covered on YOUR policy.

Thanks all. I spoke to BUPA and they said they pay all costs from the Portland BUT they need a consultants letter saying an ELCs is medically necessary. (not including PTSD). (!). Am worried about being left with a bill but it would perhaps be worth it. qTpie - do you know the name of the private obs consultant in Bristol?
Thanks all.

I know I'm repeating myself but you need to get them to WRITE to you with what "all the costs" means. The absolutely definately have a cut off for what they will pay for the actual section. You also need to check when your baby's cover will start and if they need time in SCBU/NICU that those fees are covered.

As for Bristol, you may well find a private obstetrician but there are no private wards or hospitals to deliver in. There's only London or Watford.

Your consultant's clinical decision on whether you need a cs is final, but what isn't clear us whether PTSD would be covered by the terms of the policy. But if you find an experienced consultant they'll know what and how to word things.

Just to clarify, the Portland bills the insurer separately to your consultant, and the Portlandis the cheap bit, ad they negotiate preferable rates with insurers. It's your chosen consultant's fee that might be queried - BUPAs limit used to be about £350, which is about 10% of the ACTUAL going rate of £3500, so you'd be left to pay the balance.

Watching with interest- I am Bristol based and had an awful birth with DS. Midwives said my pelvic arch is really narrow and a combination of a strong pelvic floor (not sure that's a problem anymore) and small lady bits led to my 6lb baby needing an episiotomy and then a massive third degree tear. I'm allergic to aspirin so couldn't take anything other than paracetamol for the pain so was walking like John Wayne for some time after. It's only now I'm accepting how awful it was, labour never really got going, needed all sorts of drugs to keep it going and apparently my flexibility and stamina were the only thing keeping me from an EMCS. Even with an epidural i had a lot of pain and could def feel to push. Luckily DS remained calm until the last minute or it could've been another story.
Midwives and the docs that stitched me up said not to attempt another natural birth and now we are thinking of ttc, I read all the stuff about cuts and trying to reduce ELCS. I am getting really fearful they won't book me in and will make me try another VB. We have BUPA cover and could potentially borrow from parents if we had to to go private. Obviously I'd prefer not to as it's a LOT of money.
Have made a doctor's appt to discuss as I am feeling so stressed it will not help ttc!

I would also add re the consultant's fees that my consultant (who delivers at the Portland and C&W I believe) charges £7500, not the £3500 indicated above, so £350 towards that is barely a dent.

Wrigglebum - I think the NHS would give you a section. The GP told me they would - my issue is my problems during and post labour and the fact that it was so so awful aftercare wise. My GP said to go see them before you concieve and ask to be referred to the consultant obs. They can advise on options at that point. I also think that if that consultant wrote to BUPA they would ok the section - the problem seems to be this disparity of what they pay (see Holly's post). They seems to be happy to cover the portland fees - it is the consultant fees that are the trouble - like you I might be willing to beg/steal and borrow to avoid the NHS!
Thanks all for the feedback - insurance companies are sneaky bastards arn't they? Costs enough each month - I think I have more than paid for a section!!

Yes, what QTPie said. I only saw my private chap a few times, the rest was NHS.

Thank you Samvet. I've booked to see my GP and my DH is taking the morning off to come with me, time it takes to get an appt might be pregnant by then anyway as we were first month of trying last time (albeit without the stress of this and no toddler around).
I guess once we have more ideas about what the NHS or BUPA will cover we can make an informed choice, ie would we pay to top up consultant's fees if BUPA would cover the rest. I've read about the Portland, JR in Oxford and MUMS in Solihull which all sound good but I might put up with Southmead if I can get a section there as it's really close to us (10 mins drive) so less disruption for my DS. I did find an OB online who does private deliveries at Southmead so it's another thing to consider.

No it wasn't Fraser McLeod, saw these people online and says they also do deliveries but no real information on it. I'm not looking in to it too much yet but will look into I will as and when it's needed.
I wouldn't be bothered with private pre-natal care (unless needed to get a referral for an ELCS) as I was perfectly happy with the NHS for that. I wouldn't even mind being in Southmead post-natal as it is so close to home (this time I would take ear plugs, an eye mask and get DH to bring in loads of food and drink, plus I shouldn't be so out of it as last time after 50hrs without sleep then bugger all sleep there).
I suppose the only thing putting me off an ELCS on NHS if allowed is that if they are busy you can get rescheduled to the point where you go into labour anyway and need an EMCS but I guess that can happen anyway on private as births are pretty unpredictable. Plus private is lovely and if BUPA would cover a lot of it, it would be nice. Then again, could use the money for a rather fabulous recovery holiday later on instead!
Thank you so much for your help guys, it's really appreciated. Was having a bit of a freak out yesterday after visiting Southmead for an unrelated appointment and getting scary birth flashbacks, was shaking with fear. DH was away with work last night and I was just feeling a bit rubbish about it all. Now I have made a doctor's appointment and got some great info here I feel so much more positive.
Good luck to OP with getting your ELCS.

I haven't spoken to them yet, I don't want to do too much investigation until I'm actually pregnant, seems like bad luck somehow!

I think if an ELCS is approved on the NHS I will probably go ahead with that. It just seems like even with BUPA there is so much to pay and I can think of better uses for the money! I also like the idea of being close to home as if there was a problem and the baby needed to be kept in we wouldn't need to stay elsewhere or commute. If I get a few things in to make me feel a bit better on the ward (some lovely nightwear, an iPad full of films, lovely food brought in) then I think the experience will be considerably better than last time! Southmead does have private rooms and with a CS I should get priority for one.

OP if you can't get BUPA cover what about getting a doula to provide support in the hospital, sorting out decent food, breastfeeding support and fighting your corner when necessary! Southmead seems to be a bit better than St michaels from what I've heard.

Once I am in a position to investigate a bit more I'll let you know anything I can about BUPA/Bristol private births.

Thanks so much all for your helpful comments and good luck wrigglebum. I think there is no way I can cope with the NHS aftercare as that really compounded the birth trauma, might save up and do extra work to find the 'top up' money. I can't imagine how nice it would have been to actually eat food and be clean after the birth. Do let us know how you get on. NHS pre natal care is fine, have to pay for OSCAR scans anyway, so just have to suffer odd conversation with midwife. thanks all, appreciate the advice and understanding.