(Closed) would insurance cover an elective c section?

posted 6 years ago in Pregnancy
Post # 3
Member
1080 posts
Bumble bee
  • Wedding: June 2012

I would say, no.  If the only reason you are having a c-section is because you want one, then I doubt insurance will cover it.  They are much more expensive than a vaginal birth, so unless it is medically necessary, it isn’t exactly feasible for an insurance company to cover it. Plus, most of the time, if they are a “scheduled” c-section, most insurance companies will require a pre-authorization, which has to include a valid medical reason verified by your doctor for having it.  Unless you can get your doctor to lie (which would be pretty unethical on their part), you will probably have a tough time getting a pre-authorization.  

There’s a reason they do this, too.  Vaginal birth is best for baby if at all possible.  Getting squeezed through the birth canal preps their bodies for life outside, including squeezing the fluid out of their lungs.  Plus, sometimes c-sections are performed too early when they are scheduled and baby is not yet equipped well to handle life outside the womb. 

I know you didn’t want to bring it up, but may I ask why you want an elective c-section? Are you scared of a vaginal birth? Are you asking for a friend or something? 

ETA: Once again, I don’t think a normal doctor with good morals would agree to it, because our first and foremost goal in medicine is: first do no harm (I’m a med student).  An unnecessary c-section is definitely more risky for mom and baby, so no, normal doctors don’t agree to an elective one.  Now, as far as celebrities with plenty of money, maybe, because unfortunately most people, doctors included, can be swayed by a large chunk of money.  But then it’s not a question of health insurance, so they probably get away with it sometimes.  

Post # 4
Member
7770 posts
Bumble Beekeeper
  • Wedding: July 2010

As far as I know, no doctors in my area will do an elective c-section- because it isn’t good for mom or baby. 

Post # 5
Member
10366 posts
Sugar Beekeeper
  • Wedding: September 2010

Only your insurance provider can answer that question. Coverage varies widely from plan to plan. I’m surprised you were able to find a doctor to agree to it, given recent findings on the long term effects of elective c-sections.

Post # 7
Member
6015 posts
Bee Keeper
  • Wedding: March 2012

You should probably read what your insurance covers.  If it’s not outlined in the policy you could call your provider and discuss with them.  There are new rules that will becoming into effect so things that are/aren’t covered will change.  I’m sure if you really want one, you can Dr. shop and find a Dr. that says you need it medically. 

Post # 8
Member
5543 posts
Bee Keeper
  • Wedding: December 2011

Most providers are moving away from elective c sections because the cost and risks it can have so I.would be surprised if insurance would cover it. Pretty much nothing that isnt “medically required” is covered. 

Post # 9
Member
445 posts
Helper bee
  • Wedding: July 2012

I would say if an ultrasound without medical reason isn’t cover then a c-section without reason would DEFINIETLY not be covered.

Post # 10
Member
9115 posts
Buzzing Beekeeper
  • Wedding: December 2012

I’d doubt it, tbh.

Post # 11
Member
1297 posts
Bumble bee
  • Wedding: June 2011

It depends on your insurance coverage. A friend of mine had an elective c section because her doctor suggested it to her, being that she was high risk. It was covered. 

Post # 12
Member
580 posts
Busy bee
  • Wedding: May 2012

If it was totally elective (you aren’t high risk, etc), then I would say no, probably not. I had to have my gallbladder out a few years ago and I could not have the operation without having all these tests to prove that I needed it, even though my Dr. and I knew that was what was wrong.  

Post # 13
Bee
979 posts
Busy bee
  • Wedding: September 2008 - A tiny town just outside of Glacier National Park

I doubt it, but call your insurance provider. They’re the only one who would tell you for sure. You could probably seach to see if there are any providers available who DO, but I don’t think you could opt to switch if you’re already pregnant (possibly a pre-existing condition in that case?). 

Post # 14
Member
1572 posts
Bumble bee

I highly doubt it, but it doesn’t hurt to call the number on your insurance card and ask.

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