You Need To Know: C-Sections, Hospitals And Your Insurance Company

Here’s the oxymoron of the day.

If hospitals start telling obstetricians stop doing C-sections (or try to reduce them), that’s problematic for hospitals because they make money off them.  So they are less likely to engage in C-sections because many hospitals are struggling to stay afloat.   But get this, if you’re a woman who has had a C-section the insurance company sees you as an even bigger risk for complications.

This can lead to you seeing higher insurance premiums or being denied for coverage altogether.

Why?

Mainly because having the operation once can often lead to more c-sections in future births. The problem for insurance companies is that a c-section is usually over $2,500 more expensive than a regular birth. Rather than take the risk of having to pay for another c-section, insurance companies label the women as having a health condition and charge them higher rates. This practice is actually illegal in some states, in which case the insurance companies simply reject applicants completely. Like other so-called conditions, insurance companies are simply looking for a way to protect themselves from possible expenses.

Recommended action:  Talk to your insurance company around their practices in denying/approving women for coverage who have had C-sections.  Check with your state to make sure that you understand the law: is it illegal?

Now You’re Asking How Can I Avoid A Rate Hike?

Obviously, if your doctor wants you to have a c-section, there isn’t a lot you can do to avoid it. In some cases, the procedure may be optional, in which case you’re probably better off doing things naturally. Some companies are willing to overlook a c-section if the woman is sterilized after the operation, as then there’s no risk that they could have another pregnancy and c-section. A premium increase may also be avoided if the woman applies for coverage at least two years after giving birth and is a certain age. Another thing to keep in mind, insurance purchased through employers isn’t likely to increase due to a c-section as group policies generally require that the insurer cover everyone in the group at approximately the same rate.

Have you had a C-section?  Did your rates go up?  Tell us about it!

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