Insurance companies and delivery decisions

[Anonymous]

Everyone - I was reading on another pregnancy forum about a woman whose insurance company (Kaiser) wouldn't "let" her go beyond one week of her expected due date without being induced. I'm presuming that insurance companies have protocols for the safety of the mother and the baby, although I wonder how a rigid hard-and-fast rule like one week could fit every woman's unique situation? Surely the doctor or midwive should determine that?

Does anyone have knowledge on this topic? Is it really possible for insurance companies to intervene in a woman's care to the point where one would be forced to be induced? I have Blue Cross Blue Shield CareFirst, so any specific information on this company's policies would be helpful (I will also call the company for information, although in the past I haven't found them willing to be very specific with their answers).

[Anonymous]

Anonymous wrote:Everyone - I was reading on another pregnancy forum about a woman whose insurance company (Kaiser) wouldn't "let" her go beyond one week of her expected due date without being induced. I'm presuming that insurance companies have protocols for the safety of the mother and the baby, although I wonder how a rigid hard-and-fast rule like one week could fit every woman's unique situation? Surely the doctor or midwive should determine that?

Does anyone have knowledge on this topic? Is it really possible for insurance companies to intervene in a woman's care to the point where one would be forced to be induced? I have Blue Cross Blue Shield CareFirst, so any specific information on this company's policies would be helpful (I will also call the company for information, although in the past I haven't found them willing to be very specific with their answers).

Can you ask your doctor's office what they find to be the standard when dealing with that insurance company?

[Anonymous]

Kaiser is unique because it is a fully integrated system. Kaiser "owns" their own doctors and hospitals, so if you are covered by Kaiser, you have to follow the protocals of the doctors and hospitals that they own. Basically, your Kaiser doctor and hospital are your insurance company-- there is no separation, if that makes sense. Kaiser is really the only insurance company in the country that still operates this way. BCBS does not own their doctors and hospitals, so they don't have the power to tell your doctor when to make you deliver. I would not worry too much.

[Anonymous]

I have Carefirst BCBS and didn't have any issues when I went past my due date. My OB's office didn't bill the insurance company for prenatal care and delivery until I had the baby, so I wonder how they would know when the due date is?

[Anonymous]

This sounds to me like a doctor trying to scare her into an induction. I had the same thing happen to me - I wanted to leave the hospital (after a perfectly normal vaginal delivery) after 24 hours and the doctor said Kaiser would not cover my hospital bill if I did that. I found out later that it was a big fat lie. Kaiser is interested in keeping costs LOWER -- and induction potentially costs more money because it automatically involves more interventions than if a woman goes into labor spontaneously. Plus the ACOG still advocates allowing women to gestate until 42 weeks if necessary, so I can't imagine Kaiser would be encouraging routine induction at 41 weeks.