Will my insurance cover varicose veins treatment?
Insurance coverage for varicose vein treatment varies depending on your insurance provider and your specific policy. In general, most insurance providers will separate vein treatments into two categories:
• Cosmetic Procedures
• Medically Necessary Procedures
Cosmetic procedures usually are not covered by insurance providers. Treatments for small, non-symptomatic spider veins are not considered medically necessary; patients will have to pay out of pocket.
However, larger veins that are symptomatic (pain, aching, burning, itching and/or swelling along with additional criteria set by your insurance carrier) will usually be considered medically necessary and will be covered by insurance providers.
Examples of additional criteria are:
• Lifestyle Disruption: Do the symptoms in your legs affect any daily activities such as not being able to shop, do yard work, use stairs, run after children etc, without having to rest?
• Failure of Conservative Measures: Conservative measures include the use of compression stockings, leg elevation, weight loss, exercise and over the counter pain relievers that have failed to provide satisfactory relief over a specific period of time.
• Vein Size: Your vein size has to be greater than specific size (set by your insurance provider).
• Complications: Complications, such as phlebitis (inflammation of the vein), bleeding veins, leg swelling and leg ulceration make it more likely that an insurance company will consider treatment medically necessary.
In these cases, after documentation of venous insufficiency (the valves in your legs are not properly functioning) determined by ultrasound, most insurance providers will deem surgical procedures to be medically necessary.
At Restoration Vein Care, we know that this process can be confusing. Our Patient Care Coordinator will assist you with your insurance carrier to see if they will cover any procedures done in our office. However it is best to check your policy and call your insurance provider to find out what their exact coverage will be.