Does Health Insurance Cover Varicose Vein Treatment?

DOES HEALTH INSURANCE COVER VARICOSE VEINS TREATMENT?

Most health insurance will cover treatment of chronic venous insufficiency (CVI) the condition that is often responsible for varicose veins. If varicose veins are painful, interfere with daily activities, and are caused by CVI, it’s likely your insurance plan will cover at least some of your treatment, depending on your deductible and other factors.

As with any medical treatment, insurance policies differ, and it’s best to ask about coverage beforehand. Your doctor can provide the necessary information for you to check with insurance before obtaining any treatment.

Definition of ‘Medically Necessary’ Treatment

With varicose veins (and with a related condition called chronic venous insufficiency), poorly functioning valves allow the blood to pool in the lower leg and cause symptoms. Varicose veins can occur in almost anyone, affecting up to 35% of Americans.

Varicose veins can cause symptoms including discomfort (itching, swelling, burning, leg heaviness) and bleeding when a vein bursts as a result of minor trauma. Most insurance policies recognize that venous insufficiency is a real disease and treatment isn’t merely ‘cosmetic.’

Most insurance companies require that the varicose veins cause leg pain or other symptoms that affect daily life. If you have to stand to do your job, for example, varicose veins can prevent you from working or require frequent breaks to elevate your legs. An inability to do housework or exercise can also negatively impact daily life.

If you have symptoms of varicose veins, your first course of treatment should be to wear compression stockings. Many people find adequate relief from symptoms by wearing the stockings, and most insurance companies require that you try them for at least three months before they will cover any other type of treatment. Insurance will typically cover the cost of the stockings (if you’ve met your deductible and copay).

Your doctor can confirm if you have venous insufficiency using ultrasound, which is painless. Many insurance plans cover ablation therapy for the treatment of venous insufficiency/varicose veins, provided the other criteria are met.

We’ve provided a list of questions to ask your insurance provider to find out if your treatment will be covered.

Out of Pocket Payment with No Surprises

If insurance won’t cover your treatment—either because you are choosing to cosmetically treat spider veins, for example, or you haven’t met your deductible—you may choose to pay ‘out of pocket’ and cover the costs yourself.

At Muskegon Surgical Associates, we provide you with the total cost of treatment upfront, so there are no surprises. This removes the uncertainty that usually comes with receiving multiple bills after a procedure. We also offer a number of payment options, including 0% interest for 12 months, through CareCredit.

Sources:

MSA
MSA Patient Resources