Are these treatments covered by insurance?
This depends on your policy and specific coverage provided by your insurance carrier. In general, most insurance providers have two categories under which vein treatments may fall:
- Cosmetic Procedures
- Medically Necessary Procedures
Some vein treatments will fall under the category of cosmetic procedure, and as such, will not be covered by most insurance providers. This is commonly the case for asymptomatic spider veins.
In certain circumstances, however, insurance companies may deem varicose veins and other disorders medically necessary and thus will offer varying degrees of coverage depending on their contracts with the patient and the doctor. Insurance companies use varying criteria in order to determine if vein treatment is to be considered “medically necessary.” These criteria may include one or more of the following:
- Lifestyle Disruption: The daily activities of the patient must be disrupted significantly.
- Pain: The patient must be experiencing pain as a result of their vein disorder.
- Failure of Conservative Measures: Other methods of treatment, such as compression hose, have failed to provide adequate relief.
- Vein Size: Bulging veins larger than 4 mm are often considered medically significant.
- Complications: Complications, such as phlebitis, bleeding veins, leg swelling and leg ulceration make it more likely an insurance company will consider treatment medically necessary.
A trial of conservative management is sometimes required prior to providing coverage for varicose vein treatments. This includes a number of features, such as compressive therapy, rest, elevation and other maneuvers. It is best to check with your insurance carrier if you have any questions about your coverage.