Date last updated: November 28, 2018 During your initial session, inquire about insurance coverage and payment choices with your vein expert. You may be surprised to learn that many varicose vein treatment methods are covered by insurance when judged “medically essential.” In addition, most vein clinics accept a number of payment methods for procedures that are not covered by insurance.
Varicose veins that cause pain are they covered by insurance?
Skip to content Date of Publication: June 22, 2020 Does Insurance Cover Treatment for Varicose Veins? The following parameters decide whether insurance will cover varicose vein treatment: Most insurance policies, including Medicare and Molina, cover varicose vein treatments deemed “medically required care” but not “cosmetic care.” Varicose veins (swollen leg veins) must produce symptoms such as leg discomfort for insurance coverage. Varicose veins must be accompanied by leg discomfort or other symptoms. Varicose veins must produce symptoms such as leg discomfort, heaviness, chronic swelling, nighttime cramps, or burning for vein therapy to be deemed medically required. Indicative of therapy for varicose veins are leg ulcers (open wounds) caused by the condition, recurring blood clots or phlebitis, burst veins that bleed, and ankle skin discolouration.
- Symptoms impact daily activities.
- The symptoms must be severe enough to interfere with the individual’s ability to do everyday tasks or job.
- For instance, a teacher with varicose veins may be unable to stand and do their duties because they must frequently raise their legs.
- A waitress at a restaurant who experiences leg pain after a few hours may no longer be able to perform lengthy shifts.
Symptoms might interfere with a person’s lifestyle by reducing the amount of activity they can perform or preventing them from cooking or performing housework owing to leg discomfort.6 to 12 weeks of conservative therapy must be attempted. In the majority of situations, insurance demands that many weeks of conservative treatment have been attempted.
- Compression stockings, leg elevation, exercise, weight loss, anti-inflammatory medicine such as ibuprofen or vasoactive drugs such as horse chestnut or Vascular, and hot/cold packs are examples of conservative treatments.
- PRIOR TO APPROVING TREATMENT, MANY INSURANCE TYPES REQUIRE 6 to 12 weeks of wearing medical-grade compression stockings.
You should schedule your appointment immediately and begin incorporating conservative management into your lifestyle. You should start a daily journal to document that you are utilizing conservative therapy. If your primary care physician has already prescribed compression stockings, it is good to get a note or prescription from him or her, as this will count towards your conservative management time period.
- Varicose veins without associated symptoms
- Spider veins
Does Your Vein Disorder Meet the Criteria for Medical Necessity? If you responded “yes” to each of the four areas, you are likely to fulfill the vein therapy medical necessity criterion. This questionnaire has been streamlined for patient convenience and comprehension. Varicose veins may result in at least one of the following symptoms.
- Leg discomfort
- Heaviness
- Persistent swelling
- Pain, heaviness, or pulsing
And/Or have you had any of the following varicose vein complications?
- Leg ulceration
- Ruptured bleeding vein
- Blood clot recurrence or phlebitis
Do your symptoms (leg pain, etc.) impair your everyday life?
- It does influence my job.
- Yes, it impacts my dwelling.
- Yes, it impacts my regular activities or leisure time.
Have you already attempted conservative treatment for your vein disease, but it has not been totally successful?
- Yes, I have tried compression socks and at least two of the following:
- Leg elevation
- Exercise
- Weight reduction
- Ibuprofen or another NSAID
- Cold or warm packs
- Venoactive medications such as Vascular or over-the-counter dietary supplements including horse chestnut or grapeseed extract.
Have you undergone an ultrasound that revealed underlying venous reflux disease?
- Yes, my ultrasound revealed and confirmed reverse blood flow in my veins ( venous reflux )
- The ultrasonography testing revealed that my veins operate normally.
However, some individual insurance policies do not cover varicose vein therapy; this is typically due to an employment exclusion. Sometimes in this situation, one may request that varicose vein treatments be included in the coverage. You can contact the number listed on the back of your insurance card to inquire whether it covers vein treatments.
Does it make sense to have varicose veins removed?
Varicose veins are not always curable. If your varicose veins are not giving you discomfort, treatment may not be necessary. Generally, treatment of varicose veins is required just to: If your varicose veins are giving you pain or discomfort, address the symptoms.
Treat consequences, such as leg ulcers, swelling, and skin discoloration. Some people receive therapy for cosmetic reasons; however, this type of treatment is seldom covered by the NHS, so you’ll often have to pay privately for it. If treatment is required, your physician may first prescribe self-care.
This might include: Using compression socks (your blood circulation will first be checked to see if these are suitable for you) exercising routinely and avoiding extended hours of standing Resting with the afflicted area elevated
Compression stockings and socks are an essential component of the treatment regimen for varicose veins. This information was published on August 18, 2014. Prior to authorizing and paying for varicose vein therapy, insurance will ask that they be utilized for 6-12 weeks.
- Compression socks and stockings are now available in a range of fashionable patterns and hues.
- Because modern compression sock types are more fashionable, you may include medical therapy into your professional and casual wear.
- Compressrx.com contains fashion compression.
- We have observed a trend over the last year regarding insurance coverage for varicose veins; insurance coverage standards for varicose veins are getting increasingly stringent.
Whether or not an individual’s insurance coverage covers vein therapy varies by policy (office visits, diagnostic ultrasound examinations, and consultations are typically covered benefits by most). Before a person may be eligible for varicose vein treatment, the majority of insurance policies mandate that they have worn and attempted medical-grade compression for at least 3 months.
- In particular, the patient must have been utilizing medical-grade compression for at least three months with no improvement in symptoms.
- Medicare and Anthem need only a six-week trial of compression therapy.
- Compression socks and stockings are a component of conservative vein disease treatment.
- Compression socks of medical grade are stronger than those available over-the-counter and may require a prescription.
Because your insurer may demand you to wear compression socks/stockings for three months before they would cover your medical vein surgery, you should start wearing them immediately and keep track of it. For example, request a prescription from your primary care physician.
Keep your purchasing receipts, since some insurance policies need verification of when compression was first used. Typically, compression stockings are not covered by insurance, but a flexible health savings account can be used. In addition to leg elevation, exercise, weight loss, and NSAIDs, compression stockings should be utilized as a trial of conservative therapy.
We are pleased to address inquiries regarding vein operations and insurance coverage. We may be reached at 858-550-0330.
Is surgery for varicose veins painful?
On the day of your vein treatment, you will likely suffer mild discomfort and bruising in the area where your veins were treated. If the pain becomes unbearable, your doctor may recommend ibuprofen or Tylenol, depending on your health. You should be able to resume your regular activities without difficulty.