Many patients and individuals wonder if the expensive health insurance they pay for will cover treatment of their varicose veins. In a nutshell, the answer is yes. As with all health insurance covered procedures and treatments, however, there are some hoops to jump through in order to receive approval.
All major health insurances, excluding some specific plans, cover treatment of varicose veins when deemed medically necessary. While there is some difference amidst health insurance companies about what the requirements are for medical necessity, there is a basic outline that most follow.
The four basic requirements for medical necessity are:
- A duplex ultrasound must be completed and confirm the presence of venous reflux and enlargement of the vein(s) to be treated.
- Patient must experience some symptoms in their legs, such as swelling, itching, burning, skin discoloration, or ulcers.
- Completion of a 6 week or 3 month “Conservative Therapy” period which includes daily tasks of wearing compression hose, walking 30 minutes, and elevating the legs.
- A lack of significant improvement in symptoms following the Conservative Therapy period.
Once these four requirements have been met, insurances generally agree to cover treatment of the problematic vein(s). At Totality, we request an authorization from your insurance prior to all procedures to ensure that it will be covered by your specific insurance plan. This step gives you and our office assurance and peace of mind.
Please remember, coverage of a procedure does not ensure out of pocket costs to be $0. Procedures performed at Totality are subject to any copays, coinsurances, or deductibles as outlined by your health insurance plan.
If you have questions regarding what your out of pocket costs may be or if your insurance plan covers varicose vein treatments, contact our office today!
There is no need to wait any longer to take care of your problematic veins, Totality is here to help.
We accept all major health insurances including Medicare and Medicaid.