Is Leg Vein Treatment Covered by Insurance?

leg cramp, senior woman suffering from leg cramp pain at home, health problem conceptThe treatments for varicose veins and spider veins have become less painful and less invasive, with shorter recovery times over the past decade. But what about the cost? Are these treatments covered by health insurance? The answer to this question depends on the reason(s) you’re seeking treatment. Most insurance companies will cover these treatments if they are deemed “medically necessary” and not for cosmetic purposes.

Below are some criteria for a medically necessary procedure, as defined by many insurance carriers. This list of conditions is a high-level overview of the most common health insurance and Medicare treatment coverage qualifications. Please note that your individual policy may be different.

Conditions for Medically Necessary Leg Vein Treatment

  • Vein condition causes pain or other symptoms (i.e., heaviness, swelling, cramping, burning, etc.)
  • Symptoms affect quality of daily life
  • Conservative treatment must be tried for 6-12 weeks (i.e., compression stockings, leg elevation, exercise, weight loss, ice/heat application, over-the-counter medication)
  • Venous reflux must be diagnosed via medical imaging (usually ultrasound)

Other issues that could qualify you for covered vein treatments include bleeding from the veins through the skin, blood clots or phlebitis in your veins, or ulcers resulting from venous disease.

Varicose veins almost always constitute a medically necessary treatment because they fit one or more of the criteria above. Spider veins, however, are sometimes categorized as a cosmetic condition, the treatment for which is sought for “aesthetic reasons.” However, because spider veins can be caused by venous reflux, treatment may be considered medically necessary and would therefore be covered by insurance. That’s why it’s so important to schedule an initial consultation; this appointment will reveal the true state of your vein health, along with any underlying issues that may be present.

Financial Options for Leg Vein Treatment

If your treatments are not covered by your insurance, don’t give up hope. A number of secondary strategies exist to help, including:

  • Vantage Radiology offers a discount for patients who wish to pay out of pocket or are uninsured. Patient account representatives are available by phone at661.1700 to answer your billing questions Monday through Friday, 9:30 AM to 4:00 PM. Billing inquiries may also be e-mailed to question@vrads.com.
  • You may also be able to reduce your out-of-pocket payments by utilizing a health savings account (HSA) and/or a flexible spending account (FSA) to cover a portion of the treatment.
  • If your insurance policy omits varicose vein treatment as a result of employer exclusion, consider approaching your employer to ask for vein treatments to be included in its employee health plans.

Regardless of whether your treatments are deemed medically necessary or cosmetic, better vein health is priceless. It’s up to you to take the first step by scheduling your consultation.

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