Does Insurance Cover Varicose Vein Treatment?

GPT Patient filling out a medical form while talking to a doctor.

You’re ready to get your varicose veins treated but are concerned about the cost. Before you make an appointment, you may want to know if varicose vein treatment is covered by insurance. How much will your insurance plan cover, and how much will you pay out-of-pocket? And if it isn’t covered, how much does varicose vein treatment cost without insurance?

You may be happy to know that most insurance plans cover the cost of vein treatment, but there are a few factors to consider to determine how much will be covered.

Understanding Insurance Coverage

Most insurance plans include treatment for varicose veins, venous insufficiency, and venous ulcers if the treatment is medically necessary. This includes most common insurance plans such as Medicare, PPOs, and IEHP. At Empire Vein Specialists, we are in-network with and accept most insurance plans.

If you have a medical diagnosis that requires treatment, there is typically no issue with getting it fully or partially covered. How much will be covered will depend on your insurance plan. However, insurance will not cover vein treatment for cosmetic reasons. There is no insurance plan that covers sclerotherapy for cosmetic spider veins. At Empire Vein Specialists, we offer affordable treatment options for sclerotherapy, and we will provide a quote prior to any treatment. 

The extent of coverage depends on your provider and the terms of your policy. If you are unsure what your policy covers, call your insurance company for the details. Our expert team can also help with insurance verification and coverage-related questions. 

Criteria for Insurance Coverage of Varicose Vein Treatment

Most insurance providers want to know that you have a medical reason for vein treatment beyond cosmetic purposes. Typically, your insurance provider will require a diagnosis of a specific vein-related condition or symptoms that indicate vein disease, even if you don’t have visible varicose veins.

A few physical symptoms to look out for include: 

These symptoms may indicate that vein disease needs to be evaluated and treated before it gets worse. When you visit our office, our team will discuss your symptoms, perform an ultrasound assessment, and then work with you to meet the requirements of your insurance for the treatment you need.

Navigating Your Insurance Plan

When you need treatment for any medical condition, the last thing you want is to get stuck with an unexpected bill because you didn’t understand what your insurance would cover. Navigating your insurance plan and understanding all associated fees can be tricky. 

Start by knowing your plan. If you have any questions, call the insurance company. Be sure to set up your access to the plan’s online portal, as many questions can be answered quickly via their website.

Keep track of communication with your plan, especially if you are actively receiving treatment for a medical condition. This may include keeping a record of phone calls, anything that comes in the mail, and tracking bills that have already been paid.

Finally, be sure your provider has the right insurance information. This can reduce confusion and prevent you from getting billed for procedures that should be fully covered.

Documentation and Proof Required for Coverage Approval

What do you need to do for your vein treatment to be covered by insurance? Here’s some advice on how to get insurance to pay for varicose vein removal.

The most important documentation your insurance company needs is information from your doctor saying you have a medical need for treatment. At Empire Vein Specialists, our board-certified physicians will provide a comprehensive evaluation of your medical history and a physical examination. This information, along with a quality ultrasound performed in our office, will be submitted to your insurance for vein treatment approval. Over 97% of our patients have their procedures approved by insurance. 

We are dedicated to providing all the documentation and proof required for your insurance, so there are no surprises on your final bill.

How to Appeal a Denial of Coverage for Varicose Vein Treatment

If your insurance denies your varicose vein treatment, you or your healthcare provider can appeal their decision. Typically, the insurance company will send a letter of denial. In that letter, there are instructions for how to appeal their decision. Tell your doctor that you are appealing the decision, as they may be able to provide additional documentation to help the treatment get covered.

If the insurance plan is unwilling to cover your vein treatment, how much does varicose vein treatment cost without insurance? The cost of vein treatments can vary widely depending on a variety of factors. Some of these can include:

  • The type of treatment performed (injectables are typically less expensive than laser treatments)
  • The number of veins treated
  • The number of treatments needed 

We offer Care Credit as a payment option for those who pay out of pocket, helping you pay for treatments you need in monthly installments.

At Empire Vein Specialists, we can help you navigate the complexities of insurance billing and help you get the care you need for your varicose veins. Schedule a free screening today to get started by calling 1-800-VARICOSE (1-800-827-4267) or booking online today.