Trying to live with varicose veins can be a bit of a daily battle. At some point, it makes sense to seek treatment for varicose veins that have become symptomatic. When people get to this point, they often want to know if their insurance company will extend coverage to help pay for the cost of treatment. In many cases, the answer is yes. However, there is a caveat. Spider veins and some varicose veins may be classified as mild and cosmetic in nature. In these cases, an insurance company does not deem treatment medically necessary. This is a key term in obtaining coverage for varicose vein treatment. How does an insurance company make this determination? We’ll discuss that here.
Criteria for Medically Necessary Vein Treatment
Patients who are interested in getting vein treatment covered by their insurance should keep in mind that the following are general criteria. Some insurance companies may vary in their guidelines. It is important to speak with your insurance provider directly to ensure you follow their recommended steps for coverage.
- Varicose veins are significantly symptomatic.
Vein treatments can be performed for cosmetic reasons. Patients don’t have to wait for their veins to become extraordinarily swollen and ropy to seek treatment. However, cosmetic vein treatments are not covered by insurance. Companies typically want to see documentation of some sort that states that varicose veins are causing symptoms such as leg cramps, aching, burning, skin discoloration, blood clots or phlebitis, or skin ulcerations.
- Symptoms affect daily life.
Symptomatic varicose veins often affect a person’s ability to fully enjoy their day-to-day life. Those that may qualify for medically necessary vein treatment are varicose veins that force a person to take breaks during their workday or that impede a person’s ability to work a full-time job. If legs must be elevated often, moved frequently, and still present with aching, cramps, and other symptoms, they affect daily life.
- Conservative treatment for 6-12 weeks.
One of the criteria that we tend to see from most insurance companies is that they want documentation that a patient has tried conservative vein therapy for 6 to 12 weeks before seeking coverage for vein treatment. Commonly, this guideline refers to the use of medical grade compression stockings to help move blood out of the veins. We have an extensive supply on hand in our office so patients can begin their therapy right away after their consultation.
Sun Vein and Vascular offers professional vein treatments in a comfortable, friendly environment. To schedule your consultation at our Dallas office, contact us at (214) 556-8880.