A healthy living blog from Marshfield Clinic Health System

Will my insurance cover varicose vein treatment?

woman with smooth legs sitting on a beach

Health insurance may cover treatment for varicose veins if it is medically necessary.

In September 2015 we published a post about simple treatments for varicose veins and got questions about insurance coverage.

Coverage depends on your health insurance plan and medical circumstances. Marshfield Clinic Patient Financial Services can help you find out if your treatment will be covered. Here’s how the process works:

Make a vein consult appointment

The first step is getting a vein consult. Marshfield Clinic Vein Services providers will examine your varicose and spider veins and explain treatment options.

Vein Services staff will submit a pre-admission review request to Patient Financial Services to check your benefits and coverage for the treatment.

Will treatment be covered by insurance?

Each insurance company and plan is different. Some cover varicose vein treatment if it is medically necessary. Others do not. Some insurance companies require the patient to meet a deductible or pay the copay or coinsurance before covering the treatment.

A Patient Financial Services representative can explain what your insurance policy covers.

Medicare will consider covering vein treatment if it is medically necessary.

Marshfield Clinic fee estimators can provide information about a procedure’s cost if insurance won’t cover it.

What does ‘medically necessary’ mean?

Medicare patients must undergo six weeks of conservative treatment before interventional treatment is covered. Conservative treatment includes weight reduction, daily exercise, compression stockings and periodic leg elevation.

Medicare will deem interventional varicose vein treatment medically necessary if patients still have symptoms of significantly diseased blood vessels after conservative treatment. Some symptoms are pain and edema that interferes with activities of daily living, bleeding, lower leg ulcers, inflammation and clotting in veins near the skin’s surface.

Additional criteria and limitations apply to certain types of treatment.

Private health insurance companies and plans may have different criteria for covering varicose vein treatments. A Patient Financial Services representative can review these criteria with you.

Learn more about in-office treatment for varicose veins.

Learn about Patient Financial Services.

Call 877-MC-VEINS to schedule a vein consult appointment.

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