Varicose vein removal surgery isn’t covered by your health insurance. Treatment for varicose veins must be medically necessary in order to receive insurance reimbursement. Insurance policies will not cover cosmetic procedures if you don’t like the way they look.
For insurance to cover the charges, your ailment must have symptoms that need to be eased. It must also be medically necessary for your health and well-being and prevent any future complications from developing.
The complete expense of therapy will be your responsibility if you don’t have any symptoms such as discomfort or swelling but still want it addressed because the way it appears concerns you.
Varicose vein removal must be medically necessary if there are symptoms that negatively impact your daily life. For a while, you may want to experiment with various therapy options besides vein removal. The insurer will pay for the removal surgery if the symptoms persist for the stated period of time.
Continue reading this post to learn more about varicose vein removal and how to get insurance to pay for treatment.
What Are Varicose Veins?
Varicose veins are caused by swollen and twisted veins in specific areas of the body. Because of the increased pressure on the veins induced by walking and standing, this is more frequent in the lower limbs.
Varicose veins aren’t life-threatening in and of themselves, but they can wreak havoc and potentially set the stage for more problems. The symptoms of varicose veins may not be obvious to some people, and they may not require immediate treatment. For cosmetic reasons, therapy may be necessary if this is the case
In addition to varicose veins, there are spider veins, which are smaller. They can be seen through the skin in blue or red and resemble spider webs, which is why they are called spider veins.
Vascular injury is the primary cause of varicosity, which is characterized by bulging veins. As a one-way gate, these valves are responsible for preventing low-oxygen blood from entering the heart. Blood can flow backwards and collect if the valves are compromised. When blood is forced to rise against the force of gravity, this occurs primarily in legs. This explains why varicose veins are most commonly detected in the legs of individuals. As a result of the increasing pressure, the veins expand and dilate.
Continue reading this post to find more about how to acquire insurance for varicose vein removal.
4 Main Criteria for medically necessary vein treatment
Varicose veins must cause leg pain or other symptoms.
There must be symptoms like leg pain, heavyness, swelling, cramping, or burning in order for varicose vein treatment to be medically essential. Leg ulcer (open wound) from the vein problem, repeated blood clots or phlebitis, ruptured bleeding vein, or skin darkening around the ankle are all possible complications of varicose veins.
Symptoms affect daily life.
This condition requires that a person’s day-to-day activities or employment be significantly hindered. Varicose veins, for example, might make it difficult for a teacher to stand for long periods of time and do their duties. Because of leg pain, a restaurant server may be unable to work for long periods of time. If you have leg discomfort, you may be unable to accomplish household duties like cooking or cleaning because of your symptoms.
Conservative treatment must be tried for 6-12 weeks.
For the most part, insurance companies require that a few weeks of conservative treatment have been attempted first. Exercise, diet, anti-inflammatory drugs like ibuprofen and vasoactive agents like horse chestnuts and Vascular, and hot/cold packs are some of the most used conservative treatments. Wearing medical-grade compression stockings for 6 to 12 weeks before treatment is required by many insurance companies. Once you’ve had your consultation, you should start living a conservative lifestyle and practicing what you’ve learned. You should start maintaining a daily record of the conservative therapy you are utilizing. Having a note from your primary care physician stating that you’ve been prescribed compression stockings is helpful because it counts against your conservative management time period.
Venous reflux must be demonstrated on ultrasound.
Ultrasound must be used to confirm the presence of underlying venous insufficiency. Nearly all types of insurance will pay for both the diagnostic ultrasonography and the doctor’s appointments.
Cosmetic therapies, like as Botox and fillers, are not covered by insurance.
- No signs or symptoms of varicose veins
- Veins with spidery patterns
Does Your Vein Condition Qualify for Medical Necessity?
If you replied “yes” to all four of the following questions, you are probably eligible for vein therapy. Please note that this is a condensed version of a more comprehensive survey for the benefit of the patient.
Do your varicose veins cause at least one of the following symptoms?
- Anxiety in the lower extremities
- Unrelenting bloating
- Constant pain or discomfort.
Has your varicose veins caused any of the following issues?
- A wound on the leg
- Vein that has burst and is dripping blood
- A condition in which there is an increased risk of blood clots
Do your symptoms (leg pain, etc.) affect your daily life?
- My job is affected.
- Yes, my house is impacted.
- My regular routine and leisure time have been impacted, yes.
Have you already tried conservative management and the conservative management has not completely resolved your vein condition?
- Compression socks/stockings and at least two or more of the following have worked for me
- Elevating the legs
- a reduction in body weight
- Ibuprofen or another nonsteroidal anti-inflammatory drug (NSAID)
- ice or heat packs
- Vascular or over-the-counter supplements like horse chestnut or grape seed extract can be used as venoactive medications.
Did you have an ultrasound examination that demonstrated underlying venous reflux disease?
- In fact, my ultrasound showed and verified that my veins were flowing backwards (venous reflux)
- My veins appear to be healthy, according to the results of the ultrasound.
Varicose vein treatment may be excluded from some individual insurance policies due to an employer exclusion. Varicose vein treatments may be added to the insurance coverage if requested by the employee. Inquire about vein therapy coverage by calling the phone number on the back of your insurance card. At the outset of your vein therapy, we will help you understand your insurance coverage. Obtaining preauthorization (permission) and answering queries are also responsibilities of our prior authorization professional.
When Vein Removal Is Medically Necessary
The presence of swollen and painful veins is regarded a sign of medical necessity. If varicose veins are not surgically removed or closed, using thigh-high compression stockings can help circulate blood through the afflicted area.
Before approving varicose vein therapy, most insurance companies need a venous ultrasound. Most insurance plans cover a brief consultation at a vein specialist’s clinic, during which the provider can demonstrate the condition of your veins. Your treatment will be considered medically required if an ultrasound reveals that your varicose veins are causing swelling, ulceration, heaviness, or backward blood flow. Your insurer will use this evidence to pay for the removal treatment if you present it to them.
If Your Veins Are Cosmetic Concerns
Smaller vein problems can be dramatically improved with cosmetic vein therapy. Cosmetic veins such as spider veins, in contrast to varicose veins, are not considered medically necessary for treatment. Cosmetic procedures are not normally covered by insurance, and this type of treatment falls into this category. Cosmetic procedures are often not covered by insurance, so patients will have to pay for them themselves.
Vein Removal Treatment Options
Varicose vein treatments are available at Hinsdale Vein & Laser.
Endovenous laser ablation
Varicose veins can be cauterized (burned) and closed with this procedure. Vein-related symptoms like pain, edema, and irritation can be alleviated with this treatment. Traditional vein removal surgery is more invasive and risky than ablation. Using ultrasonography, your doctor will be able to see the vein in question. Through a small incision, a fiber or electrode is inserted into the vein and guided to its final destination. Fiber or electrode can be placed in the vein and a local anesthetic is given in order to cause the vein to dilate around it. As a result of the energy, the vessel is heated and forced to close, allowing the damaged vein to contract.
Chemical ablation using state of the art foam sclerotherapy (Varithena)
To treat varicose leg veins caused by difficulties with the great saphenous vein (GSV), Varithena (polidocanol injection foam) is applied to the GSV and other GSV-related veins in the leg. Varithena helps alleviate the symptoms of varicose veins, as well as the visible signs of varicose veins. Within seconds, a column of concentrated foam will cause the lining of the vein wall to be destroyed, resulting in an inflammatory response that causes the vessel to collapse. Sclerosis is often safer and more effective when compared to several other forms of the disease.
Medical adhesive that results in closure of the unwanted veins (Venaseal)
An adhesive is used to seal the vein during this process. VenaSeal closure system distributing gun attached to catheter dispenses the medical adhesive into the syringe filled by skilled clinician. Under ultrasound guidance, the catheter is inserted into the affected vein. To administer the medical adhesive, the catheter is inserted into the sick vein and a series of trigger pulls are performed by the treating physician.
Mechanochemical ablation of the vein (MOCA)
To execute mechanicochemical vein ablation, chemical sclerosants are injected with catheters that spin, causing mild damage to the vein lining as they are delivered directly into the damaged saphenous vein trunk. For obliterating a vein, this combination is designed to be more effective.
In ambulatory phlebectomy, tiny incisions in the skin are used to remove superficial veins. Both asymptomatic and symptomatic superficial cutaneous veins can benefit from this procedure. On the other hand, varicose and bulging veins can also be treated with this procedure. Small incisions are made in the skin to remove bulging veins segment by segment.
Does Insurance Cover Varicose Vein Removal
If you want to know if your insurance will pay for your varicose vein removal, you need to know a few things. Insurance companies will only pay for your treatment if it is absolutely necessary for you. You should seek treatment for its symptoms because it is detrimental to your health.
The symptoms you’re experiencing should be affecting your day-to-day activities, such as being unable to work as usual. If your profession needs you to stand for a lengthy period of time, you may be unable to do so because to the exhaustion and soreness in your legs caused by this ailment.
Also, if the problem can be cured or managed with utilizing other techniques, the therapy will not be paid. For example, there are compression stockings and other forms of exercise as well as oral medication for weight loss. Try these out for a set period of time.
If the problem persists, varicose vein removal may be required. Duplex ultrasonography, for example, should be used to further assess your health. In order to have the removal operation performed for reasons other than those indicated above, you will be responsible for the charges.
Getting Insurance: Ways For Varicose Vein Removal
Patients with varicose veins can select the procedure they prefer for treatment and removal. It also relies on the treatment options available at the facility they choose to go to. Listed and explained below are a few of the more prevalent ones.
A solution is injected into the veins in order to eliminate them. Vascular closure is a result of injury and scarring caused by the solution. Instead, blood will be pumped through alternative pathways. In the case of tiny veins, sclerotherapy is frequently explored.
#2. Laser treatment
The heat from the laser causes the veins to collapse, scarring them. The dwindling veins would vanish from the scene and fade into oblivion. The blood that’s meant to be flowing through those veins is actually going through healthy ones.
#3. Vein stripping
Mini-surgery involving ligation and stripping is used to remove veins with defective valves. In other words, if you don’t have varicose veins, you won’t have any damaged valves. There are two little incisions made on either side of the vein, where a thread is placed. A procedure to strip or remove the vein will be performed next.
I hope you’ve learnt how to receive insurance for varicose vein removal at the end of this post. I appreciate you taking the time to read this far. We truly value the time and effort you have put in.
Treatment for varicose and spider veins is not always covered by health insurance.