One of the most frequent questions my vein patients ask is if insurance will cover treatment for their varicose veins.
Insurance companies consider varicose veins to be a medically necessary problem when complications such as clotting, bleeding or skin changes have already developed from them, or when they cause symptoms such as heaviness, aching, tiredness, throbbing, burning, itching and/or swelling, which impact an individual’s routine daily activities or ability to work. We then have to verify that there is indeed a problem with the veins. This is done by performing an ultrasound with the patient standing. Healthy veins carry blood up toward the heart, while varicose veins don’t function normally, allowing blood to flow backwards toward the feet, often resulting in dilated, bulging veins. This flow abnormality called venous reflux can be determined with ultrasound. Once we have documented the patient’s symptoms and the fact that they do indeed have venous reflux, their subsequent treatment is typically covered by insurance. Some insurance carriers require patients to undergo a “trial of conservative therapy” prior to approving vein treatment. This usually means having patients wear compression stockings for a period of time, sometimes up to 6-12 weeks. Once they have completed this, we can submit our records to the insurance company for treatment approval.
