The process for getting varicose vein treatment covered by your insurance, Medicare, or Medi-Cal may seem like a long and frustrating one with insurance companies issuing denials for claims or pre-authorizations for the procedures. Often, this happens because the physician or the physician’s office is not familiar with the requirements that different insurance companies have for covering varicose veins. Almost every major commercial insurance company – companies like Aetna and Anthem – covers treatment for varicose veins, including venous insufficiency and venous ulcers, but they all have different guidelines for treatment and want to see different things documented in the patient’s chart before they will agree to cover treatment.
Our office routinely deals with insurance companies, Medicare, and Medi-Cal to ensure that our patients can get the vein treatment they need covered by their insurance, including:
- Laser varicose vein treatment
- Minimally invasive varicose vein removal
- Foam sclero-ablation for varicose veins, venous ulcers, and venous insufficiency
Because we have experience getting approval for varicose vein treatment by insurance, our office can make the process as painless for you as possible.
If you need varicose vein treatment covered by Medicare, our staff will ensure that you meet all the necessary treatment guidelines for varicose veins and venous insufficiency as issued by Medicare before initiating treatment. The same goes for varicose vein treatment that needs to be covered by MediCal. Typically, patients have to have undergone a period of conservative (non-treated) interventions of their varicose veins like using compression stockings, trying leg elevation, and attempting to reduce weight. It is also important that patients have documented symptoms or injuries like venous ulcers as a function of their varicose veins – it cannot just be a cosmetic treatment.
Commercial insurance companies like Cigna and Blue Cross Blue Shield also cover varicose veins but their requirements are typically different from Medicare and Medi-Cal. In addition to requiring that physician offices contact the insurer and obtain pre-authorization approval for varicose vein treatment, commerical insurers may also want specific things to be documented including:
- For United Healthcare, varicose veins have to be measured in a certain part of the leg on ultrasound in order to qualify for coverage
- For Blue Cross Blue Shield to cover varicose vein treatment, certain language pertaining to the origin of the varicose veins must be included in the ultrasound documentation.
Considering the sheer number of insurers that may cover varicose vein treatment, it is important that your physician understand the right things to ask you when performing your varicose vein evaluation and documents your visit accordingly. If treatments are performed and not authorized properly, insurance companies may deny coverage resulting in surprise medical bills which can be thousands of dollars, so it pays to go to a specialist location which is expert in vein treatment.
No insurance company covers treatment for spider veins, hand veins, or facial veins. Vein treatments covered by insurance are performed in the office, take an hour or less, and do not have any downtime. If you come to our office, Dr. Malvehy will be in touch with your primary care provider so they are aware of your treatment plan and can coordinate any ancillary care as necessary.