Are Procedures to Remove Vericose Veins Covered by Most Insurance Providers?

Many insurance companies we deal with do not cover the vein treatment unless a vascular surgeon assess the area and deems it to be medically necessary, and even then sometimes it is denied depending on the carrier.  With lupus, vein removal must be done with great care as things could get worse in some cases.  See a Board Certified Dermatologist for this treatment.

Cosmetic veins are not covered by insurance companies.  However, symptomatic veins are usually a covered procedure.  Certain criteria need to be met to cover veins by insurance including symptoms and a trial of medical management.  However, we also classify veins by two methods--CEAP  and  VCSS.  If these classifications are significan, then medical management may not be necessary.  See a vein specialist.

Insurance companies will cover treatments for varicose veins if you have symptoms. There are generally 11 types of symptoms which include aching and pain in the legs, heaviness, tiredness (tired legs), itching and burning (over tributary veins), cramping and throbbing of veins, restless legs at the end of the day and very importanly, an element of swelling of the legs, ankles and sometimes in bad cases, feet and toes.Read the ebook about venous insufficiency provided on the link below. 

Like most questions on this site, it depends. Chronic venous insufficiency, of which varicose veins are one consequence, is the most common disease in North America. In fact, if you add up diseases 2-5, they don't exceed CVI. It affects one in eight Americans, with over half being symptomatic.

Symptoms occur often and can range from pain, fatigue in the legs, bursting feelings, itchiness, burning and swelling all the way up to ulceration and skin breakdown.

Seeing a vascular specialist allows one entry into the system. A duplex ultrasound should be performed (a noninvasive pain-free test) that evalutes the patient's venous valves. Most PPO's allow treatment for symptomatic legs that have 500 milliseconds of reflux. That means the blood is flowing the wrong way in the veins for over half a second (away from the heart).

If this is present, insurance will often cover an ablation procudeure to rid one of reflux and removal of the varicose veins (often called microphlebectomy).

If reflux is not present (which it almost always is with large painful veins) the treatment may be considered cosmetic and then it's on the patient to cover the cost of laser/sclerotherapy or surgery. Hope this helps.

If your veins are not bothering you (not painful, itchy, tender, achy, etc), then it is unlikely that insurance will cover for treatment of these veins.  I have had good success in getting my patients' varicose veins treatment covered by insurance ompanies as long as they satisfy the insurance company's criteria.  Every insurance varies but generally they include:

1) have moderate to severe symptoms;

2) failing a trial of conservative therapy for 1-3 months (pain medication, compression stockings, weight loss and exercise);

3) documented ultrasound study showing venous reflux (blood flowing in the wrong direction causing the varicose veins).

Good Luck!

-Dr. Mann