Insurance Information

Insurance coverage information for the treatment of varicose veins

General Insurance Information

Do insurances cover varicose vein treatments?

Yes, for the most part. There are some insurance companies that consider some of the treatments as investigational or cosmetic. We do a complete evaluation at your initial visit in order to prove medical necessity. Any non-covered treatments would be discussed with you at this initial visit as well.

Are “varicose veins” considered a pre-existing condition?

Most insurance companies apply “varicose veins” under their pre-existing condition list. If you are in a pre-existing waiting period, it is best to call your insurance to verify whether or not varicose veins are considered a pre-existing condition. Venous ultrasounds and treatments will not be covered by your insurance while you are in a pre-existing waiting period.

What insurances do you accept?

We accept all major insurance providers: SelectHealth, Medicare, Blue Shield, United Healthcare, Altius, Aetna, DMBA, PEHP, and EMIA. Please call our office to verify if we are contracted with your insurance if it is not previously listed. (801) 379-6700.

Do I need a referral to come to your office?

We do not require a referral from your doctor to be seen at our office. However, if your insurance plan requires you to have a referral to see a specialist, you will need to have one sent over to use from your primary care provider.

Are there any pre-requirements before starting treatment?

IVC does not require patients to have tried conservative measures before receiving treatment. However, many insurance providers require some period of time where conservative measures have been attempted. We will discuss, at your initial evaluation, what your insurance requirements are.

How much do the treatments cost?

The initial evaluation ranges from $538 to $725, depending on whether or not both legs are evaluated. The initial evaluation will be billed to your insurance and can be applied to your deductible. We go over all other cost and insurance benefits at the time of your initial visit.

Specific Insurance Information

Conservative Measures:

Many insurance policies require that you complete a 3 month trial period of conservative measures. These include, but are not limited to, the use of prescription strength compression stockings, the use of anti-inflammatory and pain medications, and exercise. Once the trial period has been followed and the results are documented, we will submit your clinical to your insurance for prior authorization.

Prior Authorization:

Most of the insurance providers require a pre-authorization before you start to receive treatment. We will submit your clinical information to your insurance provider in order to obtain prior authorization. A medical director, from your insurance, will review the clinical and determine whether or not you meet medical necessity requirements for their varicose vein policy.

Investigational or Experimental

When an insurance provider considers a treatment investigational or experimental, it means they feel there is not enough medical data available to determine the benefit or success of the treatment. For example, some insurance providers will cover laser treatments for the greater saphenous veins, but consider laser treatments for tributary veins or smaller diameter veins as investigational. If a procedure is considered investigational by your insurance provider, it does not mean it is not medically necessary, but rather it does not fall under the guidelines of their varicose vein policy.

Below is a list of the major insurance providers and their covered treatments. For more specific benefit and cost information, please refer to your “Patient Responsibility Form” provided to you at your initial visit.

SelectHealth

Covered procedures: Endovenous Thermal Ablation and Ambulatory Phlebectomy.

Medicare

Covered procedures: Endovenous Thermal Ablation, Ambulatory Phlebectomy and
Sclerotherapy. Conservative measures required.

Blue Shield

Covered procedures: Endovenous Thermal Ablation (limited to certain veins),
Ambulatory Phlebectomy and Sclerotherapy (limited to certain veins). Conservative measures required. Pre-authorization is required.

United Healthcare

Covered procedures: Endovenous Thermal Ablation, Ambulatory Phlebectomy and
Sclerotherapy. Conservative measures required. Pre-authorization is required for all procedures.

Altius

Covered procedures: Endovenous Thermal Ablation, Ambulatory Phlebectomy and
Sclerotherapy. Conservative measures required. Altius has a very strict varicose vein policy. Please call the office for more information. Pre-authorization is required for all procedures.

DMBA

Covered procedures: Endovenous Thermal Ablation, Ambulatory Phlebectomy and
Sclerotherapy. Conservative measures required. Pre-authorization is required for all procedures.

PEHP

Covered procedures: Endovenous Thermal Ablation and Ambulatory Phlebectomy.

EMI Health

Covered procedures: Endovenous Thermal Ablation, Ambulatory Phlebectomy and
Sclerotherapy. Conservative measures required. Pre-authorization is required for all procedures.

AETNA

Covered procedures: Endovenous Thermal Ablation, Ambulatory Phlebectomy and
Sclerotherapy. Conservative measures required. Pre-authorization is required for all procedures.

Humana

Covered procedures: Endovenous Thermal Ablation, Ambulatory Phlebectomy and
Sclerotherapy. Conservative measures required.