Insurance Coverage of Varicose Vein Treatment

Getting treatment for varicose veins can be daunting and sometimes frustrating. We hear you and want to help.

Does this scenario sound familiar:
Physician: How long have you suffered symptoms?
Patient: Explains reason for visit.
Physician: Well, I know we can help you with that. What insurance do you have?
Patient: Gives insurance information
Physician: Oh, I’m sorry to tell you that not all these procedures are covered by your insurance.

If this has happened to you then you are not alone. Most insurance companies have complex policies that are difficult for even their own employees to understand let alone the layman. So, what is it that you need to know about insurance coverage for varicose vein treatment and whether or not your insurance will pay? Three things: symptoms, anatomy and conservative measures.

Varicose Vein Symptoms

Insurance companies are not in the habit of paying for cosmetic procedures; therefore, if you simply do not like the way your legs look then you will have to dig deep into those pockets to pay for those treatments on your own. However, many of our patients are not aware they are experiencing symptoms from their varicose veins because they did not know what to look for. Most patients experience aches and pains in their legs, along with heaviness and sometimes swelling. Another symptom commonly associated with varicose veins is itching. The insurance companies like to quantify these symptoms by determining how they affect your life on a daily basis (Activities of Daily Living). Read about Activities of Daily Living.

Vein Anatomy

We know you have no control over your vein anatomy but regardless the insurance companies have limitations on what they will and will not treat. When you come to an appointment at IVC, you will have a complete ultrasound that we call a “vein mapping”. This vein mapping allows us to determine which veins are healthy and which veins are not. It also allows us determine the diameter of the diseased veins and their shape so we know which modality we should use for treatment. You may hear us mention that a vein size is too small to be covered by your insurance. Most of the time, these smaller veins are not causing the symptoms you are experiencing; therefore, it is not detrimental to your health to not proceed with treating those veins.

Conservative Measures for Varicose Veins

Okay, now we have established that you are experiencing the symptoms the insurance wants for treatment and your vein anatomy meets their policy requirements. What are conservative measures and why do you need to do them? The majority of insurance companies are going to require a patient to have a trial period of wearing prescription strength compression stockings for at least three months prior to approving treatment. The styles really have come a long way from when our grandparents wore compression socks, but they still are tight and can be uncomfortable so the three months can sometimes feel like a lifetime. Insurances also like to see that you tried taking anti-inflammatories to alleviate symptoms. Some require these medications to be prescription strength and others require OTC. Either way, the insurance companies want to determine whether your symptoms can be managed by conservative treatment with medications and compression before they opt to pay for other forms of treatment.

Once you have completed your conservative measures trial period, then it is time to submit your clinical for prior authorization and move forward with treatment. Having insurance does not guarantee they will pay so it is very important to choose a clinic that will walk you through the process. Do not be afraid to ask questions to be informed as much as possible because ultimately the buck stops with you.

Insurance – it’s the name of the game. Does it mean anything to you?

When it comes to insurance we all have a lot of questions. Do you ever feel that you never get a straight answer? Welcome to the game. For the next few weeks I will be your coach and will provide you with insurance insight that pertains to varicose vein policies. This week I will share general requirements that many of the insurance providers enforce through their guidelines. In the following weeks I will highlight an individual insurance plan.

I’m sure you have questions regarding your deductible and if it will apply to the procedures. You may also wonder what your responsibility will be. All of these questions will be answered during your new patient appointment.

Many insurance companies require conservative measures, such as compression stocking usage. The use of anti-inflammatories and pain meds are required; exercise and being as active as possible is also encouraged. And what about symptoms? Swelling, achiness, PAIN, etc. Ay yi yi. The list goes on and on. I promise I will not leave you hanging. I will address all these things and more in the following weeks and be specific as to which insurances require all or none of these conservative measures and symptoms.

Whether you are playing “Shoots and Ladders” or friendly rounds of fantasy football, all games have rules. I hope to share the rules to the “insurance game” in a way that is easy to understand and help you maneuver through the field of policy madness.

Conservative Measures Mystery

Even though IVC does not require patients to have tried conservative measures before receiving treatment, many insurance providers do. What are conservative measures? Conservative measures include the use of prescription strength compression stockings, the use of analgesics and NSAIDS, leg elevation, weight loss and exercise.

We all know that prescription strength compression stockings are never fun to wear, especially in the hot summer. However, they do help alleviate some of the symptoms caused by varicose veins. Prescription strength compression stockings are specially fitted to help reduce the pooling that occurs in diseased veins. The gradient pressure design of the stocking is highest at the ankle and lessens as the stocking moves up the leg. The compression stockings are to be worn all day and come in many styles and colors. Prescription strength compression stockings can range from $65 – $125, depending on the style.

Many people already use analgesics for the discomfort they experience from their varicose veins. Analgesics include Aspirin, Acetaminophen (Tylenol), NSAIDS (nonsteroidal anti-inflammatory drugs such as Ibuprofen) and Narcotics. Even though this may be an insurance requirement, IVC does not recommend the long-term use of analgesics to control varicose vein symptoms.

Myth: Exercise will make varicose veins worse. Exercise actually improves the blood circulation through your legs. Any activity involving your legs are good to relieve varicose veins and helps reduce the aching associated with them. Such exercises include swimming, walking, bicycling, jogging, and aerobics. We recommend for our patients to be as active as possible, even after receiving treatment.

Even though going down the conservative measures road is time consuming and somewhat tedious, we will do everything we possibly can to help keep the inconveniences to a minimum.