By Dr. Cohen
You may have heard stories about how insurance will or won’t cover vein treatments.
While there is some variation among insurers, there are a few consistent rules I can share with you. Your vein doctor’s office should help you understand and deal with your own plan and coverage before any treatment.
The general rule is that insurance companies will not cover any treatment done for strictly cosmetic reasons (No symptoms or complications? No insurance).
Insurance will generally cover most treatments of venous insufficiency and varicose veins if you either have symptoms, skin damage, or complications from your vein problem.
- Symptoms including pain, swelling, cramps, itching, restless legs, etc. are typically considered adequate to warrant coverage.
- Some plans require that skin damage or bulging varicose veins of a specific size be evident.
- In the end, it usually comes down to the ultrasound findings.
But that’s not all.
Most insurance plans require that each patient try “conservative measures” first. These might include compression stockings, leg elevation, exercise, weight loss, avoidance of prolonged standing, pain pills, etc. How long you may have to try this varies by plan, anywhere from 2 weeks to 6 months. If you have done these measures and later return to your doctor showing that your symptoms have not improved, your insurance is likely to approve coverage for your treatments.
At my office, the staff will work directly with your insurance provider to obtain the necessary authorizations for you, and then review your expected out-of-pocket expenses with you. You’ll want to know in advance if your doctor is going to do this for you or you’re on your own.
Another very important question to ask your vein doctor is whether or not they are “in-network” or “participate” in your particular insurance plan. Your out-of-pocket expenses will typically be a lot lower if your doctor is “in-network”. At Advanced Vascular Associates, in order to keep our treatments as affordable as possible, we participate in almost all major New Jersey insurance plans.
The best way to find out the condition of your veins and whether you insurance will cover them is to consult a vein specialist. Once you get a diagnosis, the doctor should be able to advise you based on his or her experiences with your specific insurance provider.
You can arrange for a quick and easy consultation right now by calling 201-265-5300.
About us: There are 20 million Americans with vein problems that can seriously affect the quality of their lives. And as we age, they just get worse. As one of the few New Jersey medical practices committed exclusively to vein care, Advanced Vascular Vein Care is uniquely capable of alleviating those problems, whether they are medical or cosmetic. All treatments are non-surgical, usually covered by insurance, and delivered in an office setting. And we do it as it should be done – with compassion, excellence, affordability, convenience, and the personal touch. Call 201-265-5300 or visit AdvancedVascular.com for a quick and easy consultation.