I have spider veins and varicose veins. Will my insurance ppo bluecross pay for it?
I was told by my insurance co they would pay if it is medically necessary, they hurt and are getting worse, I am a nurse.
Most insurance companies will cover laser vein treatment provided reflux is demonstrated and you meet the requirements of the PPO. Sclerotherapy, on the other hand, may not be covered since this is often times considered to be a cosmetic procedure. However, this varies from company to company so you should check with your insurance company and plan.
Published on Jul 11, 2012
With the symptoms you have, if ultrasound demonstrates insufficiency of the greater or lesser saphenous vein, insurance will likely pay for treatment. However, your insurance company may require you to wear compressions stockings for several months (time varies by company), without adequate relief, to cover the treatment.
Published on Jul 11, 2012
Blue Cross plans do often pay for varicose vein procedures. They have guidelines that are plan specific, which allow payment based on medical necessity. For example, if the patient has pain, which is worsening and affecting their activities of daily living. They also have requirements based on the size of the varicose veins and which veins are the source of the problem, which is determined by an ultrasound examination.
Published on Jul 11, 2012
If you are symptomatic with significant reflux documented by ultrasound, most insurance companies will cover the treatments.
Published on Jul 11, 2012
Generally most insurance companies will cover treatments for the larger varicose veins. Spider veins are generally cosmetic in nature and treatments for these are not covered in my experience.
Michael Ingegno, MD
Published on Jul 11, 2012
Every insurance company has different rules. Generally, continued pain, tenderness, swelling, or advanced skin changes of venous insufficiency which have not resolved over a course of conservative treatment may qualify a patient for some treatment. Many insurance companies have specific coverage rules for specific procedures as well. You need to see your vein specialist to sort out your needs.
Stephen F. Daugherty, MD, FACS, RVT, RPhS
Published on Jul 11, 2012
Yes, most insurance companies will cover treatment of venous insufficiency
(manifest as painful varicose veins or other symptoms such as skin changes,
swelling, pain , restless leg syndrome) as long as you have documented
symptoms, history of conservative therapy with elevation compression hose
and analgesics for 3 months or more and an ultrasound which documents the
location and severity of the insufficiency. They may require a letter of
preauthorization or predetermination from your Doctor documenting all of the
above. Injections sclerotherapy is something I reserve for treatment of
cosmetic small varicose veins and spider veins and usually wait for at least
one month after the other veins have been treated with endovenous techniques
as some of the spiders in the lower leg may resolve after the abnormal
saphenous veins are sealed.
Published on Jul 11, 2012
Yes most insurance companies will pay for treatment. If you have symptoms it is medically necessary.
Sincerely,
Colin E. Bailey, MD, FACS
Published on Jul 11, 2012