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Is treatment for varicose veins considered cosmetic?

I want treatment for my varicose veins but I am not sure if I can afford it. Does insurance typically pay for treatment of varicose veins or is it considered a cosmetic surgery?


Doctors Answers (8)

The first step is to obtain an ultrasound to see if there are problems with your deeper veins. If there is a problem with deeper veins, then insurance usually covers the treatment.

That is a better question to ask your insurance provider or HR person as it is not really a medical question anymore, but rather a question of insurance coverage. In general, small veins including spider veins have always been considered cosmetic and have never been covered as a medical treatment. Large bulging varicose veins that have venous reflux and symptoms are usually considered a medical problem (by doctors and insurance) and are typically covered at 60-100% depending on your coverage, after you have met your yearly deductible. You should always get a letter of medical necessity and a treatment plan from the doctor that evaluates your veins, and also prior approval for treatment from your insurance before your treatment to avoid surprises. Rules are constantly changing, and what is considered "cosmetic" is often quite arbitrary and certainly influenced by cost saving efforts by the insurance providers. Better insurance coverage will always cost more in premiums. We also have many patients with their own businesses or are self employed without insurance and have had their veins treated (out-of pocket) since these office procedures are typically quite reasonably priced.

Varicose veins that are bulging and visible to the eye (usually measure greater than 3-4mms and larger) are covered by insurance. Spider veins, typically measure 1.0mm or less, are considered cosmetic treatment and are not covered by insurance.

If medically necessary, most insurance plans do cover varicose vein surgery. Typically it is not just the veins you see on the surface, but caused by venous insufficiency (valve failure in deeper veins). If you have symptoms (pain, aching, heaviness, cramping/restlessness, changes in the skin or ulcers in the ankle to name a few) and you try conservative therapy (prescribed compression hose, elevating your legs, exercise, weight loss and anti-inflammatory medication such as Advil or Aleve) this will be covered. The time for this varies by insurer from 6 weeks to 6 months. If you do not have a deeper problem and no symptoms, it is considered cosmetic.

This depends on whether or not someone has symptoms and has tried and failed conservative medical therapy like compression hose, leg elevation and taking anti-inflammatory medications.

Treatment is often covered by insurance, depending on the symptoms. Please consult a physician knowledgeable about venous diseases.

Treatment for varicose veins is considered cosmetic if there are no symptoms or discomfort regardless of how bad they look. On the other hand, treatment is medically necessary, and therefore a covered benefit, if a doctor determines that the veins are causing symptoms, again - regardless of how they look.

Varicose veins are primarily caused by chronic venous insufficiency (CVI). If you have symptoms with CVI, then insurance usually covers the treatment.

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