Medicare benefits cover vein treatment if they’re causing health issues. The term spider veins refer to smaller varicose veins. When veins beneath the skin become swollen and visible, they are varicose veins. How Medicare covers varicose veins depends on medical necessity.
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Medicare Guidelines for Varicose Vein Treatments
Under Medicare guidelines for varicose vein treatment, your veins must be causing health issues for Medicare to pay the bill. You may meet Medicare guidelines if you have large and bulging varicose veins. But, before Medicare approves any treatments or procedures – your doctor must deem that treatment medically necessary.
What Varicose Vein Treatments Does Medicare Cover?
Some of the Varicose Vein treatments Medicare covers include:
- Sclerotherapy
- Micro sclerotherapy
- Endovenous ablation therapy
- Endoscopic vein surgery
- Laser surgery
Does Medicare Cover Varicose Veins Laser Treatment?
Medicare insurance may pay for the costs – or most of them. Laser treatment for varicose veins has been very successful. Varicose vein laser cost varies but can range anywhere between $2,000 up to $7,000.
Medicare will cover 80% of the cost. If you have a Medigap plan, that will cover the remaining 20%. However, if you have a Medicare Advantage plan, your out-of-pocket costs will be different, more than likely you will spend more than 20% of the total cost for the laser treatment. Unlike Medigap carriers, Advantage carriers choose how much you pay out of pocket.
Does Medicare Cover Varicose Vein Removal?
The amount you pay for varicose vein removal varies on a large scale. Removal prices include doctor’s fees, anesthesia, facility cost, meds, and testing. Medical tests like ultrasounds tests can help your provider see your circulation within your veins.
The cost of removal may vary depending on how many sessions you undergo and the method of extraction. Part B will cover 80% of the cost. Again, leaving you with 20% coinsurance unless you have supplemental insurance.
Does Medicare Cover Varicose Vein Surgery?
There are different types of surgeries for varicose veins — the cost changes depending on the type and where you undergo the procedure. For example, vein stripping surgery prices are between $1,500 and $3,000 – not including the facility fees. Additional facility or surgery center costs may increase the total amount.
Another varicose vein surgery is called ambulatory phlebectomy. Ambulatory phlebectomy is a much less invasive procedure compared to vein stripping and ligation. Prices change depending on how extensive the service is.
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The medical world has several available surgery options for treating varicose veins. Your doctor should discuss your condition and what surgeries may be best for you. Regardless of the surgery you and your doctor decide is best, you’ll have to pay 20% out of pocket if you don’t have supplemental insurance.
Does Medicare Cover Venous Insufficiency?
If you have venous insufficiency, that means your veins struggle to send blood from the legs back up to your heart. Without treatment, this may weaken the vein walls and damage your valves. Medicare covers venous insufficiency if lifestyle changes don’t help.
Part D may include some of the medications your doctor prescribes. Check your plan’s formulary to make sure your prescription is on their list of covered drugs. Otherwise, ask your doctor for an alternative that your policy does cover.
Does Medicare Cover Sclerotherapy?
Specific procedures are done right in your doctor’s office or clinic. One example is sclerotherapy, which is best for spider veins.
Medicare covers sclerotherapy when necessary due to a medical condition. Medicare Part B may include a local anesthetic to numb the area.
Does Medicare Advantage Cover Varicose Vein Treatments?
Carriers offering Medicare Advantage plans MUST include all the benefits of Medicare. So, if Medicare covers your varicose vein treatment, an Advantage plan will also cover the costs. But, Advantage plans often have a specific network of doctors and facilities the beneficiary must use.
Going outside the plan’s network may be costly. Check your plan’s policies and find out what doctors and facilities are in-network to avoid unwanted medical bills. The other crucial point with Advantage plans is they choose how much you pay out of pocket for a service, making your medical costs very unpredictable.
How to Get Help Paying for Varicose Vein Treatments with Medicare
Medicare may cover your varicose vein removal or treatment. Although you may still have out-of-pocket expenses, including deductibles, coinsurance, and copayment costs. Depending on the treatment type and how often you must go – some require more than one session; these costs can add up. That’s why having a Medicare Supplement is so important.
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Medigap helps to pay for the gaps left by Medicare. Give us a call at the number listed and talk to one of our agents about the best policy for you. Our team of experts can help you find the most suitable options. We compare rates and plans in your area at no cost to you. Can’t call? Fill out the online rate comparison form and get the process going now!
My vascular surgeon states that I have Venous Insufficiency and have had spider vein bleeds too – once a gushing artery major bleed. He mentions that I need sclerotheraphy and asked me to confirm of my documentation if this is covered by my Medicare A & o rB & also my Medigap insurance? What specific coding should he use for Medicare billing purposes? Will Medicare cover this 80% coverage with documentations from surgeon?
Hi Dale – sclerotherapy will receive coverage from Medicare if it is medically necessary, meaning that the leg with the varicose veins is experiencing symptoms, which yours is. We do not specialize in coding for medical billing, but your Medigap plan will cover the 20% that Medicare leaves (if Medicare covers the procedure), as Medicare Supplement plans cover the same types of care as Original Medicare.
Hi. I am an LVN wound treatment nurse in SNF suffering from severe varicose veins after years of prolonged walking and standing. In the past years, I used to walk an average of 6.5 km (fitbit measured) in a 7am to 3pm shift and make an average of 35 patient contacts treating wounds, ostomy care, etc followed by a 3pm to 11pm shift as a charge nurse. I used compression stockings and sleeps in a hammock to effectively elevate my legs but still the regression continues. I can only work part-time now because i experience pain, swollen and heavy legs at the end of the day at work. I would like to have an endovenous laser therapy (EVLT) to manage my condition. I am now preparing for my NCLEX-RN looking forward to be a wound and ostomy care RN by which I can work full time because there is less standing in this role. I will appreciate if you can help me enroll in a medicare and medigap for this purpose.
Hello! If you have not done so already, you can apply for Medicare online, by phone, or in-person at your local Social Security office. Once you have Part A and Part B, give us a call. We’ll be happy to help you enroll in the Medigap plan of your choice.