Does Medicare Cover Varicose Veins Treatment?

Last Updated : 09/12/20184 min read

Varicose veins occur when veins become enlarged, dark purple or blue, and twisted and bulging. This commonly occur in the legs, although they can appear in other body parts.  As the Mayo Clinic explains, under normal circumstances the veins act as one-way valves that pump circulating blood back to the heart.

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  The veins in the legs and feet work the hardest because they work against gravity.  Varicose veins occur when the valves weaken and allow blood to flow backwards. This increases the pressure in the vein, often causing swelling, pain, itching and discoloration to the affected area.

What causes varicose veins?

According to the Mayo Clinic, a number of factors can place an individual at risk for developing varicose veins, including

  • Increasing age
  • Being female
  • Heredity (family history of varicose veins)
  • Pregnancy
  • Prolonged standing or sitting (maintaining the same position for long periods)
  • Obesity

Does Medicare Cover varicose veins treatment?

If the procedure is determined medically necessary, Medicare may cover some of the cost of varicose vein treatment under Medicare Part B (medical insurance) since many varicose vein treatments involve outpatient surgery. However, vein repair treatments that are considered cosmetic procedures are typically not covered by Medicare. How do you know whether Medicare will consider your varicose vein repair a cosmetic procedure or medically necessary treatment?  The best way to know with certainty whether Medicare will cover your varicose veins treatment could be to have your doctor request a preauthorization.

What are the options for varicose veins treatment?

Your doctor should discuss with you treatment options based upon your unique circumstances and condition.  You can expect this discussion will follow a preliminary physical examination during which your doctor may ask you to describe your symptoms and whether you are experiencing pain, swelling, or bleeding.  According to the Mayo Clinic, your doctor may perform an ultrasound to diagnose your venous condition and to check for a blood clot.

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As the Mayo Clinic explains, there are various treatments for varicose veins including:

  • Lifestyle changes: e.g., increased exercise, weight management (Medicare generally covers obesity screenings for individuals with a BMI of 30 or more)
  • Compression stockings: may reduce the symptoms of varicose veins, prevent and reduce leg swelling and decrease the risk of blood clots
  • Sclerotherapy: injections into the veins a liquid or foam chemical to block off a larger vein
  • Ambulatory phlebectomy: tiny skin incisions to remove smaller varicose veins
  • Laser surgery: strong bursts of light to close smaller varicose veins
  • Endovenous ablation therapy: the use of heat and radio-frequency waves to block off a vein
  • Endoscopic vein surgery: the use of a small scope inserted through a small incision to block off a vein. This is an outpatient operation.

When is Medicare coverage for varicose vein treatment more likely?

Medicare coverage for varicose vein treatment could be more likely if you are experiencing complications. According to the Mayo Clinic, complications could include extremely painful ulcers, blood clots, and bleeding when veins close to the skin burst.

If you are seeking varicose vein repair because you don’t like the appearance of varicose veins, Medicare is likely to consider the procedure cosmetic in purpose and consequently not a covered benefit.

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