Does Medicare Cover Varicose Vein Treatments?

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  • Does Medicare cover varicose vein treatments? This article explains the eligibility criteria for varicose vein treatments through Medicare and what you'll pay.

Varicose veins occur when the veins under the skin's surface become twisted and enlarged because of increased blood pressure, most commonly in the legs. Varicose veins are rarely serious, but they can be very noticeable. They can also cause burning or aching in the affected area and secondary health problems such as ulcers. 

Varicose vein treatment can be expensive, so it's understandable that many affected individuals want to know if their health insurance can help with the costs. So, does Medicare cover varicose vein treatments? Below, you can find out who qualifies for varicose vein treatments through Medicare and what you'll pay out of pocket. 

Does Medicare Cover Varicose Vein Treatments?

Original Medicare (Part A and B) may cover varicose vein treatment if your doctor considers it medically necessary and your varicose veins are causing symptoms. It won't fund your treatment if you want it done for cosmetic reasons. 

If you're eligible, varicose vein treatment usually falls under Part B because it is generally performed in an outpatient clinic. However, your treatment may fall under Part A if you require inpatient treatment. 

Some Medicare Advantage plans also cover medically necessary varicose vein treatments. These plans are available through private Medicare-approved companies and, unlike original Medicare, limit the amount that beneficiaries must contribute out of pocket. 

How Are Varicose Veins Treated Through Medicare?

Varicose veins are often treated through a process called endovenous ablation. During this procedure, the affected area is numbed with a local anesthetic. A catheter is then inserted into the varicose vein to close the vein using heat. Medicare may cover the costs of varicose vein ablation and ultrasound guidance during the procedure. It may also fund treatment to close the veins by injecting medical adhesive or Varithena foam.

However, Medicare doesn't cover every available varicose vein treatment technique. For example, it doesn't fund treatment for pregnant women, non-FDA-approved treatments or non-compressive sclerotherapy.

Who Is Eligible for Varicose Vein Treatments Through Medicare?

Medicare only considers funding varicose vein treatment for beneficiaries with varicose veins wider than 4mm. It also requires enrollees to undergo at least 6 weeks of conservative treatment before it considers varicose vein treatment necessary. 

Conservative treatments for varicose veins include weight loss, compression garments and elevating the affected extremity to reduce pressure. You will be expected to show records of which treatments you've tried. If you can't wear compression garments for any reason, your doctor will need to explain why not. 

Medicare may agree to pay for your varicose vein treatment if you are still symptomatic after exhausting all conservative treatment options. You will generally need to present with at least one of the following symptoms to qualify:

  • Bleeding varicose veins
  • Stasis ulcer
  • Severe pain or swelling that interferes with your daily life
  • Stasis dermatitis
  • Recurrent superficial phlebitis (blood clots in the veins beneath the skin surface)
  • Dependent edema (fluid retention in your lower body) that doesn't respond well to treatment

How Much Does Varicose Vein Treatment Cost?

How much it costs to treat varicose veins depends on the extent of the treatment required. Generally, you can expect to pay between $600 and $3,000 for ablation therapy. Varicose vein surgery is generally more expensive, costing between $1,500 and $3,000.

How Much Does Varicose Vein Treatment Through Medicare Cost?

Generally, you should expect to pay 20% of the Medicare-approved amount for your varicose vein treatment out of pocket. Beneficiaries who have their varicose veins treated as an outpatient are also responsible for paying the Part B deductible, which is $203 in 2021. Beneficiaries treated as inpatients are liable to pay coinsurance and the Part A deductible, which is $1,484. There is no cap on the amount of coinsurance you can be expected to pay through original Medicare. 

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