Sclerotherapy may be recommended for spider veins. This technique costs roughly $350-500 per session for those who do not have insurance. This is dependent on the cost of living in each state. For example, the cost of living in Oregon is often higher than in Mississippi. As a result, operations in cities are likely to be more extensive.
Multiple treatments are not uncommon, especially if both legs need to be treated. During your appointment, your therapist can estimate the number of sessions you’ll require, so there are no unpleasant surprises. For more severe situations, multiple sessions could cost several thousand dollars.
We specialize in varicose veins at Inovia, and we have a variety of state-of-the-art, minimally invasive treatments to address your specific needs. As a result, there will be less downtime and greater results.
Closurefast (Radiofrequency Ablation) may be required (RFA). We use moderate, targeted heat to seal the big saphenous veins that contribute to varicose veins in this operation. Blood will reroute itself through healthier veins after the valve is closed.
How much does it cost to get rid of varicose veins?
The cost of vein stripping operation varies between $1,500 and $3,000, plus any hospital or surgical center expenses. Depending on how much of the vein needs to be treated, EVLT might cost anywhere from $600 to $3,000. However, if the varicose veins are unpleasant or incapacitating, insurance may cover a portion of the cost.
Researchers discovered that individuals who had EVLT experienced slightly more pain in the first week after their treatments than those who had vein stripping surgery, but that the pain went gone faster as well.
Patients in the EVLT group experienced pain for an average of eight days following their treatments, but those in the HLS group reported discomfort for an average of 17 days.
Does insurance cover removing varicose veins?
Patients with both medical and aesthetic vein problems are not rare. What is the distinction? Most insurance companies only cover varicose vein therapy if it is judged necessary “Medically required.” Cosmetic treatments are those that do not match the policy’s criteria. What is considered medically necessary by insurance companies? Is it even worth it to try to get your insurance to pay for your vein treatments? All of these are regular inquiries that we receive on a daily basis. Sometimes the answers are self-evident, and other times the distinction between medical and cosmetic vein disease is hazy. The answer to whether or not your varicose veins are medically necessary may be determined not only by your symptoms, but also by the terms of your insurance coverage. This means that what is medically required under one insurance plan may be considered cosmetic under another. In this article, I’ll explain what you’ll need to get insurance to fund your vein treatments, as well as whether or not attempting to do so is in your best interests.
To begin with, most insurance plans would say that spider vein therapy is not medically necessary. As a result, the majority of spider vein treatments are deemed cosmetic. The only exception is when a patient’s spider veins are causing hemorrhage. Spider veins are small red and blue veins on the skin’s surface that are smaller than 1mm in diameter. Varicose veins, on the other hand, are bigger (3mm or greater), ropy veins beneath the skin’s surface. Varicose veins frequently bulge or protrude, forming lumps. However, not all varicose veins are visible on the surface of the skin; in fact, many people have varicose veins beneath the skin and only visible spider veins on the surface. An examination by a vein care specialist can help you establish if there is any pathology beneath the skin that meets medical requirements. Swelling and even ulceration, for example, are symptoms of severe vein disease, although they can also occur in the absence of ropy varicose veins.
This brings us to the first medical necessity criterion: symptoms. It is not medically required to dislike the sight of a vein; however, having symptoms usually is. Aching, heaviness, discomfort, throbbing, leg tiredness, frequent nighttime cramps, itching, swelling, and restless legs are all common venous symptoms. Other possible presenting signs include bleeding, pigmentation (skin discoloration), and even ulceration. Many patients do not know how symptomatic they are until their veins have been treated, in my experience. Patients mistakenly feel that their symptoms are just normal indicators of aging since venous disease symptoms develop slowly, frequently over several years. It’s vital to keep in mind, though, that your legs should not hurt or be tender. On a daily basis, fatigued or heavy legs are not normal. Similarly, leaving imprints on your ankles with your socks is an indication of swelling. If you experience any of the symptoms listed above, you may have venous insufficiency, and a medical vein disease workup is recommended.
Venous reflux is the next criterion that most insurance companies use to determine medical necessity. This criterion is reasonable. In essence, the insurance companies are claiming that they would not cover the costs “If a vein isn’t broken, it can be repaired. Although blood should go up the veins from the legs to the heart, gravity always pulls it back down to the feet. Backwards flow is prevented by valves in the veins of our legs. If the valves fail, gravity pulls the blood back down rather than up the vein. Reflux is the term for this retrograde flow. An ultrasound is the most accurate technique to identify whether you have reflux or not, and it should be performed in a standing position to be accurate. This criterion also rules out spider vein treatment because ultrasounds aren’t sensitive enough to detect reflux in such small veins.
A trial of conservative therapy is the final requirement frequently seen in most insurance policies when it comes to the medical necessity of venous care. Essentially, your insurance provider encourages you to attempt non-invasive methods to alleviate your symptoms. Maintaining a healthy weight, walking, periodically lifting your legs above the level of your heart, calf raises, and using compression stockings are all conservative steps you may take at home. In fact, most insurance companies require you to wear class 2 compression stockings (medical grade or at least 20-30mm Hg) for 6-12 weeks before they will pay treatments. To aid with venous symptoms, I usually recommend all of the aforementioned conservative approaches. Unfortunately, while compression stockings, leg elevation, and walking all assist, none of them provide long-term relief in my experience. That is, symptoms usually return shortly after you remove the compression stockings or put your legs back down.
In summary, the three most common medical necessity criteria are symptoms, venous reflux, and a conservative therapy trial.
Is this to say that everyone with symptoms should bill their insurance for all of their treatments? Again, the answer to this inquiry will be determined by your coverage and deductible. If you have symptomatic varicose veins that are likely to show reflux on an ultrasound but might be readily treated with sclerotherapy and a high deductible plan, you might be better off treating and paying for it as a cosmetic operation. This is because the cost of an ultrasound and therapy will almost certainly be less than your deductible. In certain circumstances, bypassing the ultrasound and going straight to therapies could save you money.
If, on the other hand, your deductible has been met, the identical scenario could be ethically and legally billed to your insurer because the veins are symptomatic and meet the policy’s medical necessity rules. Of course, you should consult with a physician to see if you can avoid the ultrasound. If the veins are small but overlie or drain areas of commonly diseased veins, you may have a problem with one of the named superficial veins, such as the Greater Saphenous Vein. In this case, sclerotherapy alone is unlikely to provide long-term relief, and an ultrasound would be recommended to determine the exact source of the problem. If your doctor determines that an endovenous ablation is necessary after the ultrasound, those operations are more expensive, therefore it’s probably preferable to bill them to insurance and have them applied to your deductible.
It’s also worth noting that these are only guidelines; each insurance coverage is unique. It’s critical to verify with your insurance company to see what your policy’s exact requirements are.
Please contact our office if you have any further questions about whether you have medical or cosmetic vein disease, or both. We provide free cosmetic tests, and if it is discovered that you have a medical condition, you may be scheduled for a formal and full clinical assessment, as well as an ultrasound if necessary.
Is it worth getting varicose veins removed?
When you can, prop up your leg (or legs) on a pillow or a chair, exercise, and lose weight if necessary. If these measures do not alleviate your symptoms, you may need surgery or a procedure.
- If you are concerned about the appearance of your legs, surgery or a procedure is a preferable option. Varicose veins will not improve with home treatment. Pain and other symptoms can also be reduced with surgery and other procedures.
- The sort of therapy you receive is determined by the size of your varicose veins. You may need surgery (ligation and stripping) or less invasive techniques such as radiofrequency closure or endovenous laser treatment if you have bigger veins. Sclerotherapy, external laser treatment, or a little surgery called microphlebectomy are commonly used to treat small to medium-sized varicose veins.
- Procedures for closing varicose veins and preventing their recurrence appear to operate similarly. Laser treatment, radiofrequency closure, sclerotherapy, and surgery are some of the methods available.
- Check your insurance to determine if it covers the cost of any surgery before going ahead with it. Some policies exclude operations performed solely for personal, rather than medical, reasons.
Do veins grow back?
When a surgeon removes a part of the body in most surgical procedures, it is gone. We do not anticipate it growing back. Many individuals would be angry if, for example, a bothersome gallbladder grew back after being medically removed.
Organs aren’t veins, and veins aren’t organs. They are made up of the body’s connective tissue and are designed to regenerate after any trauma.
For example, if you undergo surgery or a trauma to your arm (such as a dog bite), you anticipate things to heal quickly. As part of the healing process, you expect the skin to repair and the veins to regrow.
As a result, when you have varicose veins removed, your body has no idea that a surgeon wants them gone for good. Your body simply recognizes that there has been trauma, thus it will attempt to regrow connective tissue, including veins.
Unfortunately, when veins regrow after trauma, they never have any valves. As a result, when varicose veins are removed, the veins grow back and there are no valves in them.
Stripping does not work because of this. This was demonstrated in our 2007 study.
However, stripping isn’t the only problematic varicose vein surgery procedure still in use.
Endovenous thermoablation (also known as endothermal ablation) is a term used by the National Institute for Health and Clinical Excellence (NICE). Radiofrequency ablation (bipolar, monopolar, or segmental), endovenous laser ablation (various wavelengths and fibre types are utilized), and, more recently, steam vein sclerosis and microwave are all covered under this umbrella category.
With so many procedures and equipment to choose from, it’s no surprise that prices vary widely. Branded procedures with a lot of research and development behind them that have been optimized both in their production and use tend to be more expensive, just like everything else in life. Those made with the intention of being inexpensive frequently have little, if any, study behind them. Quality, like many other things in life, comes at a cost, and medicine isn’t a good place to hunt for discounts if medical care is cheap, there’s usually a reason for it.
Patients believe the treatment has worked in many circumstances, only to have the veins return many months later. This is due to insufficient endovenous thermal ablation treatment, which induces thrombosis (or clots), which blocks the vein briefly before reopening when the clot or thrombosis resolves.
Furthermore, ultrasound guided foam sclerotherapy (the National Institute of Health and Clinical Excellence’s second-line treatment) has an even lower success rate in large veins, with only a somewhat excellent success rate in smaller veins.
Even if duplex ultrasound scanning has found the correct vein, the right technique must be applied in the right way to provide the greatest outcomes. This is why The Whiteley Protocol was created: to ensure that the best scan is performed and that the best therapies are advised based on the scan’s results.
What is the best varicose veins treatment?
Spider or varicose veins can have an impact on more than just your appearance. These veins can be extremely painful. Varicose veins can cause complications such as a blood clot or open sores on your legs.
Leg veins can be removed or faded with minimally invasive treatment. Treatment can also help to alleviate symptoms such as pain and exhaustion, as well as prevent complications.
Why we get visible leg veins
Damaged veins cause varicose and spider veins. When tiny one-way valves inside the veins get weakened, we develop them. These valves drive blood in one way back to our hearts in healthy veins. Some blood flows backward and collects in the vein as these valves fail. The extra blood in the vein puts pressure on the vein walls.
The vein walls weaken and swell as a result of constant pressure. A varicose or spider vein develops over time.
Some persons are more prone to acquiring these veins than others. You’re more likely to get them if you have blood relatives who have them. Many people develop them as a result of spending most of their week sitting or standing for lengthy periods of time. With aging and during pregnancy, these veins grow more prevalent.
How dermatologists treat leg veins
Self-care to minor surgery are all alternatives for treatment. One or more of the following treatments may be used by a dermatologist:
Self-care: Your dermatologist can provide you with suggestions on how to improve your circulation. These are some of the suggestions:
Self-care tips can help you avoid getting new varicose and spider veins, but they won’t help you get rid of the ones you already have.
Compression stockings: These stockings offer constant pressure to the legs to assist in the return of blood to the heart. The constant pressure also helps to minimize edema in your lower legs and the danger of a blood clot. Leg veins will still be apparent, though.
A dermatologist can evaluate you if you need compression stockings so that you get the optimum size and quantity of pressure.
Sclerotherapy is the most popular treatment for varicose veins in the legs. Dermatologists have improved sclerotherapy over time to make treatment safer and provide better results for patients. It is being used by dermatologists to treat spider veins and minor varicose veins.
The spider or varicose vein is irritated by a substance that your dermatologist injects into it. Injections are made in various regions of the vein.
You should take daily walks and wear the compression stockings as advised to help reduce side effects. The compression stockings are typically worn for two to three weeks by most patients.
Sclerotherapy causes the vein’s walls to cling together, preventing blood from flowing through it. This increases circulation and lowers edema in the affected limb.
In most cases, spider veins fade away in 3 to 6 weeks. It takes 3 to 4 months to get rid of varicose veins.
You may need two or three treatments to achieve the optimum effects. These treatments can be done in the office by a dermatologist. There is no need for anesthetic.
Spider veins and minor varicose veins are treated with lasers by dermatologists. The laser light is directed at the vein by your dermatologist during laser treatment.
Can varicose veins be treated without surgery?
Varicose vein treatment has come a long way in the last decade, and it no longer necessitates general anesthesia or extensive incisions to remove a troublesome vein, a procedure called vein stripping2. Most troublesome veins, from the tiniest spider veins to the largest varicose veins, can be treated without surgery using minimally invasive techniques. Heat, adhesive, or a solution injected straight into the veins are some of the newer treatments.
Varicose vein treatment should be tailored to the individual. Your treatment may consist of a single procedure or a combination of procedures, depending on your vein problem. Treatment for varicose veins is usually covered by insurance when vein disorders cause health problems; but, in other circumstances, therapies are considered cosmetic. Check with your insurance company to see if you’re covered.
The most conservative treatment approach is compression therapy. Compression stockings are non-prescription pantyhose that provide specific pressure to the legs to relieve discomfort and swelling.
Endovenous ablation is a procedure that cauterizes a defective vein and redirects blood to healthy veins using heat (either radiofrequency or laser radiation).
VenaSealTM, a form of medical adhesive that doesn’t require heat, is a viable option for patients with troublesome veins near the skin’s surface.
Sclerotherapy is a procedure in which a solution is injected directly into the defective veins, causing them to shrink and collapse. All of these procedures are outpatient, and patients can return to their typical activities within a day.
Microphlebectomy is another minimally invasive procedure that involves removing a troublesome vein through microscopic nicks in the skin. Because the incisions are so small, no stitches are necessary, and the procedure is performed under local anesthetic. This procedure is best used on huge, bulging veins. Most people wear compression stockings for a week, after which they can walk and resume normal activities.
Because other veins take over when varicose veins are removed, blood flow is unaffected.
When is varicose vein treatment medically necessary?
Is Varicose Vein Treatment Covered by Insurance? The following are the factors used to assess if insurance will cover varicose vein therapy.
Varicose vein treatments that are considered “medically required care” will be covered by most insurance types (including Medicare and Molina), but not for “cosmetic care.”
To be covered by insurance, varicose veins (bulging leg veins) must produce symptoms such as leg pain. Spider veins (tiny clusters of blood vessels on the surface of the skin) are a cosmetic procedure that is not covered by insurance.
Vein treatment that is medically necessary indicates the varicose veins are causing symptoms like leg pain, heaviness, chronic swelling, nighttime cramping, or burning. Leg ulcers (open wounds) from varicose veins, repeated blood clots or phlebitis, ruptured bleeding veins, or skin darkening around the ankle are all symptoms that may indicate therapy.
The symptoms must be severe enough to interfere with a person’s everyday activities or capacity to work. A teacher, for example, may have varicose veins that hinder them from standing and doing their job because they need to elevate their legs frequently. Due to leg soreness after a few hours, a restaurant server may no longer be able to work long shifts. Symptoms might make it difficult to live a healthy lifestyle, such as limiting the amount of exercise one can do or being unable to cook or perform housework owing to leg pain.
In most circumstances, insurance companies demand that conservative methods be taken over a period of time. Compression stockings, leg elevation, exercise, weight loss, anti-inflammatory medicine such as ibuprofen or vasoactive drugs such as horse chestnut or Vascular, and hot/cold packs are all examples of conservative therapy. Before being authorized for treatment, many insurance companies require that you wear medical-grade compression stockings for 6 to 12 weeks. You should schedule an appointment as soon as possible and start incorporating cautious management into your daily routine. You should start maintaining a daily journal of the conservative therapy you’re using. If your primary care physician has previously prescribed compression stockings, having a note from your doctor or the prescription will help you stay within your conservative management time frame.
Ultrasound testing is required to confirm underlying venous insufficiency. Most insurance kinds cover the ultrasound study to determine the treatment as well as the physician appointments.
The following treatments are not covered by insurance because they are considered “cosmetic services”:
If you responded yes to each of the four questions, you are likely to meet the medical necessity requirements for vein treatment. Please note that this is a condensed questionnaire for the benefit of the patient’s understanding.
And/or have you had any of the following varicose vein complications?
- Have you tried conservative management but it hasn’t totally healed your vein problem?
- Yes, I’ve tried compression socks/stockings as well as at least two of the following:
- OTC supplements like horse chestnut or grapeseed extract or venoactive medications like Vascular
- Have you had an ultrasound to see whether you have underlying venous reflux disease?
- Yes, my ultrasound showed reverse flow in my veins, which was documented (venous reflux)
Some individual insurance policies, however, do not cover varicose vein therapy; this is mainly due to an employer’s exclusion. In this instance, it’s possible to urge the company to include varicose vein treatments in the insurance policy. You can call the number on the back of your insurance card to see if vein treatments are covered. We will assist you in determining what your insurance will cover when you begin the vein treatment process with us. Our prior authorization specialist will acquire preauthorization (permission) for your treatment and will be available to answer any questions you may have.
Is varicose vein surgery painful?
Is it uncomfortable to get varicose veins removed? Treatments are virtually pain-free thanks to modern procedures and light local anesthetic. Our gentle, minimally invasive approach to treatment allows you to leave the same day and quickly resume your daily activities.
What happens if varicose veins go untreated?
When varicose veins are left untreated, blood pools in the veins, aggravating the situation and leading to one or more of the following conditions:
- Increased pain and swelling – If varicose veins are left untreated, the veins get more damaged, causing the pain to worsen and the legs to swell.
- Symptoms that persist. Just because a person with varicose veins isn’t having any symptoms right now doesn’t imply they won’t in the future. The longer varicose veins are left untreated, the more probable they are to cause pain sooner rather than later.
- Tiredness and weakness – Untreated varicose veins can lead to leg weakness over time. This means the person will become weary more quickly and with greater severity. This can be a major issue for those who live active lifestyles or work in jobs that demand them to be on their feet all day.
- Ulcers – Untreated varicose veins increase the risk of lesions such as ulcers developing. They can also cause spontaneous bleeding and make wound healing more difficult.
- Other conditions – If varicose veins are left untreated, they can lead to serious complications such deep vein thrombosis, blood clots, and lipodermosclerosis.
To summarize, failing to treat varicose veins leads to worsening veins, more painful symptoms, and more vein damage. This is why obtaining treatment is so important. A vein expert can assess your veins, medical history, and lifestyle habits in order to offer treatment suggestions that include not only medications or medical treatments, but also lifestyle changes that can help slow the progression of the problem and alleviate symptoms.
What is the main cause of varicose veins?
Increased blood pressure in the veins causes varicose veins. Varicose veins develop in the veins near the skin’s surface (superficial).
One-way valves in the veins direct blood flow towards the heart. Blood can gather in the veins if the valves become weaker or broken. The veins widen as a result of this. Long hours of sitting or standing can cause blood to pool in the veins of the legs, raising the pressure within them. The increasing pressure might cause the veins to stretch. The walls of the veins may be weakened, and the valves may be damaged as a result.