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July 24, 2008  
VEIN NEWS: Feature Story

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  • Varicose Veins;Can Removal be Covered by Insurance

    Varicose Veins – Can Removal be Covered by Insurance?


    October 20, 2005

    By: Maayan S. Heller for Veins1

    In today’s world we have increasingly more ways to tweak and correct our looks, improve our flaws and fix whichever parts of us affect our confidence. For many adults, this includes varicose veins – and eliminating these unsightly imperfections is definitely an option.
    Take Action
    What you can do to prevent and treat varicose veins

    Prevent:

    Maintain regular exercise and healthy body weight.

    Try to keep the amount of time just standing or sitting to a minimum.

    Try not to cross your legs.

    Treat:

    Whenever possible, and especially after extended or prolonged periods of time, elevate your feet – try to prop them up at or above heart level.


    Wear compression stockings (in more advanced cases).


    While some might consider vein removal an optional, cosmetic procedure, many people in their twenties and older can experience swollen and painful legs as a result of varicose veins. For these individuals, the cosmetic benefits are secondary to relief from suffering.

    But the question remains: will insurance cover their removal?

    “Typically insurance will cover medical treatment if patients have symptomatic varicose veins that have failed conservative treatment,” says Susan Hong, MD MPH, a general internist at the University of Chicago.

    Varicose veins are enlarged veins near the surface of the skin. They can occur anywhere on the body where veins are close to the skin, but they most often develop in the legs and ankles.

    Blood is carried to the heart by way of the body’s vascular (vein) system. The veins in your legs have special one-way valves which allow the blood to flow against gravity toward the heart. But sometimes these valves are faulty.

    When the valves don’t function correctly, the veins become “incompetent”: the blood pools, pressure builds up, the vein walls get weaker, and the veins become enlarged and twisted.

    But besides the visible nature of varicose veins, for many people there are no other symptoms. For others, however, there can be more painful associated results.

    Lots of people have “heavy, tired, achy and painful legs,” says Dr. Hong. And, she adds, “in some cases varicose veins can become inflamed – a condition known as superficial thrombophlebitis – and/or ulcerated.”

    If you have varicose veins, there are some simple things you can do to care for them.

    Doctors initially recommend uncomplicated treatments such as elevating your legs after a long day, exercising regularly and wearing compression stockings for more advanced (but not extreme) cases.

    If, however, these conservative treatments fail to improve symptoms, patients may be eligible for more involved medical treatments which are often covered by insurance.
    Dr. Hong says some of the more common of these options include sclerotherapy (where a substance is injected into the vein causing a clot to form), a variety of surgical procedures (like venous stripping), and newer minimally invasive catheter-based techniques using lasers or radiofrequency ablation.

    “In the case of the radiofrequency ablation technique,” explains Dr. Hong, “a probe is inserted into the vein. The probe is then heated with a radiofrequency energy source [causing] fibrotic closure of the vein.”

    Injection sclerotherapy, while only effective for small varicose veins, is also minimally invasive. “Patients are often able to return to work the same or next day.”

    Surgical treatment, on the other hand, is often more involved and requires the use of general anesthetics.

    Insurance coverage is not guaranteed

    In order for varicose vein surgery to be covered your doctor must first give you a physical and document your medical history regarding your veins. Usually you need to follow the more conservative treatments and wear compression stockings for several weeks.

    During this time, you need to regularly visit your doctor, so that he or she can keep track of your complete health, medical history, symptoms and all treatments attempted in order to help prove the need for the surgery to the insurance company.

    Before you reach the point of surgical removal, though, keep in mind there are some things you can do to both lessen the likelihood of the appearance of varicose veins and to reduce them once they’ve already appeared.

    “It is important for people to maintain an ideal body weight, exercise regularly, avoid crossing one’s legs when sitting, and as much as possible avoid standing for prolonged periods of time,” advises Dr. Hong.

    And once they develop, “again, exercising regularly and losing weight (if you are overweight) can help,” she adds.

    So when you come home, remember the old adage: sit back and relax! – and keep your legs up!

    Last updated: 20-Oct-05

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