Does Medicare Cover Treatment for Varicose Veins? 

Varicose veins are often considered a cosmetic problem, but can these enlarged veins be a medical  concern? Despite often appearing as bulging through the skin, varicose veins are usually relatively harmless. They may come along with age, but in some cases, they may be a sign of an underlying medical condition. The cause of varicose veins is primarily a weakening of the walls of a vein’s interior. Over time, pressure builds in these weakened spots, leading to an engorged appearance. 

If you have varicose veins and are eligible for Medicare insurance, your coverage may be able to help address related issues.

Will varicose veins go away on their own?

For the most part, once a vein has become varicose, it will not go away on its own. The issue here is that the vein walls have already been stretched out. If varicose veins are due to an underlying medical condition that is treated, the stretched vein tissue will remain stretched, meaning the enlarged portion of the vein will remain enlarged.

How are varicose veins treated?

Treatment for varicose veins depends on the cause, but by and large, surgical intervention is necessary to completely get rid of these veins. While things like compression socks can reduce the swelling inside of a varicose vein to a degree, treating the vein directly or surgically removing the portion that has become enlarged are the only current methods of fully getting rid of varicose veins.

There are a few types of varicose vein treatment available. The type of treatment you choose will depend on the severity of your varicose veins and any underlying medical conditions. Laser therapy uses a high-powered laser to ablate the affected vein and close it off. Some varicose veins may need to be ligated and then removed. Radiofrequency energy can also be directed at the affected area to close off and seal the part of the vein leading to enlargement.

Does Medicare cover treatment for varicose veins?

Original Medicare may provide coverage for the treatment of varicose veins, but benefits will depend on how your condition and treatment are classified. In general, Medicare benefits do not apply to treatments or procedures that are not qualified as medically necessary. This means that if you are seeking treatment for varicose veins based solely on cosmetic factors, your treatment is unlikely to receive coverage.

If, on the other hand, your doctor believes that treating your varicose veins is a medical necessity and that no better option exists, Medicare coverage will likely apply. Even if you receive a cosmetic benefit from having treatment performed, Medicare will provide coverage as long as your doctor believes that the treatment is required to preserve your health. This may be the case if you are suspected of having venous insufficiency, a condition that can lead to blood clots, heart attack and stroke.

How does Original Medicare coverage pay for varicose vein treatment?

Original Medicare benefits for varicose vein treatment typically come from Part B. This is the outpatient portion of Original Medicare, and it helps to pay for things like doctor visits, lab work, and outpatient surgery. Most varicose vein treatments are completed in a clinical setting on an outpatient basis. Under Medicare Part B, Medicare typically pays 80% of the cost of treatment while you pay the remaining 20%.

Medicare may also pay for varicose vein treatment through Part A. This is the inpatient benefit of Original Medicare, and it pays for treatment if you are formally admitted to a hospital or skilled nursing facility. Medicare Part A is available to provide full coverage of all treatment for 60 days per benefit period. After 60 days, Medicare recipients can receive another 30 days of coverage by paying a daily rate. From day 91 onward, lifetime reserve days can be used to continue coverage. 

Does Medicare Advantage (MA) cover treatment for varicose veins? 

Medicare Advantage plans must include the same Part A and Part B coverage as Original Medicare, but many plans include additional benefits. If you want to know more about how your plan will cover your treatment for varicose veins, review your plan’s benefits or speak to a licensed agent.