Does Medicare Cover Vein Surgery? 

Veins and arteries both play important roles in the body. Veins are the vessels that carry blood to the heart, meaning impaired veins can potentially cause additional cardiovascular problems. Although anyone can be affected by vein issues, seniors are among the most affected in the United States. Vein problems affect tens of millions of  men and women in the United States. The risk of developing vein problems increases with age, so it’s important to understand Medicare benefits for vein surgery.

How venous insufficiency is a danger

Although vein impairment can take on a number of forms, one of the most common vein challenges is venous insufficiency. This is a condition where the veins are not able to deliver sufficient blood flow to the heart. This can be a chronic condition, and left unchecked, it may develop into thrombosis, a condition that can lead to blood clots.

What are the symptoms of venous insufficiency?

Venous insufficiency may not cause any symptoms at first. Many people, including seniors, only begin to notice the signs of venous insufficiency when the condition progresses.

In most cases, venous insufficiency affects the veins in the legs first, so seniors with venous insufficiency may start to notice a dull ache in the calves that gets worse over time. Varicose veins, or veins that appear large and bulging under the skin, may also develop.

How are vein problems treated?

Treating vein problems depends on the severity of the condition and the risk factors associated with it. Medications may be prescribed to help strengthen the cardiovascular system and thin the blood. Lifestyle changes may also help, and people who are bedridden due to a medical condition may need physical therapy to help keep blood flowing if they are forced to lie in bed all day.

In severe cases, vein surgery may be necessary to repair or restore damaged veins. Vein surgery is performed by a vascular surgeon, but a team of specialists may be involved in treating venous insufficiency.

Does Medicare cover vein surgery?

Medicare benefits are available for medically necessary vein surgery through Medicare Part B, the outpatient benefit. Medicare Part B pays for surgeries that are performed on an outpatient basis. Even if your vein surgery is performed in a hospital, Medicare insurance considers the treatment an outpatient procedure since it is not being performed in conjunction with admittance to an inpatient facility.

If, however, you are admitted to an inpatient facility and vein surgery is ordered by your care team, Medicare Part A covers the treatment instead. Medicare Part A is inpatient insurance. Medicare benefits available through Medicare Part A pay for all medically necessary care during an inpatient admission for 60 days with 30 additional days available at a discounted rate per each benefit period. Part A will cover inpatient care in a Medicare-participating skilled nursing facility, but Medicare benefits only cover 20 days of full coverage with 80 additional discounted days available.

Your costs for vein surgery under Medicare

Medicare recipients who carry Part B coverage will need to pay a monthly premium in order to keep benefits current. Medicare Part B also requires that you meet a deductible before benefits apply toward healthcare costs. In 2024, the standard Part B deductible is $240, and the standard premium is $174.70. Medicare insurance pays for 80% of outpatient costs.

Medicare Part A is usually available at no cost to seniors and retirees who have worked at least 40 quarters or 10 years and paid in FICA taxes during that time. If you don’t qualify for premium-free Part A, you may obtain it by paying a monthly premium that works on a sliding scale. Those who qualify for Medicare benefits in 2024 but have only worked between 30 and 39 quarters can pay $278 per month to carry Medicare Part A, and those who worked fewer than 30 quarters can pay $505 per month to carry Medicare coverage through Part A.