Does Blue Cross Blue Shield Cover Varicose Vein Treatment?

VARICOSE VEINS, VENOUS INSUFFICIENCY AND LEG ULCER TREATMENTS

Insurance coverage is always dependent upon benefit eligibility, as outlined in your specific benefit plan.  Some employers have chosen not to cover varicose vein treatment specifically, so be sure and check with your human resources department or call the toll-free number on the back of your insurance card.

BCBS typically will cover if medically necessary

For the most part, as long as your situation meets Blue Cross Blue Shield’s definition of "medical necessity," then your treatment will be covered and paid according to your plan benefits. BCBS provides contracted providers with a comprehensive 17-page report that explains how a patient meets criteria. The measures and conditions they require are very straightforward. During your examination, duplex ultrasound, and consultation with Dr. Jilanne Rose, she will be able to determine if you meet the standards for BCBS insurance coverage.

If you have not sought treatment before and your symptoms do not significantly interfere with your activities of daily living, Jilanne will most likely recommend conservative treatment for at least 3 months, to see if your symptoms improve without the need for more invasive options. If you are like most of our patients, you’ve been suffering for many months or years and have had numerous rounds of conservative treatment…to no avail. In this case, it’s very likely you will meet the treatment criteria at your initial visit and we can proceed with RFA, EVLT, and/or sclerotherapy immediately.

Prior authorization

Our staff including Michella, Beth, or Lucy will call BCBS of Arizona and request “prior authorization” as well as obtain benefits. This way you know how much you will owe before any treatment is done and you can be assured the insurance has “authorized” the treatment as well. It is our goal to make sure the insurance companies provide the level of benefit coverage that you and/or your employer pay for on a monthly basis, as well as make a painless of a process for you. You can also contact our office to discuss varicose veins treatment costs if your insurance will not cover EVLT, RFA, ClariVein, or VenaSeal.

To find out if you are at risk for CVI, or any other venous disease of the lower limb, download and fill out this assessment.

Want to speak with someone right away?   It's really easy to talk to Dr. Jilanne Rose.  Just call the office or fill out this form to get a conversation started about your symptoms and whether vein treatment may be needed.

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About Jason Babcock, MBA CMPE

Jason is the Practice Administrator and CEO of Advanced Vein Institute of Arizona. Mr. Babcock brings over 25 years of healthcare administration experience to the organization with a strong background in finance, business development, operational improvement and customer service to AVIA.