Health Insurance and FAQs

 
 
Vein Institute | Insurance | FAQs | Health Insurance | Vein Disease | Vascular Disease

If you suffer from pain, discomfort, or other vein disease symptoms, the last thing you need is confusion over how your health insurance plan works.

A member of our team will contact your insurance company to verify plan coverage and out-of-pocket patient responsibility. You will be provided with a cost estimate prior to proceeding with treatment. Most insurers cover a variety of minimally invasive treatments for vein disease, when deemed medically necessary.

If you’ve been diagnosed with vein disease, you may be wondering, does insurance cover varicose vein treatment? 

We are committed to offering affordable and accessible vein care. Our varicose vein treatments are covered by most major insurance plans. Below is a list of the most common insurance carriers that are accepted at all of our locations.

We Got You Covered with these Participating Health Plans:

This listing reflects current Vein Institute participation, contracts etc. However individual physician’s network participation may vary. In order to receive the highest level of benefits, please check with your health plan by calling the number on the back of your insurance card to verify physician participation. Please note that insurance company websites may not be up-to-date.

If you don't see your insurance plan, call your provider or our office 203-426-5554 today to see if we're in network.

 
 

Frequently Asked Questions about Health Insurance

Here’s what you need to know.

Does Health Insurance Cover Varicose Vein Treatment?

If you have painful and uncomfortable vein symptoms, rest assured that health insurance usually covers varicose vein treatment. However, it is important to understand that insurance coverage does not mean you will not have out-of-pocket expenses, which we review below.

If you suffer from varicose veins, you know the resulting health issues aren’t just cosmetic. Varicose veins can cause a range of life-altering symptoms, including: 

  • Heavy legs 

  • Swelling 

  • Itching and burning 

  • Pain relief when legs are elevated 

If you are experiencing any of the above symptoms, we recommend contacting a vein specialist to explore your options. When it comes to vein treatment, the exact medical costs vary from plan to plan. 

The largest cost-determining variables are: 

  • Whether you have an HMO or PPO health insurance plan 

  • If your provider is in or out of network with the plan 

  • Medical Necessity 

In the following section, we will describe the differences between an HMO and a PPO. To prepare for that, let’s first define several common insurance terms: 

  • This term is short for copayment, or the amount that you are required to pay at the time of service for a covered healthcare service. This amount can vary. For instance, you may have a copay of $20 per doctor’s appointment or $100 for an emergency room visit. Often, insurance plans with lower monthly premiums have higher copays, and vice versa.

  • This is the amount you pay for covered services before your health insurance plan takes over and starts to pay. If you have a $1,000 deductible, you must pay for all healthcare services until costs reach $1,000. Not all insurance plans involve a deductible. Some plans may have a copay for office visits and/or procedures and deductible for ultrasounds.

  • Some health insurance plans require that you pay a percentage of expenses after reaching your deductible. Co-insurance is a percentage of the insurance rate that is shared by the patient. For example, an 80/20 plan means that after reaching your deductible, your plan will pay 80% of expenses. You will be responsible for the other 20% until you reach your plan’s out-of-pocket maximum.

  • This involves any healthcare expenses that aren’t covered by your insurance plan. These can include copays or coinsurance charges, and all accrued costs before reaching your deductible.

  • Health Savings Accounts (HSA) or Flexible Spending Arrangements (FSA) set aside tax-free funds for out-of-pocket expenses. An HSA is used in conjunction with a high-deductible health insurance plan. An FSA is used similarly, but only offered as part of an employee benefits package.

  • You may be able to use CareCredit as a method of payment for out-of-pocket medical expenses. If approved for this medical financing option, you can use it to receive special financing terms for health expenses. This can be particularly helpful if you are not covered by health insurance but need medical services.

  • Each insurance has its own Medical Policy in regard to Varicose Veins treatment. Some procedures may require prior authorization while others may not. Vein Institute will consult your insurance carrier’s medical policy to educate you on your coverage. Your provider develops a treatment plan based on his or her clinical findings and accepted medical standards. It is possible that some recommendations will not qualify for insurance coverage based on your specific plan’s medical policy for coverage. Please note, prior authorization means procedures meet medical policy criteria, however, it also needs to be considered a covered benefit by the actual plan.

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PPO: Similar to an HMO, a Preferred Provider Organization (PPO) features a network of medical providers. These providers have also agreed to provide services for pre-established rates. However, PPOs generally involve higher monthly premiums and out-of-pocket costs for patients. 

PPO costs are higher than HMO costs for several reasons. First of all, PPOs provide greater flexibility to visit a broader range of healthcare providers, including those out-of-network. Also, you are not required to establish care with a PCP. This can be more convenient since you don’t need a referral to visit a vein specialist or other medical specialists.

What Is the Difference Between an HMO and a PPO?

HMO: A Health Maintenance Organization, or HMO, is an organized network of doctors, hospitals, and other medical providers. These individuals and organizations have agreed to accept payment rates that are predetermined by the insurance company. This healthcare model generally results in lower monthly premiums for patients. 

Some HMO plans require a primary care physician (PCP) to direct your care. Once primary care is established, your PCP can refer you to a vein specialist or other medical specialties when necessary. These providers must be in-network and your HMO will pay them directly. If you choose to see a provider out-of-network, you will be responsible for paying all involved costs out-of-pocket. 

Vein Institute | Health Insurance | Insurances covering vein disease, varicose veins, hemorrhoids, bulging veins
 

What Can I Do If I Don’t Have Health Insurance?

If you are avoiding vein treatment because you don’t have health insurance, we want you to know there’s help available. Vein Institute offers the following options:

  • Discounted, affordable cash pay rates

Vein Treatment at Vein Institute

At Vein Institute, our vein specialists treat varicose veins, spider veins, venous ulcers, restless leg syndrome, and other venous conditions.

  • Most insurance companies consider spider vein treatment cosmetic and do not cover it. However, varicose vein treatments are generally covered.

We accept the above forms of health insurance, along with many additional insurance plans. If you are concerned about your insurance coverage and out-of-pocket costs, we are available to discuss your plan’s details. Just give us a call at 203-426-5554

If you have questions about your vein condition, please schedule a consultation with one of our experts. We are available to meet with you at any of our locations across the state of Connecticut. We look forward to helping you look and feel your best!