Cigna covers any high risk varicose vein indicators. Procedures, including Ambulatory phlebotomy, ligation and excision, RFA, EVLT, or sclerotherapy, are considered a medically need when under the following circumstances:
- Leg ulcerations persist because of varicose veins
- Bleeding occurs and reoccurs from a given vein(s)
- You have history of bleeding that is most often severe
- You suffer from pain because of functional impairment; this means that everyday things like standing, sitting and cleaning become taxing and evenimpossible to do
- Phlebitis or thrombophlebitis often occurs
- Dependent edema occurs more than once
- Stasis dermatitis is persistent
- You have been diagnosed with chronic cellulitis
Although any of these mentioned symptoms can constitute for medically treated varicose veins. Cigna emphasizes that a Doppler or Duplex ultrasonography evaluation and report MUST be done no more than 1 year prior to the request for a procedure. These tests will confirm that the vein is in need of medical attention and treatment.
There must also be a report documenting whether a previous invasive treatment was performed, and proof that suggested and medically delegated methods for treatment (like compression stockings or therapy) for a long period of time were done and monitored, showing no significant changes.
What isn’t covered?
When a procedure is considered a cosmetic need, Cigna does not cover treatments. What this means is that if the severity of your condition does not cause any medical deficiencies, it will not be paid for by Cigna. There are other specification of what is not covered:
- Treatment of veins that are small in size (less than 3mm)
- Glycerin or glycerol based sclerotherapy
- Varicose vein treatment done by an intense pulsed-light source
Procedures that are considered ‘experimental’ are not covered by Cigna. These include non-compressive sclerotherapy, transdermal laser therapy, transilluminated powered phlebotomy, or SEPS.
The treatment of reticular and spider veins are not considered a medical necessity, and therefore are not covered by Cigna.
The specifics of what is and is not covered by Cigna for varicose vein surgery is detailed and specific. If you have questions that pertain to your indiviudal case that were not mentioned here, please call us at (855) 690-0565 to learn more about Cigna insurance and varicose vein treatments.
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