To be covered for varicose vein treatment by United insurance, a specific list of criteria must be met. This means that if any parts of the required mentions are missing, United may not consider the procedure a medical need.
These requirements state that junctional reflux must be present, and it should exceed 0.5 seconds). Skin ulcerations, bleeding from the vein(s), document of superficial thrombopgelbitis and moderate to severe pain are considered functional impairments.
The size of veins is also a deciding factor in treatment availability. United states that the great saphenous vein should be 5.5mm or bigger, and smaller saphenous veins must also measure at 5mm or greater.
Though reflux indicated the need for medical treatment, the duration of this reflux is also accounted for under insurance coverage policy. United suggests that the reflux must be greater or equal to 500 milliseconds for both the great and small saphenous veins. Ultrasound is used to confirm that reflux does indeed persist, and at what rate it exists.
For perforated veins, a medical approved procedure is determined based on evidence that the perforated vein is insufficient and 3.5mm or bigger.
What Is Not Covered?
Like most other medical procedure, if a given case of varicose veins is not considered medically necessary, it is most often not covered by insurance. These kinds of procedures are considered cosmetic, and United health insurance states that they do not cover this kind of treatment in any of their policies. They consider the following a ‘cosmetic need:’ Procedures that correct but do not improving or restoring physiologic function.
- Psychological consequences or socially distant behavior as a result of an injury or sickness does not classify surgery as a reconstructive procedure. United will not cover any procedure that is done for personal issues with the condition that are only necessary to aid personal issues.
- Spider veins and Telangiectasias are considered to be cosmetic and therefore excluded from coverage.
The specifics of what is and is not covered by United Healthcare for varicose vein surgery is detailed and specific. If you have questions that pertain to your individual case that were not mentioned here, please call us at (855) 690-0565 to learn more about United Healthcare insurance and varicose vein treatments.
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