Both spider and varicose veins are surface veins that become prominent and distended because the blood that should normally be circulating through the body has accumulated in the legs. This is symptomatic of the diseased legs insufficiency to push blood back up towards the heart.
Spider veins appear as thin surface veins and can turn red or blue under the strain caused by venous reflux. Spider veins affect the appearance of the skin on the legs and are therefore considered a cosmetic problem and not a medical condition since they rarely cause, or are associated with, other symptoms like physical discomfort. Typically, Spider veins are addressed using a variety of non-invasive techniques.
Varicose veins, unlike Spider veins, are a more serious manifestation of venous reflux disease and a medical condition that needs clinical attention. Varicose veins are often associated with clinical symptoms like throbbing, pain, muscle cramps, burning sensations and fatigue. The swollen varicose veins often protrude from the skin by several millimeters and can become tangled and knotted. Left untreated, varicose veins can also lead to leg ulcers, blood clots and other health conditions.
The treatment of varicose veins has been debated amongst physicians for over two thousand years. Hippocrates himself wrote about the condition in fifth century B.C. This debate brings into consideration the medical necessity for the treatment of the disorder. Under our modern healthcare system, health insurance complicates the matter of treatment options even more.
Most patients insurance or Medicare plans require that a treatment be deemed medically necessary before being covered by insurance. In order for a treatment to meet the definition of medical necessity a physician must determine that the treatment is required to either improve the patient’s health or protect their well being. Treatment options for conditions, which do not meet this definition, are often considered elective or cosmetic and therefore not covered by most insurance companies.
Treatment for varicose or spider veins that is aimed at improving the patient’s appearance is considered cosmetic. Nearly all procedures addressing spider veins will fall into this category because of the lack of other symptoms associated with the condition.
However, treatment for varicose veins when associated with symptoms like throbbing, pain, muscle cramps, burning sensations and fatigue or the advanced symptoms of venous reflux disease like skin ulcers and blood clots, are in fact treating a medical condition and are considered medically necessary. These symptoms can interfere with a patient’s ability to perform daily tasks, functions or work and will lead to more severe conditions without treatment. Treatment options for this type of varicose veins would be considered under most health insurance and Medicare plans.
There is one option however that is available to treat spider and varicose veins that is generally always covered up to applicable limits under a patient’s insurance plan. VNUS Closure, a procedure that is designed to treat and prevent the underlying venous reflux disease that causes spider and varicose veins, is considered medically necessary as it is rarely used for cosmetic reasons. Successful treatment of venous reflux disease with the VNUS Closure treatment option often improves the cosmetic appearance of the veins.