Are Varicose Vein Treatments Covered by Medicare?

April 30, 2020
April 30, 2020 Dr Zil

Varicose veins are the result of a medical condition called Chronic Venous Insufficiency, or CVI. The impacted veins are swollen, twisted and are blue or purple in appearance. It’s an extremely common issue – around 30% of Australians will develop varicose veins, and thanks to modern technology, there are several treatment options available. But with all these options, it can be difficult to know which treatment is covered by Medicare, or if any are covered by Private Health Insurance. We’re here to help!

What are the different types of veins?

If you are unsure if you have varicose veins, we have developed a simple self-assessment tool which may be able to help. Try it now.

  • Bulging veins: veins that bulge and protrude above the skin. Often found in your arms, hands and face, not all bulging veins are varicose. However, it is recommended if you see a twisted vein in your leg that you speak with a doctor.
  • Reticular veins: smaller than varicose veins, these do not protrude above the skin the way that varicose veins do. Blue or purple in colour (because of the deoxygenated blood that fills them), they are most commonly found on the inner thigh, the backs of knees, or the ankles.
  • Spider Veins: these are small clusters of fine veins. They are typically considered to be a cosmetic concern.

How to treat varicose veins

How you treat your varicose veins will depend on the severity of your case and can help determine if your varicose vein treatment is covered by Medicare. A Phlebologist will use an ultrasound to assess your veins and recommend the appropriate treatment plan. Some of these may include:

  • Compression stockings: help to reduce swelling and prevent blood from pooling in the veins. Medical-grade stockings apply pressure to the ankle which helps the blood flow upwards, towards the heart.
  • Lifestyle changes: for milder cases, a healthy diet and exercise can make all the difference to your varicose veins. An active lifestyle can improve blood flow in your feet and legs, potentially alleviating symptoms like pain and mild cramps.
  • Therapy and surgery: for more serious cases your doctor may recommend Endovenous Therapy (EVLA), Radiofrequency Therapy (RFA), Medical Superglue or Ultrasound Guided Sclerotherapy. In different ways, these treatments prevent blood from flowing through the unhealthy varicose veins, eventually causing the vein to collapse and die. Surgical stripping is sometimes required, though these days, the aforementioned minimally invasive techniques prove equally as effective with a fraction of the recovery time.

Are varicose vein treatments covered by Medicare?

To be eligible for a Medicare rebate, varicose vein treatment must be deemed medically necessary and cannot simply be a cosmetic issue. Furthermore, the size of the veins must be 2.5mm or more.

Generally, Medicare will cover between 75% and 85% of the costs, so the fee you pay will depend on the severity of your case. Below is a breakdown of the estimated out-of-pocket costs you might expect from The Vein Institute:

  • Initial consultation: 30 minutes with a Phlebologist. An ultrasound will be performed during this consultation. $215
  • Spider vein treatment: Multiple sessions with a Phlebologist are required. $500 – $1,500 (both legs)
  • Varicose vein treatment: One session with a Phlebologist who will perform the recommended treatment: Endovenous Therapy, Radiofrequency Therapy or Medical Superglue. Between 2-5 follow up sessions with a Phlebologist where Sclerotherapy may be used to treat smaller veins surrounding the affected area. A post-care plan including compression stockings. $500 – $3,000 (per leg)

Except for the smaller spider veins, which are considered cosmetic, all rebates are claimable through Medicare. In Australia, the Medicare Safety Net reimburses eligible patients once a threshold has been reached.

Private Health Insurance for varicose veins

Generally, private health providers only cover treatments performed in-hospital, as they are protected by the hospital insurance.

The minimally invasive treatment options, such as EVLA and those available at The Vein Institute, are performed in a private medical practice. As a result, minimally invasive procedures are only covered by Medicare.

Surgical stripping is performed in-hospital and is as onerous as the name implies. It involves a couple of days in the hospital, general anesthetic and a long, painful recovery time.

Do I need to treat my varicose veins?

If your varicose veins pose little discomfort and health risk, then treatment may not be necessary. However, some patients find varicose veins unsightly, and wish to have them addressed for aesthetic reasons. If you’re experiencing varicose veins or symptoms, or have a family history of the disease, it’s a good idea to see a professional vein specialist for an assessment. They will advise you whether treatment is recommended and go over all the treatment options with you.

Seek expert advice

The doctors at The Vein Institute specialise in varicose vein treatment. We offer patients a comprehensive treatment program to treat varicose veins, with non-surgical laser treatment techniques. The benefits of laser treatment to patients are;

  • Walk-in walk-out treatment
  • 98% success rate
  • Extremely effective
  • Can be performed at a clinic (no hospitalisation)
  • No general anaesthetic
  • Medicare rebates apply
  • No downtime or time away from work