Is Varicose Vein Treatment covered by Private Health Insurance or Medicare?

July 23, 2023 The Vein Institute

Varicose vein treatment can get prohibitively expensive if paid out of pocket. So, it’s no wonder many people with the condition ask if Medicare or Private Health Insurance will cover their varicose vein treatment. The good news is they can. But the bad news is there are a couple of caveats here, including where you treat them and if the condition is medically necessary to treat.

 

What “Medically Necessary” treatment means

Unlike spider veins (which are strictly cosmetic), varicose veins straddle the line between a cosmetic and medical concern. Put simply, if your case of varicose veins is strictly cosmetic (like a few bulging veins and no other symptoms), it’s not likely to be covered by private health or Medicare. Because in these cases, you can generally manage the condition via at-home remedies.

But if you are experiencing symptoms of itchiness, swelling, cramping, fatigue, or pain, your varicose veins become a medical concern. And so, private and Medicare can help you cover the cost.

 

Does Private Health Insurance Cover Varicose Veins?

Silver or Gold policies generally cover treatment under the heart and vascular system services. To be covered by the majority of insurers, private surgery for varicose veins must be medically necessary. And in most cases, you’ll only get cover if the procedure is done in the hospital.

 

What else can private health cover?

If you have extras cover, there is a good chance you have access to medical-grade compression stockings. These can be a game-changer when managing the symptoms of varicose veins.

The therapeutic effects of the VenoTrain compression stockings begin at the feet, with a comfortable sole providing pressure relief at the heel and ball of the foot. The gradient compression stimulates blood circulation to relieve symptoms of varicose veins, and the moisture-wicking material is breathable, soft, and gentle on your skin – so you can wear them all day.

Each year, roughly $4.5 billion worth of extras go unclaimed. So make sure you chat with your GP about your vein concerns.

 

Are varicose vein treatments covered by Medicare?

Medicare generally only covers varicose vein treatments if you’re experiencing symptoms and the size of the veins is 2.5mm or more.

If you qualify, Medicare may cover 50-85% of the costs, so the fee you pay will depend on:

  • The severity of your case
  • How much the clinic charges
  • Your Safety Net Threshold
  • If the clinic bulk-bills
  • And if you’re a concession card holder

Is varicose vein treatment bulk-billed?

Per Medicare guidelines, varicose vein treatment can be rebated (up to 85% if you meet the eligibility criteria). However, the cost  – in terms of equipment, supplies, and labour – is high, so private clinics cannot afford bulk billing. Instead, we at The Vein Institute combine private and bulk billing (as well as payment plans) to ensure as many people as possible can access these procedures.

Our out-of-pocket costs

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 or Vascular Sonographer. They will perform an ultrasound scan. $290
  • Spider vein treatment: You’ll likely require multiple sessions with a Vein specialist. $500 – $1,500 (both legs)
  • Varicose vein treatment: One session with a vein doctor, who will perform the recommended treatment. You may need 2-5 follow-up Sclerotherapy sessions with a Phlebologist to treat smaller veins surrounding the affected area. You’ll also need to follow a post-care plan including compression stockings. $500 – $3,000 (per leg)

Except for the smaller spider veins (which are considered cosmetic), you can claim all rebates through Medicare. In Australia, the Medicare Safety Net reimburses eligible patients once they’ve reached their threshold.

Seek specialist 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. To book a consultation and discuss our treatment program, call  13 VEINS (that’s 13 83467). Or, enquire via the Contact Us page.