Does Private Health Insurance Cover Varicose Veins?

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 varicose vein treatment can be covered by private health insurance or Medicare. The good news is it can be. But the bad news is there are a couple of caveats here, including where you treat them and if the condition is medically necessary.


What “Medically Necessary” treatment means

Unlike spider veins that 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.


Is treatment covered by Private Health Insurance?

Private surgery for varicose veins is generally covered with a silver or gold policy, it is available 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, the surgery is only covered when conducted 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 which 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, and they can provide you with a script.


Are varicose vein treatments covered by Medicare?

Along with symptoms, Medicare generally only covers varicose vein treatments in cases where the size of the veins is 2.5mm or more.

If you qualify, Medicare will cover between 75% and 85% of the costs, so the fee you pay will depend on the severity of your case.

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. An ultrasound will be performed during this consultation. $290
  • Spider vein treatment: Multiple sessions with a Vein specialist are required. $500 – $1,500 (both legs)
  • Varicose vein treatment: One session with a vein doctor, who will perform the recommended treatment: Endovenous Therapy, Radiofrequency Therapy or Medical Superglue. You may need 2-5 follow-up Sclerotherapy sessions with a Phlebologist 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.

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.