Health insurance for varicose veins
Does health insurance cover varicose veins?
- Author: Dr Nishath Altaf
- First published: 7 November 2023
Does private health insurance cover varicose veins?
Health insurance for varicose veins: Am I covered?
In Western Australia, and Australia in general, there are many factors in place whether you are covered for varicose vein treatment or not. Before we go into the details, here’s an overview of what you need to inspect before we can go into the details.
1. Type of procedure
Private health insurance policies can vary widely in what they cover. It’s wise to check your policy’s Product Disclosure Statement (PDS). Typically, if a procedure is considered medically necessary, and your vascular surgeon performs open surgery in theatre, it is likely that you’re covered, especially under hospital cover.
Medicare might cover (part of) the cost for varicose vein treatment if the procedure is considered medically necessary. For example, when your varicose veins cause pain, discomfort, or other health complications, it is likely to be partially or fully covered by Medicare. However, procedures performed purely for cosmetic reasons, might not be eligible for Medicare benefits. In case Medicare reimburses part of your treatment you can claim the remaining cost via your private health insurance, depending on your policy.
2. Level of cover
Here in Australia, private health insurance is categorised into different tiers, such as Basic, Bronze, Silver, and Gold. Higher tiers usually provide broader coverage, and typically varicose veins treatment would fall under Bronze or higher. This means that policies within the Bronze, Silver, and Gold tiers must cover hospital treatments for varicose veins to some extent. You’ll need to check with your specific health fund and policy details to determine the level of coverage for varicose vein treatments.
Even within these tiers, coverage details can vary based on the specific policy and insurance provider. Some policies might cover the full cost of the varicose vein treatment, while others might only cover a portion.
3. Waiting periods
If you are covered for varicose vein treatment, there might be a waiting period before you can claim the benefits. If you’ve just taken out the policy, or upgraded your level of cover, you may need to wait a year before you can claim benefits.
4. Hospital cover
Open varicose vein surgeries are done in a hospital theatre. If your private health insurance includes hospital cover for varicose veins, it may help cover some or all of the costs. Non-invasive treatments performed in my rooms, outside a hospital environment, typically are not covered by private health funds.
5. Gap payments
Even if your insurance does cover varicose vein treatment, there may be a gap between what the insurance pays and the total cost of the treatment. Please contact my friendly staff to get an estimate and then check with your insurance provider to understand any potential out-of-pocket expenses.
Varicose veins treatment Perth cost
How much does varicose vein treatment cost?
Now that you have a clear idea about health insurance for varicose veins treatment, you may wonder how much varicose veins treatment costs.
I have summarised my fee structure below. The costs mentioned are provided as a guide.
It’s best to contact my friendly staff to get an accurate estimate for your individual case.
Varicose veins consultation
- Initial consultation with Dr Altaf: $250
- Subsequent consultations: $100
- Discounted rates for pension holders
- Medicare rebate applicable with a valid Medicare card and GP referral
Open surgery - stripping of varicose veins
- Privately-insured patients:
- Covered if appropriate health cover, typically a Bronze plus tier cover or higher tier (Silver, Gold).
- Dr Altaf is a no gap provider with all health funds.
- Uninsured patients:
- Surgery is available in the public system if varicose veins are “complicated.”
- 3 month waiting period in the public system.
Endovenous laser ablation
- Costs are not covered by private health insurance (as it’s an outpatient procedure)
- Medicare procedural rebate available.
- Out-of-pocket costs (after Medicare rebate): approximately $3,000 per leg.
Venaseal glue ablation
- Costs are not covered by private health insurance (as it’s an outpatient procedure)
- Medicare procedural rebate available.
- Out-of-pocket costs (after Medicare rebate): approximately $3,000 per leg.
Sclerotherapy
- Costs are not covered by private health insurance (as it’s an outpatient procedure)
- Around $100 is rebated by Medicare.
- Out-of-pocket costs range from $500 for the first course of treatment.
Health insurance for varicose veins
Contact Dr Altaf
Understanding health insurance for varicose veins can be tricky. If you are unsure about costs and insurance policies, just give us a call. We are here to help.