Insurance Coverage Information
At Elmore Medical Vein & Laser Treatment Center, we work with most major insurance providers to help make your vein treatment as affordable as possible. Our experienced staff will help you navigate insurance coverage for medically necessary treatments.
Insurance Verification
Please complete and return your new patient paperwork before your appointment. The stocking form is particularly important if medical treatment may be recommended.
Before your first appointment, our team will:
✔ Check your insurance benefits
✔ Verify your coverage for vein treatments
✔ Explain any out-of-pocket costs you might expect
✔ Answer questions about your specific insurance plan
Medical Necessity vs. Cosmetic Treatment
Medical Treatments (Potentially Covered)
Insurance coverage for vein treatments is based on medical necessity criteria. To qualify, patients typically must:
Have documented venous insufficiency confirmed by ultrasound
Show specific vein measurements and abnormal blood flow
Have tried conservative treatments first (compression stockings for 6 weeks to 3 months)
Document how vein disease affects daily activities (walking, standing, cooking, cleaning)
Experience symptoms like pain, swelling, or skin changes
Cosmetic Treatments (Not Covered)
Some vein treatments are considered cosmetic by insurance companies and are not typically covered:
Spider vein treatments are almost always considered cosmetic
Treatments that don't meet medical necessity criteria
Insurance Plans Accepted
We accept most major insurance plans, including:
Aetna, Anthem Blue Cross, Blue Cross Blue Shield, Blue Shield of California, Cigna, HealthNet, Humana, Medicare (Original Medicare), Tricare, UnitedHealthcare, Many local and regional plans
Note: We are a preferred provider with Santé.
For Medicare patients:
Original Medicare covers all treatments that meet medical necessity criteria
For treatments deemed cosmetic, payment will be the patient's responsibility
Medicare Advantage plans may have different coverage rules
Note: We do not accept straight Medi-Cal.
The Authorization Process
For most medical vein treatments:
Step 1: Initial Evaluation
Dr. Gonzalez will determine if your condition meets medical criteria
Step 2: Documentation
We collect necessary documentation of your symptoms and condition
Step 3: Prior Authorization
We submit authorization requests to your insurance company
Step 4: Review Period
Insurance companies typically take 1-3 weeks for review
Step 5: Treatment Scheduling
Once approved, we schedule your treatment. If your insurance initially denies coverage, our team will assist with the appeals process.
Payment Options
For treatments not covered by insurance or for any out-of-pocket costs, we offer several payment options:
Major credit cards (Mastercard, Visa, American Express)
Care Credit healthcare financing
Health Savings Accounts (HSA)
Flexible Spending Accounts (FSA)
Health Reimbursement Arrangements (HRA)
Cash payments
Common Treatment Codes
Insurance companies use CPT (Current Procedural Terminology) codes to identify medical procedures. Common codes for vein treatments include:
36478: Endovenous Laser Ablation (EVLT)
36465: Varithena Treatment
36468: Spider Vein Treatment (cosmetic, not typically covered)
Insurance FAQs
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Coverage depends on medical necessity criteria, which varies between carriers. After your evaluation, we'll help determine if your condition meets these criteria.
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Our team will assist with the appeals process if your treatment meets medical criteria but is initially denied.
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Most private insurers have similar criteria and coverage. Kaiser has very limited coverage for vein treatment.
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Please notify us immediately of any insurance changes so we can verify your new coverage and update authorizations as needed.
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We'll handle verification when you schedule your appointment, but please notify us of any insurance changes as soon as possible.
Contact Our Insurance Specialists!
Have more questions about insurance coverage for your vein treatment? Our insurance specialists are here to help.
Contact Us
Insurance coverage information is subject to change. This information is provided as a general guide and is not a guarantee of coverage.