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Fee-for-service
This kind of health plan is best suited for people who want many options and are willing to pay for it. In other words, it allows you to select any physician or hospital your heart desires. The other good thing about it is that it allows you to self-refer.
PPO (Preferred Provider Organization)
If you use the doctors and hospitals on your list, you will greatly reduce deductible and co-payment costs and there will not be as much claims paperwork. However, you may also select your own physician and self-refer (at higher cost).
EPO (Exclusive Provider Organization)
Similar to a PPO except that the coverage for non-listed physicians and services may be less, and there are more rigorous utilization review requirements.
HMO (Health Maintenance Organization)
Your selection of doctors and hospitals is strictly limited to those on the HMO list. You also have to choose a primary care physician with whom you have to consult for vein treatment. If you receive treatment without authorization from anon-HMO physician, you will not be covered.
Point of Service
This is a combination of HMO, PPO and Fee-for-service.
Open Access
When a plan provides open access, it allows its members to self-refer an in-network or out-of-network specialist. The plan still provides full benefits or a slightly reduced benefit to its member.
Medicare
1. A program under the U.S. Social Security Administration that reimburses hospital and physicians for
medical care provided to qualifying people over 65 years old.
2. Some people with disabilities under age 65
3. People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant.)
The restrictions are based on Medicare guidelines.
Medicare HMO
Available to Medicare-eligible individual, this plan puts you in an HMO (see above) in return for lower rates. The restrictions are the same as in an HMO.
Medicare Supplement
This policy is added on to Medicare to cover additional costs not included in the standard Medicare policy. Restrictions depend on the plan you choose.check with your insurance company before considering a particular treatment option.
Many insurance companies do cover the cost of treating varicose veins, but generally not spider veins. The best approach is to check with your insurance company before considering a particular treatment option.
In order for varicose vein surgery to be covered by insurance:
1. Our physician needs to conduct a history and physical exam
as well as use ultrasound to document the presence of a vein problem .
2. The patient may be required to follow a conservative treatment plan
and wear the compression stocking for several weeks or months.
3. Our physician must track all of the patient’s general health,
medical history, symptoms and previous treatments tried to help prove
the need for surgery and sclerotherapy treatments.
Most insurance companies do not pay for sclerotherapy or any other treatment if it is performed for cosmetic reasons. Some insurance companies do pay benefits if there is pain or discomfort that impedes activity. However, each insurance carrier is different and it is recommended that individuals check with their insurance carriers to determine if there is coverage. Each patient is given a complete evaluation summary of the proposed plan of treatment at their consultation. We will submit this information to the insurance carrier to see if benefits are available if the procedure is considered medically necessary.
The following is a list of different types of insurance plans that might help you in determining your benefits:
In order for varicose vein surgery to be covered by insurance:
1. Our physician needs to conduct a history and physical exam
as well as use ultrasound to document the presence of a vein problem .
2. The patient may be required to follow a conservative treatment plan
and wear the compression stocking for several weeks or months.
3. Our physician must track all of the patient’s general health,
medical history, symptoms and previous treatments tried to help prove
the need for surgery and sclerotherapy treatments.
Most insurance companies do not pay for sclerotherapy or any other treatment if it is performed for cosmetic reasons. Some insurance companies do pay benefits if there is pain or discomfort that impedes activity. However, each insurance carrier is different and it is recommended that individuals check with their insurance carriers to determine if there is coverage. Each patient is given a complete evaluation summary of the proposed plan of treatment at their consultation. We will submit this information to the insurance carrier to see if benefits are available if the procedure is considered medically necessary.
The following is a list of different types of insurance plans that might help you in determining your benefits:
general information
Financing & Insurance
At Vein Clinic of North Carolina, we participate with a number of different insurance providers. Most insurances will pay for vein evaluations. If the vein evaluation shows the presence of reflux, then the care needed to treat this problem is generally covered as well.
Insurance will NOT cover treatment of spider veins.
Insurance will NOT cover treatment of spider veins.
