Is Sclerotherapy Covered by Insurance or Considered Cosmetic?

Is Sclerotherapy Covered by Insurance?

In most cases, sclerotherapy is not covered by insurance because it is classified as a cosmetic procedure. Sclerotherapy is commonly used to treat spider veins and very small varicose veins, which are typically addressed for appearance rather than medical necessity. As a result, insurance plans generally do not reimburse this treatment, and patients pay out of pocket.

When Is Vein Treatment Considered Medically Necessary?

Insurance coverage for vein treatment usually applies only when there is a documented medical condition. This may include larger varicose veins that cause symptoms such as leg pain, swelling, skin discoloration, heaviness, or venous ulcers. In these cases, insurers often require diagnostic testing and conservative treatment before approving coverage, and they typically cover procedures such as vein ablation or phlebectomy rather than sclerotherapy for cosmetic spider veins.

Why Sclerotherapy Is Usually Considered Cosmetic

Spider veins rarely cause medical complications, which is why sclerotherapy is most often categorized as cosmetic. While some patients may experience discomfort or cosmetic distress, insurance providers generally do not consider spider vein treatment medically necessary. This distinction is important for patients who previously received care through large health systems, where cosmetic services may no longer be offered as part of standard care.

How Much Does Sclerotherapy Cost Without Insurance?

The cost of sclerotherapy varies based on several factors, including the number of veins treated, the size of the treatment area, and the number of sessions required. Most patients need multiple sessions to achieve optimal results. Independent vein centers typically offer transparent, self-pay pricing and provide cost estimates during the initial consultation, allowing patients to understand expenses before starting treatment.

What If My Health System No Longer Offers Sclerotherapy?

When large health systems discontinue cosmetic vein services, patients may assume they cannot receive treatment elsewhere without insurance coverage. In reality, many independent vein centers continue to offer sclerotherapy as a self-pay option, often without referral requirements. This allows patients to continue care without unnecessary delays, even if their previous provider no longer offers the service.

Next Steps: How to Find Out If You’re a Candidate

The best way to determine whether sclerotherapy is right for you is through a professional vein evaluation. A consultation can identify whether your veins indicate an underlying medical condition or whether cosmetic sclerotherapy is the most appropriate option. This visit also provides an opportunity to discuss expected results, treatment timelines, and pricing so you can make an informed decision about your care.