Cost and Insurance

Insurance

There is a common misconception that treatment of varicose veins is only provided for cosmetic purposes; however Denver vein therapy goes beyond aesthetics. You may be surprised to learn that health insurance covers more than 80% of treatments at VCI and your varicose vein treatment may be covered by insurance.

In order to attain insurance coverage for your Denver varicose vein treatments, there are a few steps involved. Through a series of ultrasounds showing the inner workings of the veins in your legs, we can gain a better understanding of whether or not your veins are functioning at full capacity. We may determine that you suffer from a treatable condition known as Venous Insufficiency.

At VCI, we work with your insurance provider, utilizing documentation of your vein deficiency to gain consent for treatment. We will request a Pre-authorization form from your insurance provider, giving us permission to provide a medical attention. Your insurance company may request that you try a number of over the counter remedies for your varicose veins such as Advil or compression stockings, before providing approval.

When we are notified that your insurance provider has, approved vein therapy treatment, we will first provide an estimate of your potential out-of-pockets costs. Often, even with insurance coverage, you may be required to pay out-of-pocket expenses such as, co-payments or deductibles. These costs are unique to each individual insurance plan. Prior to providing any treatment, we will give you a comprehensive break down of the details and will additionally work with you to establish a payment plan for out-of-pocket costs.

Once you have approval for Denver vein therapy from your insurance provider, you may probably receive paperwork and information that is somewhat confusing. Understanding a few key terms often utilized in insurance policies will help you wade through the parameters of your coverage.

Referral:

Often, insurance policies require authorization for you to make use of a specialist for varicose vein treatment. Once you have seen your primary care doctor and he or she wishes to refer you to a specialist, your physician will make this request with your insurance provider. Some insurance companies such as Aetna HMO, Cigna HMO and Secure Horizons require a referral, whereas some do not.

Co-Payment:

Many insurance policies require the insured individual pay a pre-determined dollar amount for medical visits. This expense is commonly referred to as a co-payment. Depending on the type of medical care you need, the amount of your co-payment may fluctuate. Typically, a co-payment is made at the time of your appointment. Your specialized co-payment costs will be displayed on your insurance card.

Deductible:

Most insurance policies require a deductible, an out-of-pocket sum you are required to pay before insurance will take over the cost of your care. Every insurance plan has distinct parameters and deductibles vary based on your chosen plan.

Co-insurance:

n addition to a deductible, some insurance plans require a percentage each time you make a claim. This percentage is known as co-insurance.

The following is a simple example of co-insurance: if you make a claim for $100 and your policy requires 10% co-insurance on all claims, you will pay $10 and your insurance company will pay $90.

Cost Sharing Cap or Out-of-Pocket Maximum:

Your insurance policy may set a maximum on your annually accrued out-of-pocket expenses. Typically, your co-insurance payments are included in this number, but your co-payments and deductible do not have any affect on the set maximum. Your insurance policy will pay 100% of your claims once you reach your out-of-pocket maximum.

In Network Benefits:

Doctors and medical facilities contract with certain insurance companies to provide medical services at lower costs. When you use a health care provider from within your network, you will benefit from reduced costs based on the agreement between your insurance company and the network healthcare providers. Call your insurance company or your medical facility to determine if that provider is within your network.

Out of Network Benefits:

Some insurance policies require that you utilize healthcare providers from within your network, although some policies provide limited benefits for out of network care. Often, your out-of-pocket, deductible and co-insurance costs will increase for out of network treatment and care.

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