One of the most frequent questions I get asked is if insurance will cover treatment for varicose veins. Insurance companies consider varicose veins to be a medical problem when they cause symptoms such as heaviness, aching, tiredness, throbbing, burning, itching, and swelling. We then have to verify that there is indeed a problem with the veins. This is done by performing an ultrasound with the patient standing. Normal veins carry the blood up toward the heart while varicose veins are broken and allow the blood to flow backwards toward the feet, often resulting in bulging veins. This flow abnormality called venous reflux can be determined with ultrasound. Once we have documented the patient’s symptoms and the fact that they do indeed have venous reflux, their subsequent treatment is typically covered by insurance. Some insurance carriers require patients to undergo a “trial of conservative therapy” prior to approving vein treatment. This usually means having patients wear compression stockings for 6-12 weeks. Once they have completed this, we can submit our records to the insurance company for treatment approval.