Vein Specialists of Northern Californias Trusted Partners and Educational Sites
Please take a few minutes to visit the following web sites and learn more about our products, our procedures, and the professional resources used by Vein Specialists of Northern California.
American College of Phlebology
www.phlebology.org
Diomed Laser (EVLTŪ)
www.evlt.com
Insurance Coverage: Where You Fit In
Below you'll find a comprehensive list of insurance
packages that may or may not cover vein sclerotherapy
and other services offered at Vein Specialists of Northern
California. Read each to find out which procedures you'll
be covered for, and added information about each coverage
plan.
Will Your Insurance Plan Cover Sclerotherapy?
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 own insurance carriers
to determine if there is coverage. Each patient is given
a complete evaluation summary of their proposed plan
of treatment at their consultation to submit to their
carrier to see if benefits are available.
The following is a list of different types of insurance plans that might help you in determining your benefits:
- Fee-for-service
This kind of health plan is best suited for people who want a lot of 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'll greatly reduce deductible and co-payment costs
and there won't be as much claims paperwork. However,
you may also select your own physician and self-refer
(at higher cost). Currently, Dr. Isaacs is not a member
of any PPO.
- 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 all referrals regarding specialized
care or hospitalization, including a referral for
vein treatment. If you receive treatment without authorization
from a non-HMO physician you will not be covered.
Currently, Dr. Isaacs is not a member of any HMO.
- Point of Service
This is a combination of HMO, PPO and Fee-for-service.
- Medicare
Medicare patients should understand that we will bill Medicare for the medically necessary portion of treatment. We will not bill for cosmetic treatment. A waiver must be signed by each Medicare patient prior to his/her treatment acknowledging that cosmetic treatment will not be covered.
- Medicare HMO
Available to Medicare-eligible individuals, 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.
Ready to schedule an appointment? Click
here.
Questions about our services? Please see our FAQ page,
here.
If you would like any further information or wish to schedule a consultation, please call
(925) 945-8656.
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