Varicose Veins

Aetna covers great or small saphenous vein ligation/division/stripping, radiofrequency endovenous occlusion (VNUS), endovenous laser ablation (ELAS/EVLT), endovenous catheter ablation for incompetent saphenofemoral/saphenopopliteal junctions, and surgical/endovenous treatment of incompetent perforators when specified ultrasound and clinical criteria are met. Key requirements: recent (≤6 months) duplex confirming junctional incompetence with reflux ≥500 ms and target saphenous vein ≥4.5 mm (perforators ≥3.5 mm with outward flow ≥500 ms located beneath a CEAP C5–C6 ulcer), plus symptoms (ulceration, significant hemorrhage, recurrent superficial thrombophlebitis, or severe persistent pain/swelling) refractory to a 3‑month trial of conservative care including prescription compression (trial waived if prior ablation/stripping in same leg); many other techniques (e.g., MOCA/ClariVein, cyanoacrylate/VenaSeal, ambulatory phlebectomy for junctional reflux, sclerotherapy for junctional reflux) and treatments for small/cosmetic veins are considered experimental or cosmetic and are not covered.