Insurance Coverage for Laser & Other Vein Treatments

For covered medical procedures/visits, Sutton Place Laser Vein Care accepts nearly all insurances, including Medicare, Medicaid, nearly all HMO/PPO plans, and nearly all Union plans. For the few insurance plans we do not participate in, you may have out of network benefits that you can use in our office.

For self-pay/cosmetic procedures/visits, we accept check, cash, and credit cards, and have payment plans that are affordable.

Cosmetic procedure fees/package treatment are established at the time of consultation.

Insurance coverage for Vein treatments and Ultrasound testing (“vein procedures”), as well as for Consultation/follow up visits can be divided into 2 types:

Cosmetic: No symptoms or signs of vein disease present; patient wants treatment solely for improved appearance.  A brief free consultation is offered. If an ultrasound is required, this may be covered by insurance. A cosmetic reason for obtaining vein procedures and consultation / follow up visits are never covered by insurance, and patients are responsible for full self-payment of fees, by check, cash, or credit card. Financing is also available via our office. Please contact us at 212.593.9800 for procedure fees. Our fees are very competitive with other vein centers in Manhattan.

Medical: When symptoms or signs or vein disease are present (and patients often do not realize the symptoms they are having are active, as they are often slow and insidious, and they often do not realize their symptoms are actually due to their veins ! please see more about this below), most vein procedures are covered by most insurers, though precertification is often required, and many plans require anywhere from 6 weeks to 3 months of documented efforts at conservative therapy (please see the Services page), along with copies of the vein ultrasound test report and digital photos of the veins or limbs affected. Therefore, immediate treatment on the first or single visit is never possible (nor is it good medical practice, as all patients are advised to undergo vein ultrasound to determine the most effective treatment plan, followed by discussion with the practitioner as to risks, benefits, alternative treatments, and why the plan is individualized to your condition). We always make every persistent effort to obtain precertification on your behalf when it is required.

As noted, patients often have to think hard about whether or not they have symptoms of venous disease, as they often do not connect certain symptoms with their veins, and also because vein symptoms are often so slowly evolving, or dependent on hot weather or prolonged standing, that the patient often gets used to having symptoms that should not be present ! Patients often are not aware that many of these symptoms are due to underlying invisible vein disease when visible varicose veins are not present. Additionally, patients may not be aware that certain physical findings may in fact be related to venous disease, especially when visible veins are not present (see signs below). So what may initially appear to patients to be a ‘cosmetic’ case of vein disease often is recognized to be in fact ‘medical’ in nature, due to presence of symptoms and signs….

Symptoms typically recognized as being covered for vein procedures include: pain, aching, heaviness, itching, burning, night cramps, restless legs; signs typically include: swelling, skin changes (redness, scaling, inflammation, tree bark type thickening and coarseness), increased skin pigment or discoloration, bleeding varicose veins, or venous ulcers or skin breakdown. While most medical cases of vein conditions are covered by insurance, coverage and precertification are not guaranteed; however, we are persistent and make every reasonable effort to secure coverage. Also, you are always responsible for any copays, coinsurances, and/or deductibles, which we are contractually obliged to collect; these vary with the terms of your insurance contract / policy. Please note that precertification establishes and confirms medical appropriateness & confirms that the plan will typically cover the service to the extent of its policy coverage, but does not cover any copays, coinsurance, or deductibles. If coverage is denied, patients are responsible for payment for procedures and consultation / follow up visits.

Of course, you may always contact your insurer directly and work with us in coordinating your benefits !

Also, please feel free to contact our Billing Office Staff at any time during your care, for full information and assistance !

DISCLAIMER: The information offered herein, or by phone or email, is not in any manner a substitute for direct medical care and advice. Medical Associates of New York, Cardiovascular Diagnostics, Cosmetic Vein Solutions, & Sutton Place Laser Vein Care its officers, and its parent & subsidiary corporations do not assume or accept any liability related to any information or content contained within this website, nor within sites linked to this website. Accessing or viewing this website (or phone or email inquiries) do not in any way constitute a physician - patient relationship, does not constitute medical advice to any viewer, and the information contained herein is for general informational purposes only. Although all information was added with great care, errors are possible. All original content contained in this website and appended information, including all forms, is protected by laws regarding service marked and trademarked content. Medical Associates of New York, Cardiovascular Diagnostics, Cosmetic Vein Solutions, & Sutton Place Laser Vein Care are all registered trademarked practice corporate names in New York State. All rights reserved and content copyrighted (C) 2009-2014 by Sutton Place Laser Vein Care & Medical Associates of New York and parent corporations. We are committed to complete compliance with HIPAA and all applicable federal, state, & city healthcare laws.

Insurances we DO participate with / accept (including all subplans unless otherwise indicated): Non-Obamacare subplans of the following plans (the 2 Obamacare plans we do accept are Oscar & Health Republic): AARP, Aetna, Anthem BCBS, APWU, Blue Cross Blue Shield (including all out of state plans), Cigna, Emblem / HIP - all Commercial and Medicare plans, Empire BCBS, Empire Plan (NY State), Federal BCBS, GEHA, GHI (we accept out of network benefits if your plan provides them - we are not in the GHI network), Guardian, Health Republic, Humana, Magnacare, Medicare, Multiplan, Oscar, Oxford, Pomco, United HealthCare (all subplans except Community Medicare). See the section below regarding out of network benefits (accepted for any plan we do not participate with, if you have such benefits).

Insurances we DO NOT participate with / DO NOT accept (this list is not necessarily complete): Unless you have out of network benefits: any Compass plan, any NJ insurance plan, EasyChoice, GHI (we do accept out of network benefits if present), Neighborhood Health Plan, Health Net, Amerigroup, CenterCare, HealthPlus, NY Presbyterian Community Plan, WellCare, Emblem / HIP Community or Medicaid plans, Horizon NJ Blue Cross Blue Shield plans (we do accept out of network benefits if present), BCBS Compass, Medicaid as primary insurance (we accept only as secondary insurance), United HealthCare Community Medicare subplan, Tricare, or Workers Compensation. We do not participate with most Obamacare plans, except for Oscar & Health Republic.

Insurance participation lists are subject to change.

We do accept out of network benefits (if you have them) for any plan that we do not participate in, including GHI, Horizon NJ BCBS, any NJ insurance plan, and any others. For any plan that we do not participate with but accept out of network benefits (if you have such benefits), we will accept the amount your insurance pays us as payment in full and you will not have any extra costs other than any applicable deductible. You will receive a check in the amount of our services from your insurance company; this payment belongs to us & thus must be turned over to us ASAP.

Please note that when we do accept any insurance, it is your full & personal financial responsibility to pay any & all co-pays, coinsurances, and deductibles in a timely fashion without carrying debt with us. Deductibles also apply for out of network benefits. Having insurance coverage does not always equate to free care; these terms are dictated not by us, but by the details of the contract you have with your insurance provider.

When we refer you to another provider or to a hospital, we will give you their relevant contact information. We urge you to inquire and determine if such providers / hospitals participate with your insurance or not (in network or out). You can determine this by asking their office by telephone, by checking their website, or by inquiring online or by phone with your insurance plan.

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"Dr. Mueller is not just 'another' Vein Doctor. He is an internationally trusted opinion leader, speaker / presenter at top national & international conferences, author of numerous publications, and one of approx. 50 physicians in the world elected to Fellowship of the American College of Phlebology. Click here to see Dr. Mueller's Credentials"

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