Physicians/Specialists
Facilities/Hospitals
Ancillary
Publication Date: 
2020-06-03

Starting July 1, 2020, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will no longer require prior plan approval for the treatment of varicose veins for medically-appropriate indications.

Key Points:

  • Prior plan approval is no longer required for endovenous procedures and sclerotherapy for the treatment of varicose veins to improve or restore bodily function.
  • This applies to all commercial members, except:
    • State Health Plan members
    • Members of the following self-funded groups:
      • Reynolds
      • US Radiology
  • Benefit limits (outlined in members' handbooks) remain, as follows:
    • Endovenous procedures - 1 per limb, per lifetime/while insured with Blue Cross NC
    • Sclerotherapy treatments - 3 procedures per limb, per lifetime/while insured with Blue Cross NC
  • Claim submissions including more than the allowed standard benefit will be denied.
  • Coverage is not provided for some cosmetic services.