The coverage of vein procedures by insurance companies or Medicare depends largely on whether or not the treatment is considered medically necessary. Procedures to remove superficial spider veins are typically viewed as cosmetic and thus are rarely reimbursed. Unwanted hand veins are almost never covered. Even treatment of larger varicose veins may be questioned if the carrier or agency feels the motivation for the procedure was mainly cosmetic. Sometimes, it may be necessary to submit a letter from the doctor or get a second opinion in order to obtain pre-authorization. In any case, you should consult your insurance company or a Medicare representative in advance to verify coverage. Have the person provide the coverage quote in writing for future reference. When varicose veins cause problems severe enough to interrupt work or normal activities, treatment is usually covered by insurance and Medicare. This may include such conditions as leg ulcers; the inflamed, clotted veins known as thrombophlebitis (Thrawm-boh-fluh-BYE-tihs); and the skin inflammation stasis dermatitis (STAY-sihs der-muh-TYE-tihs), caused by a lack of blood flow.