Does medical aid cover varicose vein treatment?

What does varicose vein treatment cost?

The cost of radiofrequency ablation depends on whether one leg or both legs are treated, and on the number of veins treated. Your exact amount, and what your scheme is expected to pay, is set out in your written estimate after your consultation and scan. If you have gap cover, it will often pay the shortfall on radiofrequency ablation, depending on your plan. Your first follow-up visit after the procedure is included in the procedure cost.

Fees as at October 2026, and the same at all three centres. Fees are reviewed each year.

How medical scheme funding works

Funding for vein treatment depends on your medical scheme, your benefit option, the clinical indication for treatment, the specific procedure performed, and your scheme's authorisation requirements. Because these vary from patient to patient and change from year to year, we do not publish scheme-by-scheme cover on this page.

We treat members of all the major South African medical schemes, including Discovery Health, Bonitas, GEMS, Momentum Health, Medshield and Bestmed. Cover differs between schemes and between options on the same scheme.

Is varicose vein treatment a prescribed minimum benefit (PMB)?

No. All vein treatments fall outside the prescribed minimum benefits (PMBs). Your scheme pays according to the rules of your benefit option.

I joined my medical scheme recently. Can I still claim?

If you joined your medical scheme recently, it may apply a waiting period before it pays for existing conditions. Check with your scheme before booking a procedure.

Our team will assist with benefit verification and pre-authorisation where applicable. A written estimate is supplied after your consultation and duplex assessment, once we know which treatment you actually require.

What happens, step by step

1. Consultation and duplex scan. Your veins are examined and scanned, and a treatment plan is agreed.
2. Written estimate. You receive the procedure codes and amounts for your planned treatment.
3. Pre-authorisation. Where your scheme requires it, our team submits the authorisation request on your behalf. It usually takes one to two days.
4. Treatment day. Any estimated shortfall is paid on the day, and the balance of the account is submitted to your scheme.
5. Reconciliation. When your scheme pays, your account is reconciled and any overpayment is refunded to you.

How long does pre-authorisation take?

Pre-authorisation usually takes one to two days. Our office can assist you with the application and any follow-up with your scheme.

Medically indicated or cosmetic?

Medically indicated treatment addresses underlying venous reflux demonstrated on a duplex ultrasound scan, and the symptoms and complications that follow from it. Reflux means the valves inside a vein have failed, so blood flows back down the leg. It causes aching, heaviness, swelling, night cramps, skin changes around the ankle and, eventually, venous leg ulcers. Procedures in this category, such as radiofrequency ablation, are generally considered for funding by medical schemes, subject to your option and authorisation.

Cosmetic treatment addresses the appearance of veins where there is no underlying reflux requiring treatment.

Some treatments, such as foam sclerotherapy, may be medically indicated in one patient and cosmetic in another. Which applies to you can only be determined after examination and a duplex scan.

Is spider vein treatment covered by medical aid?

Usually not. Spider veins without underlying reflux are treated for appearance, and cosmetic sclerotherapy is not funded by medical schemes. It is payable by the patient, per session. Micro-sclerotherapy for spider veins costs R2,400 per session.

Is the consultation and duplex scan covered?

Your first consultation costs R2,200 and includes the duplex ultrasound scan. All patients pay for the consultation on the day, by EFT, credit card or cash, and then claim it back from their medical aid's day-to-day benefits.

The scan is what tells you, us and your scheme whether treatment is medically indicated. It maps the blood flow in each vein and shows which veins are refluxing, where the reflux starts and how far it extends.

Does it matter whether treatment is done in rooms or in hospital?

Yes. Schemes generally cover vein treatment done in the doctor's rooms. Some schemes limit cover when the same procedure is done in hospital.

Our treatments are done under local anaesthetic in the procedure rooms at our centres in Fourways, Umhlanga and Somerset West. No hospital admission is needed, and you walk out after the procedure.

Can I claim if I only have a hospital plan?

Yes. Endovenous radiofrequency ablation is paid from your hospital benefit, even when it is done in our rooms.

Why can't you give me procedure codes before I'm seen?

We are often asked for procedure codes or costs before a consultation. We offer several different vein treatments, and it is not possible to know which one you need without examining you, taking a medical history and performing a duplex scan. Quoting codes in advance risks giving you figures for a procedure you do not require, and your scheme's answer would then be wrong too.

After your consultation and duplex assessment we provide a written estimate listing the relevant procedure codes and amounts. Where your scheme requires it, we submit the pre-authorisation request on your behalf. Any estimated shortfall is payable on the day of your procedure, and the balance of the account is submitted to your scheme.

Where no authorisation has been obtained beforehand, payment in full is required on the day and you may then claim from your scheme. If you are not on a medical scheme, we will provide you with a detailed written quotation.

What is a shortfall?

A shortfall, or co-payment, is the difference between what the practice charges and what your scheme pays. Schemes pay at their own rates, and these differ between schemes and between options on the same scheme. The shortfall is shown on your written estimate, so you know it before you commit.

Will my gap cover pay the shortfall?

Often, yes. For endovenous radiofrequency ablation, gap cover will often pay the shortfall, depending on your plan. Send your written estimate to your gap cover provider to confirm before your procedure.

Questions to ask your medical scheme

Once you have your written estimate, call your scheme with the procedure codes and ask:

• Is this procedure covered on my option, and does it need pre-authorisation?
• Which benefit does it come from: hospital benefit, day-to-day benefit or savings?
• At what rate do you pay, and will there be a co-payment?
• Do you need any extra information, such as the scan report?

Write down the name of the person you spoke to and a reference number.

Scheme and option enquiry

If you would like us to look into your cover before booking, send us your medical scheme and benefit option and our team will come back to you. Please note that any indication given before consultation is general guidance only, not a quotation.

Frequently asked questions

How much does varicose vein treatment cost?

Endovenous radiofrequency ablation costs R31,500 to R60,000, depending on whether one leg or both legs are treated and on the number of veins treated. Most medical schemes cover part or all of this, and gap cover will often pay the shortfall, depending on your plan. Your first follow-up visit is included. Your exact amount is set out in a written estimate after your first consultation, which costs R2,200 including the duplex scan.

Do I have to try compression stockings before my medical aid will pay?

No. South African medical schemes do not require a trial of compression stockings before they approve varicose vein treatment.

My varicose veins don't hurt. Will my medical aid still pay?

Schemes look at whether reflux is present and causing problems, not only at pain. Heaviness, swelling, night cramps and skin changes around the ankle are also symptoms. Your consultation and scan will show where you stand.

What if I am not on a medical aid?

You receive a detailed written quotation after your consultation and duplex scan, before any treatment is done.

Payment options

We accept cash, credit card (Visa and Mastercard) and electronic funds transfer. Banking details for EFT are provided once you are registered as a patient in the practice.

Once payment is received from your medical scheme, your account is reconciled. Any overpayment is refunded to you.

International patients

Treatment is payable in full on the day of your procedure. You will be given a detailed statement with itemised billing for submission to your own insurer. Whether your insurer reimburses you is a matter between you and them, and depends on your policy.

Patient responsibility

Your agreement is with your medical scheme, and our practice is not party to that agreement. We render an account to you as our patient, and payment of that account remains your responsibility in full, regardless of what your scheme ultimately pays.

We will always provide transparent pricing in writing before treatment so that there are no surprises. If a shortfall arises, or if your scheme declines or partially funds a claim, the outstanding balance remains payable by you.

The information on this page is general and does not constitute a quotation or a guarantee of funding.

Video interview: is radiofrequency ablation covered by medical schemes?

In this short interview (58 seconds), Dr Johan Blignaut explains whether radiofrequency ablation for varicose veins is covered by South African medical schemes. It covers the same points as this page.

Watch on YouTube: Is Radio Frequency Ablation for Veins covered by Medical Schemes?