Is Hip Embolization Covered by Insurance?

Quick Answer

Coverage depends on your plan and is often unlikely. As of October 2026, none of the major national insurers we reviewed has a hip-specific policy, and their policies on the more-studied knee procedure call it experimental, investigational or not medically necessary, so check with your plan and get any prior authorization in writing.

One of the first practical questions people ask about hip embolization is whether insurance will pay for it. There is no single answer, because coverage depends on your specific plan. What we can do is explain how insurers generally view newer procedures like this one, what the major insurers' published policies say as of October 2026, and the steps you can take to get a clear answer before treatment. For background on the procedure, see our hip embolization page.

The short answer

Insurance coverage for hip embolization is uncertain and often unlikely. None of the four large national insurers we reviewed has a written policy that specifically addresses embolization for hip pain. Their policies on the closely related knee procedure, genicular artery embolization, label it experimental, investigational or not medically necessary. Since the hip has been studied even less than the knee, you should expect at least the same level of scrutiny. The only reliable way to know is to check with your own plan before treatment.

Why newer procedures are hard to get covered

Insurers decide coverage using written medical policies. These policies usually ask whether high-quality research, ideally randomized controlled trials, shows that a treatment improves health outcomes compared with standard care. When a treatment does not yet meet that bar, insurers often label it "experimental," "investigational," "unproven" or "not medically necessary." Those labels usually mean the plan will not pay, regardless of how well a treatment works for a given person.

Hip embolization is a good example of the problem. As of October 2026, the published hip studies are small, mostly without comparison groups, and none tested the procedure against a sham treatment. Our research summary explains the evidence in detail.

What major insurers' policies say

Insurer	What its published policy says
Aetna	Clinical Policy Bulletin 0856 (last reviewed January 2026) lists genicular artery embolization for osteoarthritis-related knee pain as experimental, investigational or unproven. We found no policy language specific to the hip.
Cigna	Its eviCore vascular guideline (effective January 2025) lists genicular artery embolization as not medically necessary and states that all other embolization indications not listed in the guideline are not medically necessary. Hip pain is not a listed indication.
Anthem (Elevance)	The Carelon guideline on vascular embolization used for Anthem plans (effective November 2026) states that genicular artery embolization is not medically necessary. We found no hip-specific language.
UnitedHealthcare	We found no policy specific to joint or hip embolization. UnitedHealthcare has announced a new vascular embolization policy, with prior authorization added for an embolization billing code, effective December 1, 2026, for its commercial, Medicare Advantage and most Community Plans.

These policies change, and individual employer plans can have their own rules. Treat this table as background, not as an answer for your plan.

What this means for your hip

Expect an "investigational" label. If an insurer considers the knee procedure, which has much more research, to be investigational, the hip is unlikely to be treated more generously.
A lack of a hip policy is not a yes. When a policy does not mention a procedure, the plan can still deny it, and Cigna's guideline explicitly treats unlisted embolization uses as not medically necessary.
Prior authorization matters. Some plans review embolization procedures before they are done. A denial before treatment is much easier to plan around than a bill afterward.
Established treatments are reviewed differently. Physical therapy, injections and hip replacement are part of guideline-recommended care for hip arthritis, so ask your plan how it covers them as well. Our comparison of hip embolization, hip replacement and injections can help you weigh those options.

Questions about your treatment options? Dr. Fox can help.

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This article is part of our Embolization Guide.

Steps to take before treatment

Get the details from the office. Ask for the procedure and diagnosis codes the practice plans to use so you can ask your insurer about the exact service.
Call your insurer. Ask whether the procedure is covered under your plan, whether it is considered investigational, and whether prior authorization is required.
Ask for the policy. Request the name or number of the medical policy the insurer is applying, so you can read it yourself.
Get decisions in writing. A verbal answer on the phone is not a promise of payment. Ask for a written prior authorization decision or reference number.
Ask about appeals. If a request is denied, your plan must explain how to appeal. Your doctor may be able to submit supporting records.
Understand self-pay. If you decide to proceed without coverage, ask the office for a written estimate that lists what is and is not included, such as imaging and follow-up visits. Also ask how costs would work if you later needed additional imaging, a repeat procedure or treatment for a complication.

Words you may see from your insurer

Experimental, investigational or unproven: the insurer does not think the research yet shows the treatment improves outcomes. Plans usually exclude these services.
Not medically necessary: the insurer has decided the service does not meet its criteria for your condition, even if your doctor recommends it.
Prior authorization: approval you or your doctor must get from the plan before the service. Without it, a claim may be denied even for a covered service.
Medical policy or clinical guideline: the written document the insurer uses to make these decisions. You are allowed to ask which one applies to you.
Explanation of benefits: the statement your plan sends after a claim, showing what it paid and what you may owe. It is not a bill, but it tells you what to expect.

How our office can help

Before treatment, our team can review your insurance benefits, explain what we find, and help with any prior authorization request. We will not be able to promise what your insurer will decide, but we can make sure you have the information you need before you commit to anything. Our general insurance coverage guide covers how we handle benefits for other services.

Questions to ask your insurer

Is transarterial embolization for hip pain covered under my plan?
Is it considered experimental, investigational or not medically necessary?
Is prior authorization required, and how long does a decision take?
If it is not covered, are related services, such as the consultation or imaging, covered?
What is the appeal process if my request is denied?

Keep coverage in perspective

Coverage decisions are about evidence standards, not about whether you personally might benefit. At the same time, the reasons insurers give, mainly the lack of placebo-controlled trials, are the same reasons you should approach hip embolization as an emerging option with uncertain results. For a broader look at how embolization fits across different joints, visit our embolization guide.

Frequently Asked Questions

Does Medicare cover hip embolization?

Medicare and Medicare Advantage plans apply their own coverage rules. Ask your plan directly whether it covers embolization for hip pain, whether prior authorization is needed, and get any decision in writing.

Why do insurers call hip embolization investigational?

Insurers generally want strong evidence, ideally randomized controlled trials, before covering a treatment. Hip embolization has only small studies so far, with no sham-controlled trials.

Can I appeal if my insurer denies hip embolization?

Yes. Your plan must explain its appeal process, and your doctor may be able to provide supporting records. An appeal may or may not change the decision, so plan for either outcome.

Will the office check my benefits before the procedure?

Yes, the office can review your benefits and help with prior authorization before treatment, but only your insurer can make the final coverage decision.

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Sources

Medically reviewed by David Fox, MD, FACS, RPVI. This article is general information, not a substitute for a medical evaluation.

Living with joint or tendon pain that hasn’t improved? Schedule a consultation with Dr. David Fox at Fox Vein & Vascular in Manhattan to find out whether embolization is right for you. Call (212) 362-3470 or request an appointment online.