Medicare coverage for dermatology is a necessity for many adults. However, depending on the policy you have, coverage can vary.
Dermatology primarily deals with the skin. But did you know dermatology also deals with conditions affecting nails, hair, fat, membranes and the various diseases affecting those areas?
The skin is the largest organ in the human body and acts as a barricade against bacteria and injury. Unfortunately, regardless of age, anyone from infants to the elderly will develop some type of skin disease.
The purpose of a dermatologist is to study, research, diagnose and then treat any condition utilizing medical or surgical procedures. These procedures work as either treatment options or as a preventative measure depending on the nature of the condition.
Another aspect of dermatology is cosmetic. Some of the cosmetic conditions often performed at a dermatologist’s office include:
- Botox injections
- Correction of skin flaws including regular scarring, acne scars, and wrinkles
- Cellulite reduction
- Laser tattoo removal
- Sclerotherapy to help diminish the appearance of spider and superficial varicose veins
- Chemical peels and laser skin resurfacing for the treatment of hyperpigmentation (sun & age spots)
- Fillers and injectables
- Hair restoration for those suffering from balding or thinning hair
- Laser hair removal
- The above conditions are just to name a few. Keep in mind that cosmetic dermatology isn’t medically necessary and therefore no insurance, including Medicare, will cover such treatments.
Whether seeking a dermatologist for a medical condition or for cosmetic purposes, it’s clear to see that a variety of conditions can be treated. Dermatology is of many benefits to many individuals.
Medicare Coverage for Dermatology
If your condition is deemed medically necessary from a healthcare provider, then your Medicare Part B benefits will generally pick up coverage.
Medicare Part B coverage includes services rendered by your physician for doctor’s office visits, medical procedures, lab tests, and diagnostic studies. It also covers some medical supplies that are considered medically necessary for the treatment of your medical condition.
If your dermatologist is a Medicare-approved provider, you may seek treatment through them. Once you have met your Medicare Part B deductible, then you become eligible for dermatology coverage.
To reiterate, once that provider determines the condition/treatment is medically necessary, then your treatment has coverage at 80% of the Medicare allowable. The 20% leftover from the Medicare amount will be left for the Medicare beneficiary.
Keep in mind, cosmetic dermatology is not covered under Traditional Medicare. If you’re wanting sun spots removed, wrinkles reduced, skin tag(s) removed, or a spider vein reduced in appearance, these are considered cosmetic.
There are, however, some exceptions to the rule with certain conditions.
For instance, if a skin tag has an infection or is blocking vision/nasal function, if a varicose vein becomes extremely painful, or if a scar revision is necessary after a traumatic injury or to improve function; then these may are medically necessary. You may then undergo medical treatment or surgical procedures in which case Medicare could pick up the cost.
Dermatology Procedures Medicare Covers
There are common skin disorders in which treatment is medically necessary under the Medicare guidelines.
Those conditions include but are not limited to:
- Fungal/skin infections
- Skin cancer
- Herpes Simplex Virus
- Shingles virus
The above conditions are just to name a few. For a complete list of coverage, you would want to talk with your healthcare provider.
Regarding the treatment of dermatological conditions Medicare covers, some common screenings/procedures include:
- Skin cancer screenings
- Cryosurgery/curettage/excision/photodynamic therapy for Actinic Keratoses
- Sexually Transmitted Infections (STI) screening and counseling
- Skin cancer biopsy/excisions
- Some forms of acne treatment
- Contact dermatitis treatments including allergy skin testing
- Mohs surgery
- Mole traditional/laser removal for further evaluation
Although, the above are just a few treatment options for your dermatological condition. Regarding which is the best course of action, you will want to discuss all treatment options with your dermatologist prior to making your decision.
How to Get Help with Dermatology Costs
Regardless of which dermatological condition you’re treating, Medicare only covers 80%. That remaining 20% left for the beneficiary can easily add up.
Depending on your course of treatment, depends on how much your out of pocket (OOP) costs will be. Keep in mind if you’re having a biopsy or surgical procedure that 20% can quickly add up.
Also, most seniors tend to rely on SSDI and are on a fixed income, every penny counts. A Medicare Supplement Plan can help save you money with those unwanted medical expenses not covered by your Traditional Medicare benefits.
Depending on what you require for your healthcare needs, specific supplement plans can work alongside your Medicare benefits for added insurance coverage.
Contact us today by calling our 800 number or filling out the online form. Our licensed insurance agents are trained to answer any Medicare beneficiary questions and can help find you the perfect Medicare Supplement Plan to fit your healthcare requirements.
There is never any obligation to purchase a plan so contact us today for more information!