Medicare coverage for dermatology services is widely available. However, coverage may vary depending on the policy.
For many adults, dermatology services are necessary. Services extend past the skin to the hair, nails, and membranes – and the ailments that may affect those areas.
The skin is the body’s barrier system and the largest organ. As we age, we want to ensure we have proper coverage.
Dermatologists often offer a range of services such as skin cancer screenings, acne, and laser hair removal.
Does Medicare Cover Dermatology
Medicare doesn’t pay for routine dermatology care unless it’s medically necessary. Part B may pay for dermatology care for evaluating, treating, or diagnosing a specific medical condition.
The Cost of a Dermatologist
If Medicare Part B is paying for medically necessary dermatology treatment, the beneficiary is responsible for any allowable out-of-pocket costs.
Expenses such as coinsurance, copayments, and deductibles.
For 2020, this may include the Part B deductible ($198). Also, the Part B coinsurance is 20% of the cost after the deductible.
Finding a Medicare Dermatologist
Dermatologists study, diagnose, research, and treat any disorders relating to the skin, nails, hair, and neighboring mucous membranes.
Specialists also manage cosmetic conditions such as scarring, loss of hair, and changes to the skin due to aging. Finding a Medicare dermatologist within a service area is easy with the “physician compare” tool.
Plugin the city and state plus the keyword “dermatology.” Search results should show specialists within a 15-mile radius.
Although doctors often have a list of specialists they recommend.
Medicare Coverage for Skin Cancer Screenings
Dermatologists often use services to screen patients to treat or diagnose a condition. If a doctor performs a skin cancer screening, Part B may cover some of the costs.
However, coverage is only available for necessary services. For example, if a patient shows no signs of skin cancer – Part B won’t cover the costs of screening.
A mole with an unusual color or a new skin growth may be the reason for Part B screenings.
Doctors often refer patients to a dermatologist for more extensive testing of potentially cancerous skin growth. In this case, Part B may cover the referral visit costs.
What Dermatology Services Does Medicare Cover
Before getting treatment, patients should talk with a doctor to ensure coverage of services and confirm cost.
Cosmetic services such as botox treatments to remove wrinkles is not part of Medicare’s covered dermatology services.
Many common skin disorders require treatment.
The following conditions usually require treatment, including but not limited to:
- Skin Cancer
- Herpes Simplex Virus
- Fungal/skin infections
- Shingles virus
Recipients may want to discuss with doctors to get a complete list of coverage.
Standard screenings include:
- Sexually Transmitted Infections (STI) screening and counseling
- Some forms of acne treatment
- Skin cancer biopsy/excisions
- Mohs surgery
- Contact dermatitis treatments including allergy skin testing
While these are just a few of the many treatment options for dermatological conditions. Patients should discuss all treatment options with their dermatologist.
Does Medicare Cover Laser Hair Removal
Medicare doesn’t cover cosmetic dermatology services, such as laser hair removal. These services are not necessary to treat or diagnose a condition.
Cosmetic procedures are services that enhance the appearance of the individual undergoing treatment. Therefore, the patient must pay the entire cost.
Does Medicare Cover Mole Removal
According to the Skin Cancer Foundation, each year in the U.S. – more people get a skin cancer diagnosis than all other cancers put together.
Dermatologists have the proper training to treat and diagnose skin cancer, moles, and other tumors found on the skin. Specialists may remove a mole, whether it’s cancerous or for appearance reasons.
Medicare covers mole removal for patients with cancerous moles or growths. Any outpatient checkups or procedures fall under Part B coverage.
Does Medicare Cover Dermatology for Acne
Treating conditions like acne, rosacea, and wrinkles may help improve the quality of the skin. Medicare covers dermatology screenings to ensure the skin remains healthy.
Preventative services may include allergy testing, STD/STI screenings, and some acne treatment. Coverage may be available for these services when necessary to treat a condition.
Does Medicare Cover a Full Body Skin Exam
Medicare doesn’t cover routine, full-body skin exams. Medicare covers examinations given in direct relationship to treating or diagnosing a specific illness, complain, symptom, or injury.
Screening procedures are for asymptomatic conditions; however, Medicare doesn’t pay for these.
Although, Medicare pays for skin exams following a biopsy because it’s not a routine service.
Part D for Dermatology Prescriptions
Certain drugs are not part of Part D coverage by law. Part D for dermatology doesn’t include the cost of meds for hair growth or cosmetic reasons.
Many dermatology meds treat skin conditions such as acne, rosacea, psoriasis, or eczema. Part D covers the cost of these drugs because they’re for treatment.
How Medicare Advantage Works With Dermatology
Private insurance companies working with Medicare offer alternative options for coverage, such as Medicare Advantage plans.
Beneficiaries may find Medicare Advantage plans appealing because many offer extra benefits. Depending on the plan, extra benefits range from dermatology coverage to dental, vision, hearing, and more.
Individual Medicare Advantage plans include Part D, while others include wellness program coverage.
Benefits and costs may vary among plans and companies.
Medicare Supplement Coverage for Dermatology
Finding the right Medicare coverage for your dermatology services may seem difficult.
Each course of treatment will determine the out-of-pocket costs. 20% of a surgical procedure can be an expensive bill due to the total cost of these services.
The excellent news is enrolling in a Medicare Supplement Plan can help you save on out of pocket costs! Also, Medigap plans may cover the costs of coinsurance and copayments.
Our team can help you find the right plan for your healthcare needs. Call us today at the number listed or fill out an online form to get your free quote today.
There’s never any obligation to buy a plan when calling our agents. We will answer your questions and compare rates at no cost to you.