Medicare coverage for dermatology services is widely available. However, coverage may vary depending on your Medicare policy. Original Medicare does not pay for routine dermatology care unless medically necessary.
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Medicare Part B may pay for dermatology care for evaluating, treating, or diagnosing a specific medical condition. This article reviews standard dermatology services and how Original Medicare covers them.
What Dermatology Services Does Medicare Cover?
Before getting treatment, patients should find a dermatologist in their area who accepts Medicare. Doing so will ensure coverage of services and confirm costs.
Cosmetic services such as Botox treatments to remove wrinkles are not part of the dermatology services Medicare covers. Per Medicare’s guidelines, Botox can receive coverage when treating severe migraines and may require prior authorization for treatment of other conditions.
Medicare covers dermatology services that are preventive or medically necessary. Below, we explain whether Medicare covers a variety of dermatological conditions. Patients should discuss all treatment options with their dermatologist.
Does Medicare Cover Skin Cancer Screenings?
Dermatologists often screen patients to treat or diagnose a condition. If a doctor performs a skin cancer screening, Medicare Part B may cover some costs.
However, coverage is only available for necessary services. For example, if a patient shows no signs of skin cancer, Medicare Part B will not cover screening costs.
A mole with an unusual color or a new skin growth may be the reason for skin cancer screenings that Medicare Part B will cover. Doctors often refer patients to a local dermatologist who accepts Medicare for more extensive testing of potentially cancerous skin growth. In this case, Medicare Part B may cover the referral visit costs.
Does Medicare Cover Dermatology for Hair Removal?
Original Medicare does not cover cosmetic dermatology services like laser hair removal. These services are not necessary to treat or diagnose a condition.
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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 combined. 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 is cancerous or for appearance-related reasons.
Original Medicare covers mole removal for patients with cancerous moles or growths. Any outpatient checkups or procedures fall under Medicare Part B coverage.
Medicare, Dermatology, and Allergy Tests
Original Medicare will cover allergy testing given to treat a specific allergen. Allergy tests that involve pricking, scratching, or puncturing the skin, also known as percutaneous tests, are an example of an allergy test that Medicare will cover.
Does Medicare Cover Skin Tag Removal?
If the skin tag removal is considered medically necessary, Original Medicare will cover it. Original Medicare will also reimburse you for wart removal and seborrheic keratosis removal if they are causing you pain or are continuously bleeding.
Does Medicare Cover a Full Body Skin Exam?
Original Medicare does not cover routine, full-body skin exams. Original Medicare covers examinations directly relating to the treatment or diagnosis of a specific illness, complaint, symptom, or injury.
Screening procedures are for asymptomatic conditions, which Original Medicare does not cover. However, Medicare pays for skin exams following a biopsy because it is not a routine service.
If you are experiencing symptoms of rosacea or psoriasis, Medicare will cover the cost of treatments such as biologics. They will also cover any available treatments with FDA approval.
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Medicare and Dermatology FAQs
How To Find Dermatologists Near Me That Accept Medicare
Finding a dermatologist that accepts Medicare within your service area is easy. Using Medicare’s physician compare tool, enter your city and state plus the keyword dermatology.
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Sources:
MedicareFAQ is dedicated to providing you with authentic and trustworthy Medicare information. We have strict sourcing guidelines and work diligently to serve our readers with accurate and up-to-date content.
- Cosmetic Surgery, Medicare. Accessed June 2022.
https://www.medicare.gov/coverage/cosmetic-surgery - What is Medicare Part B, Medicare. Accessed June 2022.
https://www.medicare.gov/what-medicare-covers/what-part-b-covers
My husband’s back is covered with moles and growths that we would like checked out as his Mother died from cancer that started with skin cancer. He has already had a growth removed from his head a few yrs ago. (before we were on Medicare) Will this check up be covered by Medicare?
i have severe pigmentation in my underarms and between my thighs. does Medicare cover me visiting the dermatologist for treatments? I’ve tried everything.
Hello, if this is a cosmetic issue, Medicare will likely not cover the visits. However, if there is an underlying medical condition and treatment is deemed medically necessary, Medicare may cover the costs.
I am 75 yrs old and have a problem with my facial skin peeling.I have tried moisturizers and Hydrocortisone 1% and nothing stops the peeling.Does Medicare cover a dermatologist appt.
Madra, Medicare typically will not cover dermatology visits for a cosmetic issue. I recommend speaking with your doctor about at home treatment options. If there is a bigger underlying issue, it could become a medically necessary appointment.
Hello, I was recently diagnosed with rheumatoid arthritis and am on a cocktail of meds including methotrexate. I am losing a lot of hair from my body and scalp and now I am losing my eyelashes. My rheumatologist is referring me to a dermatologist to see if a prescription for Lattise would help to retain, possibly grow, lashes. Will Medicare cover the dermatologis appointment?
Medicare will cover dermatology visits when it is deemed medically necessary. With hair growth, this is typically considered cosmetic. So, I would check with the doctor prior to your appointment about Medicare coverage for your appointment.
Will Medicare pay for the removal of dark spots on my face?
Hi Marcia – for Medicare to pay, the removal must be medically necessary – such as with precancerous spots. If the removal is only for cosmetic reasons, Medicare will not pay.
My boyfriend had a massive and painful bout of cystic acne that left him extremely full face scarred. He needs laser resurfacing but we dont know if his medicaid will cover it. Its reconstructive technically. Will they at least help with cost?
Hi Carrie! Medicaid & Medicare are not the same. We are a Medicare resource center. I would reach out to your local Medicaid office since each state has its own guidelines to determine if they will cover it.
Will medicare cover pimples?
Hi Clarence! Unless found medically necessary, Medicare will not cover pimples.
I have skin tags on my whole neck, they are getting bigger. They have multiplied & grown larger over the years. My neck is always irritated. Dies Medicare part B civer having them removed.
Hi Regina! If your doctor determines the skin tag removal procedure is medically necessary, then Medicare will cover it. If it’s only cosmetic, then Medicare will not cover it.
Do annual dermatology screenings have to be one year apart for coverage under Medicare?
Hi Lynette! Yes, annual screenings are covered once per 12-month period.
Does Medicare cover a painfull lump on my neck. They said I should have it removed. The nurse said it looks like a limp node but there not sure until they take it out.
Hi Susan! As long as your doctor finds its medically necessary, Medicare will cover it. How much is covered depends on what Medicare Parts and supplement plans you’re enrolled in. If you only have Part B, with no supplemental coverage, you’ll be responsible for the deductible and the 20% coinsurance.
At age 68 I am developing rhinophyma and spider veins as my facial skin becomes increasingly oily. I also have several spots of sebaceous hyperplasia. Are these conditions covered by Medicare?
Hi Barbara! Thank you so much for your question. As long as your doctor finds it medically necessary to treat the above, then Medicare will cover it. Your best option is to ask your doctor if he thinks it’s medically necessary. I hope this helps!
I have a strange spot growing on my chest that I would like to go to the dermatologist for body screening. Will this body scan be 80 percent covered if I am going on a gut feeling something doesn’t look right?
Hi Sandra! Yes, your screening should be covered by Medicare. However, I would consult with your doctor first to confirm this since it depends on what code they put in when billing Medicare. If you have a Medigap plan, the remaining 20% will also be covered.