A dermatologist can diagnose and treat skin cancers, melanomas, and other skin tumors. And that’s important because more people are diagnosed with skin cancer each year in the U.S. than all other cancers combined.
Dermatologists can also manage cosmetic disorders of the skin. This includes hair loss, scars, and skin changes associated with aging. But does Medicare cover these treatments?
Key Takeaways
- A dermatologist is a health care professional with a focus on treating skin conditions.
- Dermatological treatments can also extend to hair and nail conditions.
- Medicare Part B covers most medically necessary dermatological treatments.
- If you desire treatment for a cosmetic skin condition, such as a mole or birthmark, Medicare does not cover it.
- Medicare Advantage plans will cover skin treatments that are also covered by Original Medicare (Part A and Part B), although out-of-pocket costs may differ.
- Medigap policies cannot help with cosmetic skin treatments but will help with Medicare-approved treatments.
What Is A Dermatologist?
A dermatologist is a doctor that specializes in diagnosing and treating conditions related to a person’s skin, hair, and nails1Mayoclinic.org, “Dermatology: Overview“, Accessed December 8, 2021. Dermatology covers a wide range of services and treatments, including:2Mayoclinic.org, “Dermatology: Tests & Procedures“, Accessed December 8, 2021
- Allergy education
- Allergy skin tests
- Botox injections
- Chemical peel
- Conscious sedation
- Cosmetic surgery
- Dermabrasion
- Dermal (soft tissue) fillers
- Dermatologic surgery
- Face-lift
- Facial fillers for wrinkles
- Laser hair removal
- Laser resurfacing
- Laser surgery
- Light therapy for skin
- Mohs surgery
- Mole removal
- Platelet-rich plasma injections
- Scar revision
- Sclerotherapy
- Skin cyst removal
- Tattoo removal
- UV light therapy
How Does Medicare Cover Dermatology?
Medicare Part B generally covers doctor visits when medically necessary to diagnose and treat a skin condition. For most doctor visits, you pay 20% of the Medicare-approved amount for the cost of the visit if the doctor accepts Medicare assignment.3Medicare.gov, “Diagnostic laboratory tests“, Accessed December 8, 20214Medicare.gov, “Doctor & other health care provider services“, Accessed December 8, 2021
However, Medicare only offers limited coverage of cosmetic procedures. If you are seeing a dermatologist for the treatment of wrinkles or hair loss, for instance, you may not be covered.5Medicare.gov, “Cosmetic surgery“, Accessed December 8, 2021
For example, if you want a mole surgically removed because it is unsightly, it is considered cosmetic and you will have to pay the full price5Medicare.gov, “Cosmetic surgery“, Accessed December 8, 2021. However, if the mole is a symptom of a deeper health condition, it is medically necessary and Medicare will provide coverage for the surgery6Medicare.gov, “Surgery“, Accessed December 8, 2021.
Do Medicare Advantage Plans Cover Dermatology?
Your Medicare Advantage plans will provide coverage for any services covered by Original Medicare (Part A and Part B ). This means that your medically necessary skin treatments are covered by Medicare Advantage, but unnecessary cosmetic surgeries are not covered. For covered skin treatments, your out-of-pocket costs with a Medicare Advantage plan may differ compared to Original Medicare. 7Medicare.gov, “How do Medicare Advantage Plans work?“, Accessed December 8, 2021
Summary
Unfortunately, if you wanted Medicare to cover the removal of skin blemishes because it is visually displeasing, you will have to pay the full costs. However, if you are living with a skin condition that requires medically necessary services to treat it, Medicare will pay its share. If you are concerned with an unusual and sudden mark on your skin, consult with your doctor for a dermatologist referral.
Citations
- 1Mayoclinic.org, “Dermatology: Overview“, Accessed December 8, 2021
- 2Mayoclinic.org, “Dermatology: Tests & Procedures“, Accessed December 8, 2021
- 3Medicare.gov, “Diagnostic laboratory tests“, Accessed December 8, 2021
- 4Medicare.gov, “Doctor & other health care provider services“, Accessed December 8, 2021
- 5Medicare.gov, “Cosmetic surgery“, Accessed December 8, 2021
- 6Medicare.gov, “Surgery“, Accessed December 8, 2021
- 7Medicare.gov, “How do Medicare Advantage Plans work?“, Accessed December 8, 2021