Does Medicare Cover Dermatology?
Key Takeaways
When it comes to your coverage from Part A and Part B , routine and elective dermatology services are limited. Unless your care is medically necessary, typically, Part A and Part B won’t cover dermatology.
Original Medicare doesn’t cover an annual skin check, but it will cover an evaluation and/or testing if you or your physician discover something that needs further evaluation.
If you’re diagnosed with skin cancer, Part A and Part B will cover your treatments.
Cosmetic and preventive dermatology services typically are not covered by Original Medicare, but medically necessary services usually are covered by Part B of Original Medicare.
Medicare Advantage offers the same coverages as Part B, and some Medicare Advantage plans may also include more routine visits to a dermatologist.
What Dermatology Procedures are Covered by Medicare?
Skin cancer is the most common form of cancer in the United States. If you have been diagnosed with skin cancer, Original Medicare (Parts A and B) or Medicare Advantage (Part C) will cover treatments.
For example, Part A — known as hospital insurance — will cover inpatient surgeries or treatments related to skin cancer. Part B — known as medical insurance — will cover outpatient procedures (which is more commonly the case with skin cancer).
Medicare Advantage replaces Original Medicare and provides the same coverages as Parts A and B. Some Medicare Advantage plans will also offer dermatology coverage that goes beyond Parts A and B coverage.
Does Medicare cover dermatology skin check?
Original Medicare doesn’t cover an annual skin check, but it will cover an evaluation and/or testing if you or your physician discover something that needs further evaluation.
Medicare does not cover screening for skin cancer in asymptomatic people. It does, however, cover a physician visit initiated by a concerned patient who has noticed, for example, a change in the color of a mole or a new skin growth.”
Looking for a dermatologist that accepts Medicare? Medicare.gov provides a search tool for finding a Medicare-approved dermatologist that can address your concern.
You also may be wondering, “Does Medicaid cover dermatology?” Generally speaking, Medicaid covers dermatology much like Medicare does, although each state has its own plan for administering Medicaid.
Does Medicare Require a Referral to See a Dermatologist?
If you have Original Medicare Part B, you don’t need a referral to see a dermatologist. You may need a referral on specific Medicare Advantage plans, but some Medicare Advantage plans may cover routine annual skin checks as a preventive service.
Will Medicare Pay for a Dermatologist?
Medicare pays for an approved dermatology-related procedure the same as other services.
If Part B covers the service, Medicare will pay 80% of the cost after meeting your annual deductible. In the less common scenario where Part A covers the service, Medicare won’t require that you pay coinsurance for up to 60 days as an inpatient after paying your Part A deductible for the benefit period.
Part A, Part B, or a Part D prescription plan based on the treatment’s details will cover drugs related to treatment.
Does Medicare Advantage Cover Dermatology?
Medicare Advantage will at least cover any dermatology services covered by Part A and B. Medicare Advantage will pay based on the specifics outlined by the particular plan.
If you are interested in learning more about switching to a Medicare Advantage plan from Original Medicare, a GoHealth licensed insurance agent is a phone call away and may be able to find a Medicare Advantage plan that provides additional coverage for dermatology,
