Does Medicare cover dermatology?
Your skin is your body’s largest organ, and checking in on skin health is important—especially as you age. Aging skin is more prone to thinning, injury, and developing medical conditions. By paying attention to your skin, you can detect and prevent problems like skin cancer and rashes early on.
While Medicare makes it easy to take care of your skin if you develop a specific condition, coverage is limited if you don’t show symptoms of an underlying condition. Medicare insurance generally only covers dermatology visits when it's medically necessary.
Key takeaways:
Medicare covers dermatology visits if they’re considered medically necessary. This includes services like skin grafting surgery, allergy skin tests, and treatment for common skin problems such as psoriasis.
Medicare doesn’t help pay for procedures that are purely cosmetic like Botox injections for wrinkles or hair loss treatments.
What is dermatology?
Dermatology is a branch of medicine that focuses on your skin, hair, and nails. Dermatologists can diagnose and treat people with issues like psoriasis, acne, eczema, skin cancer, hair loss, rosacea, warts, and more. While dermatologists offer advice about more serious medical issues, they can also recommend cosmetic products and procedures to help with things like wrinkles and acne.
What does Medicare cover for dermatology?
If it’s medically necessary, Medicare will cover any dermatological service that you need to treat, diagnose, or prevent a condition. Once you reach your Part B deductible, you’ll pay 20% of any out-of-pocket expenses for covered services. A Medigap plan can help pay for some of the leftover 20%.
Medicare Advantage plans have the same coverage as Original Medicare, but your out-of-pocket costs can vary between plans and the service you get. Check your summary of benefits or contact your insurance provider to determine which dermatology services your plan covers and how much you’d have to pay for coinsurance or copays.
Below, we explain some of the specific services and conditions that Medicare covers when medically necessary.
Allergy testing
Medicare covers allergy skin testing for substances that can cause allergic reactions.
Skin grafting
If you need skin grafting to reshape or recover from a burn, infection, or injury, Medicare can help pay for the cost of the surgery. The insurance also covers skin grafting procedures for breast reconstruction surgery following a mastectomy due to breast cancer.
Skin injuries
Aging skin is more prone to damage and injury. If your skin is burned, torn, or scabbed, Medicare will pay for procedures or ointments to help it recover.
Potentially cancerous mole, growth, or lesion removal
Medicare has comprehensive coverage for cancer treatment, including mole, growth, or lesion removal from your skin.
Psoriasis, Eczema, and Rosacea
Medicare covers dermatology visits and treatment for dermatitis, which includes psoriasis and eczema. Medicare also covers treatment for rosacea, another common skin condition that results in redness in your face.
Skin tags or wart removal if painful or bleeding
While Medicare will not cover the removal of skin tags, warts, or moles for cosmetic reasons, it will pay for procedures to remove skin growths if they are painful, bleeding, or require medical attention.
There are some cases in which you may need to undergo a common cosmetic procedure to treat a medically necessary health issue. In these situations, Medicare will cover the dermatological service. Some examples include:
Blepharoplasty: This is a surgery that improves the appearance of your eyelids by removing excess skin, fat, or muscle.
Botox injections: Botox, while also used to reduce wrinkles, can relax muscle tension if you have back or shoulder problems.
Panniculectomy: This is a surgical procedure to remove extra skin and fat from your lower abdomen to improve mobility and hygiene.
Rhinoplasty: This surgery reshapes or enhances the appearance of the nose, which can be necessary after an injury.
Vein ablation: This treats varicose veins by closing or sealing them, which improves blood flow and reduces pain and swelling.
You’ll almost always need prior authorization before getting any of these procedures covered by Medicare. Once Medicare approves the request, you’ll only have to pay your deductible and coinsurance.
Does Medicare cover dermatology skin cancer screenings?
When it comes to preventative screenings, Medicare has limited coverage. Medicare will only cover screenings to detect skin cancer if you show signs of cancerous skin growths or moles. It will not cover screenings if you don’t show symptoms of skin cancer, or if you want the test for other reasons.
If you get a skin cancer screening, you’ll pay your Part B deductible and then 20% remaining costs for any doctor’s visit, skin biopsy, or other test for skin cancer. This 20% is your coinsurance, which can be reduced if you have a Medigap plan. Your coinsurance may also be a different amount if you have a Medicare Advantage plan. Because these plans vary, you should check your summary of benefits for your policy’s coinsurance amount.
When will Medicare not cover dermatology?
In general, Medicare won’t cover any service, including dermatology visits, for purely cosmetic reasons. These procedures include:
Removing benign lesions and skin tags
Botox injections for wrinkles
Hair loss treatments if you don’t have a medical issue
Facial cosmetic surgery
Body-altering surgeries like liposuction, tummy tucks, and breast enhancement
Whether or not Medicare can cover dermatology is a common question. The line between cosmetic and non-cosmetic can be tricky to identify, especially when cosmetic procedures can be used to treat certain medical conditions. Talking to a licensed Medicare Advisor is a good way to understand your plan and use it to reduce your healthcare costs. Call 855-900-2427 or schedule a chat today to get your Medicare questions answered and feel confident in your coverage.