I Have Medicare, What Dermatology Services Are Covered?

November 22, 2021

Physician coverage

The first step in identifying what services are covered is by finding a physician who accepts Medicare. This can be done by contacting 1-800-MEDICARE or by using Medicare’s “Physician Compare” tool located on their website. It is important to ensure that the physician you are planning on seeing accepts Medicare to avoid any unexpected out-of-pocket charges.

Medicare coverage and limitations

Medicare provides a wide variety of coverage for medical services, but it does not cover everything. Medicare part B will only cover 80% of the cost of services. A supplemental plan covers the remaining 20%.

For Medicare to cover a service, the service must be provided within the United States and deemed “medically necessary.” Medicare defines this as healthcare services or supplies that are “needed to diagnose or treat an illness or injury, condition, disease, or its symptoms”. Medicare will cover medically necessary telehealth appointments and in-person visits. Any cosmetic service such as Botox, laser hair removal, or removal of benign moles are not deemed medically necessary and will not be covered by Medicare.

Commonly covered services

While Medicare does not cover everything, there are a variety of services they do cover. Some of the most commonly requested dermatologic services would be visits for the treatment of rosacea, acne, psoriasis, eczema, malignant mole removal, and rashes. If you are unsure about pricing, it is recommended that you discuss and confirm the cost with your dermatologist.

If a dermatologist performs a skin cancer screening, Medicare may cover the costs. A mole with an unusual color or a new skin growth is considerable a reimbursable reason for skin cancer screening. In addition, primary care doctors often refer their patients to a dermatologist for more extensive testing of potentially cancerous skin growth. In this case, Medicare will cover the referral visit costs.

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