8 Dermatology Services & Treatments Medicare Covers (and 6 It Doesn’t)
Your skin is your largest organ, so it’s important to take good care of it. As we age, skin conditions may need medical care, and that’s where a dermatologist comes in. They are experts in keeping your skin healthy.
We’re looking at popular dermatology treatments and whether Medicare covers them.
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Medicare and Dermatology
Dermatology is covered through Medicare Part B.
Medicare Advantage may offer additional coverage on a plan-by-plan basis.
Medicare only covers medically necessary dermatological visits and procedures. That means they won’t cover anything that is considered cosmetic, but we’ll explore more about that later.
We recommend checking with your dermatologist to ensure they accept Original Medicare or your Medicare Advantage plan before your visit.
What Medicare Covers
1. Skin Cancer Screenings
Medicare will help cover skin cancer screenings if there is a visible reason to do the tests. Tests on asymptomatic people are not covered by Medicare. That means that Medicare only covers skin cancer screenings that have a physical sign of potential cancer, such as a mole with unusual color or a new skin growth.
The key to skin cancer detection and prevention is diligence. If you notice anything out of the ordinary in your own self-examinations, you should reach out to a dermatologist. As we age, it’s important to understand signs of skin cancer and to visit a dermatologist if anything appears out of the ordinary.
UV damage is a major skin concern as well, as it can damage your skin cells. Especially in the warm summer months, it is important to use proper skin care and sunburn prevention tools like sunscreen and wearing a hat to protect your face when outside. Simple measures can help you lower your skin cancer risks.
Want to learn more about skin cancer and Medicare? Check out this article that looks at skin cancer coverage in more detail.
2. Skin Biopsies
If a doctor deems it necessary to perform a skin biopsy to determine a cancer diagnosis, that biopsy will be covered by your Medicare coverage.
Skin biopsies remove a section of the suspicious area to test for cancerous cells. Once the sample is taken, it will be sent to a lab for testing, and you should hear back within a few weeks.
3. Mohs Surgery
Mohs surgery may be recommended by your dermatologist to help combat your diagnosed skin cancer.
Because it is a medically necessary procedure to remove cancer, Medicare will often reimburse or cover the costs of Mohs surgery. The exact coverage amount may depend on the location of the cancer, so bear that in mind.
4. Lipoma Removal
Lipomas are collections of fatty tissue cells that collect and grow in the body. Many grow to be large in size and cause discomfort.
If it becomes difficult to live with, Medicare may cover the costs of lipoma removal surgery. This is often an outpatient procedure your dermatologist can do in their office.
5. Psoriasis Treatment
Psoriasis is believed to be an autoimmune condition that affects skin cell inflammation. For many, it can be an itchy and painful lifelong condition. While Medicare Part D can help cover medications to lower inflammation, psoriasis medicine is not typically covered by Original Medicare.
If your psoriasis isn’t responding to conventional treatment, Medicare may cover PUVA therapy. PUVA therapy is a type of ultraviolet radiation therapy and is typically covered through reimbursement.
It is worth noting that many seniors with psoriasis also experience psoriatic arthritis. Assistance with that is often done by a rheumatologist and not by a dermatologist. Rheumatology is typically covered by Medicare and your coverage for arthritis-based treatments may vary from focusing on the skin condition alone.
6. Mole and Skin Tag Removal
Original Medicare will cover mole removal if the mole is cancerous or believed to be cancer.
Appearance-related mole removal is not covered by Medicare. Medicare may cover skin tag removal if it is deemed medical necessary.
Additionally, wart and seborrheic keratosis removal may also be reimbursed by Medicare post-treatment if you are in pain or experience continuous bleeding from the removal site.
7. Medically Necessary Botox
Most people know Botox and other similar products as fillers used to make a person look younger.
However, Botox has medical uses as well. For some, it has proven to help prevent frequent migraines and it may also be a treatment option for temporomandibular joint disorder (TMJ).
If your doctor prescribes Botox as a medical treatment, Medicare will likely cover it.
Varicose veins can be painful for many people — and for many, vein procedures like sclerotherapy provides much-needed relief.
As with many things on this list, Medicare coverage will depend on whether or not it is deemed as medically necessary treatment for your condition. If it’s to remove the spidery veins associated with varicose veins without addressing a medical need for the procedure, then it won’t be covered.
What Medicare Won’t Cover
1. Annual Skin Exams
While annual exams are still a good idea for many seniors, Medicare coverage may not be available.
Original Medicare will not typically cover annual skin exams unless you have a reason to receive the exam, such as a history of skin cancer.
2. Skin Care Products
Unless it is a prescription, which would be covered by a Part D drug plan, skin care products are not typically covered by Medicare. That would include non-medicated soaps, lotions, and topical ointments.
3. Cyst and Acne Removal
Cysts and acne are considered benign skin conditions and are not typically covered by Medicare unless the cyst is causing discomfort that is affecting everyday life.
4. Botox/Dysport/Xeomin and Other Anti-Aging Treatments
As previously discussed, Botox can have medical uses. But when it is being used to prevent wrinkles and reverse the clock, it is not medically necessary.
Cosmetic procedures like this are not covered by any Medicare plan and are also not covered by many traditional insurances.
5. Photodynamic Wrinkle Treatment Therapy
At the risk of sounding like a broken record, Medicare only covers medically necessary dermatological procedures. As much as we may want those smile lines and crow’s feet removed, Medicare won’t cover it.
6. Laser Hair Removal
Hair removal is a cosmetic procedure. Medicare won’t cover it.
Dermatology is a wide field that takes care of one of the most important parts of your body.
Understanding the ins and outs of dermatology coverage and how to determine if it’s covered can help you save money and get the care you need.
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