Do you need to see a dermatologist? Are you thinking of using Medicare to offset the cost of your dermatology treatments? The federal government’s 65-and-over healthcare program does cover some dermatological services.
So what is dermatology? Dermatology deals with skin, nails, hair, and various diseases related to those three areas. Dermatologists perform both medical and surgical procedures for disease treatment and prevention. They also do work for cosmetic reasons. Some treatments that commonly fall under the dermatology heading include:
- hair removal
- hair transplantation
- laser therapy for the management of skin disorders
- photodynamic therapy for the treatment of skin cancer and pre-cancerous growths
- removal and screening of suspicious skin growths
Medicare Part B coverage
If you have Medicare Part B, chances are that some dermatological procedures will be covered by your plan. Part B offers coverage for both services (doctor visits, surgeries, lab tests, etc.) and supplies that are deemed medically necessary to treat a disease or a condition. If you have been diagnosed with a skin condition that requires the services of a dermatologist, Medicare Part B will likely assist with your expenses. Patients will usually pay 20% of a Medicare-approved treatment amount if your doctor or specialist accepts Medicare. If your provider doesn’t participate, you may be liable for the full amount. Be sure to ask whether or not your dermatologist participates in the Medicare program before receiving treatment.
Medicare Part B does not cover cosmetic dermatological procedures. For example, if you have an acrochordon — also known as a skin tag — and you want it removed to improve your appearance, Medicare will not cover the procedure. However, if the skin tag is infected, bleeding, or interferes with other bodily functions such as vision, Medicare will likely deem the removal procedure medically necessary and will therefore assist with the cost.
Medicare Advantage Plans (Part C) may help
If Medicare Part B doesn’t meet your dermatology coverage needs, you may be able to obtain assistance through what is known as a Medicare Advantage plan. These plans, which are sometimes referred to as Medicare Part C, are offered by private companies that contract with the federal government to provide specific coverage services that may not be found in Medicare’s original Part A and Part B plans. Advantage plans include:
- HMOs (Health Maintenance Organizations)
- Preferred Provider Organizations
- Private Fee-for-Service Plans
- Special Needs Plans
- Medicare Medical Savings Account Plans
Advantage plans come in all shapes and sizes, so you’ll need to do a bit of research in order to find one that offers the dermatology treatments you need. The official US government Medicare website is a great place to start, since it offers links to Medicare’s Plan Finder comparative tool as well as eligibility information. Additionally, you may call a Medicare specialist at 1-800-633-4227 for more information.
Before researching an Advantage plan, you’ll want to make sure that you are already enrolled in a Part A or Part B plan. You’ll need to provide your Medicare number and the date your coverage started in order to sign up for Advantage.