Coffee & Coverage: Dermatology Medicare Coverage

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Nearly 10,000 Americans are diagnosed with skin cancer every day. In fact, more Americans are diagnosed with skin cancer every year than every other cancer combined, according to the Skin Care Foundation. With rates of diagnosis being so high, it’s important to see your dermatologist on a regular basis and get screened for skin cancer and other dangerous skin conditions. Here’s what Medicare will cover. 

What do dermatologists treat?

Dermatologists treat disorders of the skin, hair, and nails. These specialists can treat serious skin conditions like skin cancer, melanomas, abnormal moles, or other skin tumors. They can also help improve the quality of your skin by treating conditions like rosacea, adult acne, and wrinkles. 

Medicare coverage

Medicare Part B covers most medically necessary dermatology procedures and treatments at 80 percent. You will be responsible for the remaining 20 percent, and the Part B deductible applies. 

Procedures that are often covered by Medicare include treatment for:

  • Skin and fungal infection
  • Psoriasis
  • Eczema
  • Skin cancer
  • Dermatitis
  • Warts
  • Herpes simplex virus
  • Shingles virus
  • Rashes

Medicare also covers screenings to make sure your skin stays healthy. These preventative services include:

  • Skin cancer screenings
  • Skin cancer biopsy and excisions
  • STI/STD screenings and counseling
  • Some acne treatment
  • Allergy testing
  • Mole removal for evaluation
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What Medicare will NOT cover

It’s important to note that Medicare only covers medically necessary treatment and not cosmetic procedures. This can be a grey area for many patients, so ask your doctor how your treatment will be coded beforehand. After you know if it’s considered medically necessary or cosmetic, you can decide if you wish to proceed with the treatment knowing it may not be covered by Medicare. 

Cosmetic dermatology typically NOT covered by Medicare includes:

  • Botox injections
  • Correction of wrinkles, visible scars, or sagging skin
  • Cellulite reduction
  • Laser tattoo removal 
  • Chemical peels
  • Laser skin resurfacing
  • Cosmetic treatment of spider and varicose veins
  • Hair restoration
  • Laser hair removal 
  • Fillers and other elective injections

How to spot unhealthy skin

Not all moles are dangerous, but they should all be monitored in between appointments with your dermatologist. If a mole displays any of the following ABCDE signs, have it checked by your dermatologist immediately:

  1. Asymmetry: One half of the mole does not match the other half. 
  2. Border: The border of the mole is rough, jagged, or blurred. 
  3. Color: The mole has multiple shades of brown, black, tan, blue, red, or white. 
  4. Diameter: The mole is larger than a pencil eraser. 
  5. Evolving: The mole has changed in color, shape, or size. 

Note: dangerous moles like melanomas (the most dangerous type of skin cancer) may not check each of the ABCDE signs. If a mole exhibits just one of the ABCDE signs, have it checked immediately. Moles should also be checked by a dermatologist as soon as possible if they bleed, itch, ooze, appear scaly or feel tender or painful to the touch. 

When examining your skin, pay special attention to the skin that’s often exposed to the sun, including the back of the neck, shoulders, top of the scalp, and ears. These areas are often missed by sunscreen, and they’re hard to check regularly on your own body. The most commonplace for melanomas may appear on the back for men, and on the lower legs for women. 

Don’t forget to wear high-SPF sunscreen every day, especially if you plan on being outside, and reapply every two hours or if your face and body get wet. 


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