Some dermatology procedures are covered by Medicare, but only when they are medically required.
Dermatology services that are medically required are covered by Medicare. To put it another way, if you require dermatological treatments to diagnose or treat a skin disease, Medicare will most likely fund them.
Cosmetic dermatology procedures are typically not covered unless they are required to treat a skin disease. Preventive skin checks are likewise not covered by Medicare.
Medicare does not fund preventive skin cancer screenings unless you or a doctor see something suspicious. However, if your doctor suggests you or if you have a suspicious-looking mole, Medicare may pay your visit.
Medicare may also cover dermatological appointments for certain skin conditions, such as:
In general, Medicare will not fund skin conditions that are treated solely for cosmetic reasons. Some cosmetic services, on the other hand, may be covered if they are medically required, but they may require prior authorization.
For example, Medicare may fund varicose vein surgery or Botox to address excessive sweating — but your doctor may have to make the case that you need the therapy.
Medicare Advantage plans are obligated to cover everything that Medicare does, but they can also provide additional benefits. If you have Medicare Advantage, check with your provider to determine what dermatology procedures are covered.
Outpatient dermatological procedures are often covered by your medical insurance, Medicare Part B. Part B requires you to pay a deductible — $226 in 2023 — as well as 20% of Medicare-approved payments for the visit or treatment.
Other than the deductible, if you have Medigap, your plan may cover some or all of your Part B expenditures. (If you have Medigap Plan C or Plan F, you are covered for the Part B deductible, but these plans are no longer available to new enrollees.)
Dermatology appointments may be subject to a separate deductible and may need a fee or coinsurance if you have a Medicare Advantage plan.