Financing and Insurance
If you need to see a dermatologist, you are probably wondering, “does my insurance cover dermatology?” The answer to this question is more complicated than a simple yes or no. While dermatology is a mainstream medical specialty, many treatments provided by dermatologists are considered “elective” by insurance companies.
Coverage by your insurance provider will depend on the condition you have, the treatment your doctor recommends, and whether your company defines them as “medically necessary.” Often, the best way to figure out if your visit to the dermatologist is covered by insurance is to contact your provider. For procedures which are not covered, many dermatologists partner with third-party financing organizations to help minimize out-of-pocket expenses.
What to Know Before You Go
Before your dermatology appointment, there are a few steps you can take to ensure you receive proper coverage for your treatment.
Ask If Your Insurance Covers Dermatology
The first thing to do is contact your insurance company and find out whether your plan includes coverage for dermatology treatment.
Find Out If You Need a Referral
Some insurance plans require you to get a referral from your primary care physician before seeing a specialist. Even if your insurance covers dermatology, you may still need to see your regular doctor first.
Choose the Right Dermatologist
Before you visit a doctor, make sure they are on your current insurance plan or in your network. Otherwise, you may incur greater out-of-pocket expenses. If you cannot find a dermatologist in your area, your insurance company can refer you to one.
Is My Condition Covered?
Many of the skin conditions dermatologists treat are covered by insurance. Some of the most commonly covered conditions include:
- Skin cancer
- Port wine stains
- Poison ivy
- Keloid scars
- Skin allergies
- Severe acne
- Skin or fungal infections
It is important to keep in mind that just because treating a certain condition is medically necessary does not mean the treatment itself is covered. For example, while treatment for acne is often covered by insurance, microdermabrasion, a commonly used treatment, is typically viewed as a cosmetic procedure. However, if your insurance company denies you coverage, you may have the right to appeal the denial.
What Is Not Covered By Insurance?
Elective or cosmetic procedures are typically not covered by medical insurance. Generally put, these types of treatments do not resolve medical conditions and as such, are not considered medically necessary. Common elective dermatology procedures include:
Even for these treatments, you should always check your plan to find out what your insurance will and will not cover. In some cases, for example, Botox injections are used to provide relief for hyperhidrosis, or excessive sweating, and may fall under medically necessary treatment.
How to Minimize Out-of-Pocket Costs
The complexity involved in paying for dermatology appointments should not deter you from seeking the treatment you want or need. Many dermatologists partner with third-party financing organizations, such as CareCredit®, to help patients minimize out-of-pocket expenses. These companies provide flexible financing plans so patients have easier access to high-quality treatment.
Schedule an Appointment
In some cases, your dermatologist can work with your insurance company to determine which treatments are covered and maximize your coverage. Contact a dermatologist today and find out more about available insurance and financing options.