Health Insurance Coverage for Dermatology Services

Regular visits with a dermatologist can help you identify early signs of skin cancer and treat various problems. While many avoid scheduling a visit with a dermatologist because they assume their medical bills will be expensive, the truth is that health insurance covers this type of care.

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How Much Do Dermatology Services Cost?

How much you pay for a visit with your dermatologist depends on your health insurance. To determine your out-of-pocket expenses, refer to your plan’s Summary of Benefits page and look at how office visits with a specialist are covered.

Does Health Insurance Cover Dermatology?

Depending on your plan, you may have to meet an annual deductible before health insurance covers any of the visits and treatment. In that case, you would pay for services out-of-pocket until you hit your annual out-of-pocket limit. At that point, services may be completely covered or you may have a copay, which is a specific dollar amount that you pay for the appointment, or coinsurance, which is a percentage of the cost of the visit.

Other health insurance policies do not have annual deductibles, or they pay for specialist visits without requiring you to meet it before coverage kicks in. In most cases, you have a copay or coinsurance that you pay out of pocket.

When scheduling your dermatologist visit, make sure you find a doctor within your plan’s network. Getting out-of-network care generally results in higher cost-sharing responsibilities, if your health insurance covers the service at all.

Do I Need a Referral for Dermatology Services?

Whether you need a referral depends, once again, on your health insurance policy. Health Maintenance Organization, or HMO, usually require you to get a referral from a doctor to see a dermatologist. If you have an Exclusive Provider Organization, or an EPO, or a Preferred Provider Network, also called a PPO, you can likely schedule a visit with a dermatologist without getting a referral from your doctor.

What Dermatology Services Does My Health Insurance Cover?

Dermatology services that are considered medically necessary are typically covered by your health insurance. These typically include treating:

  • Acne
  • Skin cancer
  • Unusual moles
  • Vitiligo
  • Warts
  • Hives
  • Rashes
  • Rosacea
  • Shingles
  • Psoriasis
  • Allergic reactions
  • Scars
  • Eczema
  • Dermatitis

To ensure that you do not end up with higher medical bills than you expect, it is always a good idea to verify exactly what your health insurance covers. A health insurance agent can help you review your policy and determine whether a specific service or treatment is covered.

What Dermatology Services Are Not Covered by My Health Insurance?

While your health insurance policy generally covers any medical service that is deemed medically necessary, it does not cover elective or cosmetic procedures. Some services that your policy probably does not cover include:

  • Facials
  • Botox injections
  • Facelifts
  • Fillers
  • Dermabrasion
  • Peels

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Finding Health Insurance with Nevada Insurance Enrollment

At Nevada Insurance Enrollment, our licensed health insurance agents specialize in helping you find a health insurance plan that fits your budget and covers necessary care, including dermatology services.

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