Does Your Health Insurance Pay for Your Dermatology Appointment?

Your skin is your body’s largest organ and taking care of it is an important part of overall wellness. While many people think of skincare from a purely cosmetic angle, the truth is that it is important for general health.

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Health insurance pays for dermatology appointments in the same way that it does any other visit with a specialist. If the treatment you are seeking is “medically necessary”, and you have followed your plan’s rules for getting referrals or seeing in-network providers, you will not have to pay for your care entirely out of pocket. You’ll pay your normal co-pays and/or deductible and/or co-insurance.

Will My Health Insurance Cover Dermatology?

When Does Health Insurance Cover Dermatology?

In order for your health insurance policy to pay for your dermatology visit, the service must be medically necessary. In other words, during the appointment, the dermatologist must evaluate your symptoms, make a diagnosis, or create or continue a treatment plan. The doctor must also be able to demonstrate how not getting the condition treated could affect your general health. In other words, it will not be covered if it’s a “vanity” desire. Like removing tattoos because you think they are ugly. That’s not going to be considered medically necessary, unless the tattoo looks suspicious to your medical provider and they want to biopsy the skin or treat the skin.

In some cases, your health insurance may pay for specific treatment to treat one condition but not another.

Conditions that your health insurance policy most likely covers include:

  • Port wine stains
  • Acne
  • Skin cancer
  • Shingles
  • Warts
  • Moles
  • Rashes
  • Keloids hives
  • Skin infections
  • Eczema
  • Psoriasis
  • Varicose vein treatment (when medically necessary)

When Does Health Insurance Not Cover Dermatology?

In some cases, people seek dermatology services not to address medical issues but to improve their skin’s appearance. In these cases, health insurance plans do not cover treatment.

Cosmetic procedures that are not covered by health insurance include:

  • Chemical peels
  • Botox injections
  • Laser skin resurfacing
  • Dermabrasion
  • Microdermabrasion
  • Dermal fillers

How Can I Make Sure My Health Insurance Covers My Care?

If you are seeking care from a dermatologist to address a medical condition, it is important to follow your plan’s rules for seeing a specialist. Depending on your plan, you may be required to get a referral from your doctor. If you have an HMO plan, you must get a referral to see anyone other than your primary care provider. If you have a PPO plan, you are free to see any health care professional you want without a referral.

If the procedure is not listed as a covered benefit in your “Agreement of Coverage” document, then it will not be covered.

When scheduling your appointment, determine whether the dermatologist you choose is within your plan’s network. If you see an out-of-network specialist, you may be required to pay a higher copay or coinsurance, or you may have to pay the entire cost out of pocket.

As always, it is a good idea to talk to a health insurance agent to find out what your plan covers and where you can go for care.

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Getting Health Insurance Coverage for Dermatology with Nevada Insurance Enrollment

Without health insurance, necessary skincare services can be cost-prohibitive. At Nevada Insurance Enrollment, our licensed health insurance agents can help you find robust coverage that fits your budget and needs.

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