Going Skin Deep: What’s Covered?

Coverage for dermatology can be complicated, but that doesn’t mean you should avoid dealing with it. While some skin conditions can seem minor, others are serious. Some dermatology visits are covered as medically necessary.

What’s covered?

Most benefit plans will cover conditions traditionally treated by dermatologists, including skin cancer, rashes, psoriasis, eczema, shingles, severe acne, and more. Also, benefit plans typically cover annual check-ups for patients at high-risk for cancer or other serious conditions.

What’s not covered?

Anything considered elective or cosmetic – such as Botox treatments, tattoo removal, chemical peels, and microdermabrasion – will typically not be covered. However, some of these procedures could be covered in some situations. So, what should you do?

If you’re thinking about seeing a dermatologist, the following steps will help to minimize surprises.

  • Start by checking your benefit information. If your coverage still isn’t clear, talk to your HR team or benefits provider.
  • Specifically, confirm whether your plan requires that you get a referral from your primary care physician before seeing a dermatologist.
  • As always, make sure any healthcare provider you see is in your network.
  • Ask your dermatologist to ensure visits are coded to fit with your coverage.
  • After seeing a dermatologist, review your bills and Explanation of Benefits forms to ensure everything aligns with your expectations.
  • Be aware that while a particular condition might be covered, not all treatments for it will be. For example: Severe acne usually is covered, but microdermabrasion – a common treatment – typically is not. Always check to see whether a treatment is covered.
  • Understand that dermatologists sometimes partner with third-party financing firms to help minimize out-of-pocket expenses for procedures that aren’t covered.

Understand what’s covered before you see a dermatologist. To do so, you might have to go more than skin deep in checking your coverage, however, the extra effort will pay off in the long run.

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