Does Medicare Cover Dermatologist Checkups?

Medicare Part B may cover dermatology services in some cases, provided the visit is medically necessary for the treatment of a condition. These are services needed to diagnose or treat your condition. This might involve the treatment of skin cancer, for example, or the care for chronic skin conditions.

If Part B covers your dermatologist services, a Medicare Supplement plan (Medigap) can help pay for your out-of-pocket dermatology costs like Medicare deductibles and coinsurance.

Medicare insurance does not cover routine dermatologist check ups or dermatologist services that have cosmetic purposes, such as skin tag removal, wrinkle treatment, routine skin care and scarring.

Skin cancer screenings in asymptomatic people are also not covered. 

Does Medicare Cover Dermatologist Check Ups?

For outpatient dermatology treatment that's considered a medical necessity, Medicare Part B will help pay for some of the costs, but you may be responsible for a share of the costs yourself.

• That means you'll have to first meet your $240 (in 2024) annual Part B deductible.

• After that, Medicare will start paying the bill — to a point. Under Part B, you're typically responsible for a 20% coinsurance payment on the Medicare-approved costs of the doctor services.

Always check with your dermatologist to make sure they accept Medicare assignment (which means they accept Medicare's reimbursement for a service as payment in full). If they don't accept assignment, you could potentially pay up to an additional 15% of the Medicare-approved amount for a service — called an excess charge.

These out-of-pocket expenses can be covered with the help of a Medicare Supplement Insurance plan. Medicare Supplement Insurance (also called "Medigap") picks up the cost of some of Original Medicare's out-of-pocket costs and can help provide additional coverage for qualified dermatology services.

Does Private Medicare Cover Dermatology? 

Now that we know Medicare Part B can offer some coverage of dermatology, does Medicare cover dermatology in the private sector as well? Some Medicare Advantage plans may offer additional coverage for dermatology services.

Medicare Advantage plans must provide the same minimum coverage as Original Medicare and then each provider may add additional benefits such as dental, vision or perhaps even dermatology.

Depending on the type of Medicare Advantage plan, you may need a referral from your primary care doctor before being able to see a dermatologist. 

Medicare Part D plans allow for prescription drug coverage. If you are prescribed to take any medication by your dermatologist, you may be able to find a Part D plan that provides coverage for the drug.  

Does Medicare Cover Dermatology Cancer Screenings?

Yes. Medicare Part B may help cover the cost of dermatologist services if they are performing a skin cancer screening. If the test is considered medically necessary — and is not part of a routine dermatology appointment — then your Part B benefits will help cover the cost of your screening and full body exams.

Your Part B benefits won't cover a skin cancer screening if you aren't showing any symptoms of skin cancer. However, if you or your doctor notice an abnormal change in color of a mole or a new skin growth, a cancer screening may be covered by Medicare.

If your doctor refers you to a dermatologist for further testing or analysis regarding a potentially cancerous skin growth, Part B will cover the cost of the referral visit.

It's important to understand how to recognize potential signs of skin cancer on your body, especially as you age. 

Making Sure You're Covered

Does your dermatologist accept Medicare? Perhaps the easiest way is to talk with your doctor or your dermatologist to confirm. And remember that Medicare Supplement Insurance can help cover some of the out-of-pocket costs that Medicare doesn't pay for.