From acne to rosacea, people see dermatologists for a variety of reasons. But one of the most common questions people have when it comes to making a dermatology appointment is, “Is dermatology covered by insurance?” Unfortunately, it’s not as simple as a yes or an answer. In many cases, it depends on the person’s health insurance plan and the treatments they are receiving.
In this article, we’ll look at what dermatology is, what dermatology services are and aren’t covered by insurance, how to find a dermatologist, and more.
what is dermatology?
Dermatology is a branch of medicine that focuses on skin disorders. dermatology is about diagnosing, treating and preventing various skin problems. For the most part, dermatology falls into two categories: cosmetic dermatology and medical dermatology.
cosmetic vs medical dermatology
Cosmetic dermatology refers to procedures for the skin that are designed to improve its appearance and health. the problem may be due to aging, sun damage, or scarring of the skin. Essentially, with cosmetic dermatology, the patient wants to enhance their skin but not out of medical necessity. examples of such practices include dermal fillers, point therapy, and hair removal.
Medical dermatology refers to skin conditions of a medical nature. examples of this include eczema, psoriasis, and skin cancer. Your dermatologist can tell you if your condition is a mandatory medical one or an elective cosmetic procedure.
If it’s a medical dermatology issue, it’s imperative that you take care of it as soon as possible. on the other hand, if the skin procedure you want is cosmetic, it’s your choice whether to go ahead with it.
In the latter case, the question is “is cosmetic dermatology covered by insurance?” most of the time the answer is no. however, most medically necessary procedures will be covered by insurance.
what type of health insurance is best to cover dermatology?
There are two main types of health insurance benefit plans:
- hmos, or health maintenance organization plans, require that you name a primary care physician to coordinate your care. With this type of plan, you’ll need to get a referral from your primary care doctor to see a dermatologist
- ppos, or preferred provider organization plans, will generally allow you to access a broader range of covered care and treatment providers than is available with hmo coverage. you may not need to receive a referral.
- acne treatment
- treatment of skin cancer
- removal of skin cancer
There is no “best” type of objective health insurance for dermatology coverage. Understanding your individual policy is key to maximizing your available benefits.
If access to dermatology care is a priority for you, it may be a good idea to check the details of your plan before you sign up to make sure you have access to and coverage for the care you need.
Do I need a referral to see a dermatologist?
As mentioned above, this all depends on your health insurance plan.
If you have an hmo, you may need a referral before you can be covered for a dermatology appointment.
however, if you have a ppo, you may not need a referral. Some PPO plans require referrals, but others do not. the best way to find out is to contact your insurance company or read the details of your plan.
What types of dermatologist appointments and procedures are covered by most insurance plans?
Usually, you can expect your insurance to cover medically necessary treatments. your coverage is likely to extend to things like:
If you’re wondering if skin cancer screenings are covered by health insurance, the answer is that they probably do on the grounds that they’re considered “medically necessary.”
what types of dermatologist appointments or procedures are not covered?
You can expect that anything that is not medically necessary will not be covered by your health insurance plan. this includes cosmetic treatments such as:
In addition to medically necessary and covered services, your dermatologist may provide cosmetic procedures, but you probably won’t be covered by your health insurance plan for them.
How do I know if my insurance covers my dermatological treatment?
Whether your insurance covers your dermatology treatment ultimately depends on the type of plan you have and what that plan covers. the best way to determine this is to read your insurance plan documentation. if you still have questions, you can also connect with their customer service department and ask.
how can I make my dermatological treatments more affordable?
If you don’t have insurance coverage, one way to make dermatology treatments more affordable is to ask your specialist if they have a payment arrangement you can make. Another way is to ask if they have offered any kind of discount. however, the best way to make your dermatology treatments more affordable is to have a health insurance plan. Fortunately, you can find a variety of health insurance plans on ehealth and choose a plan that covers the dermatological treatments you want to receive.
How do I find health insurance that covers dermatology?
As the first and largest online health insurance broker, ehealth can help you easily compare all available individual and family health insurance plans to find one that fits your budget and coverage needs. If you want to make sure your dermatological needs are covered by an insurance plan, you can also contact eHealth’s team of authorized agents by phone or chat to help you. get started with ehealth today.