Dermatology coverage

Dermatology coverage is a health insurance benefit that pays for diagnosis and treatment of skin, hair, and nail conditions such as acne, eczema, and psoriasis. Most US employer health plans classify dermatology visits as specialist care, with copays ranging from $30 to $75 per visit according to KFF 2023 data.

Plans commonly require referrals from primary care providers before seeing dermatologists, especially in HMOs like Kaiser Permanente. Cosmetic procedures–like Botox or mole removal for appearance–are typically excluded from major carriers’ coverage, including UnitedHealthcare and Aetna.

Medicare Part B covers medically necessary dermatologist services for conditions like melanoma but excludes elective treatments. Medicaid programs cover necessary dermatology services in states like California and New York, but restrict cosmetic services, according to https://yourinsurance.info.

Short-term or limited-benefit health plans often do not include specialist dermatology visits; check policy details before enrolling. Out-of-network dermatologist visits can trigger higher out-of-pocket costs than in-network visits under insurers such as Blue Cross Blue Shield.

ACA-compliant marketplace plans must cover essential skin cancer screenings when medically indicated by the USPSTF guidelines (Grade B or higher). Teledermatology visits gained insurance coverage during COVID-19 emergency orders and remain covered by many large plans such as Cigna and Anthem.

Deductibles frequently apply before dermatology benefits begin paying on most high-deductible health plans.