Does Medical Insurance Cover Dermatology for A Serious Skin Disorder?

People visit dermatologists for a variety of reasons, whether it is a minor skin issue, eczema, or hair fall. However, when there’s a need for a dermatology appointment for the first time, a common question arises ‘does medical insurance cover dermatology?’. The answer to this might not be as straight as it may seem.

Precisely, it depends on the insurance plan that a patient has and the associated monthly premium. If you have stubborn acne and want to know if medical cover dermatology or is cosmetic dermatology covered by insurance, read the article to the full… The article describes every query that might be hanging around in your mind.

What is dermatology?

What is dermatology

Dermatology address skin issues and disorders and works to prevent the skin from various problems. It is a branch of science, which studies treating and diagnosing skin complications. Dermatology is divided mainly into two categories;

  • Cosmetic Dermatology
  • Medical Dermatology

Cosmetic Dermatology;

Refers to the treatment performed on the skin by which the texture, health, and appearance can be improved. Skin problems, oftentimes happen due to sun damage, ageing, and skin scarring. Cosmetic dermatology opts particularly when people want to improve their skin and enhance its beauty without being in a medical need. Cosmetic dermatology examples include laser treatment, hair removal, filler applications, and DOT therapy.

Medical Dermatology;

Medical dermatology refers to the condition of the skin that needs medical treatment for skin issues of medical nature. Examples of medical dermatology include skin cancer, eczema, psoriasis, etc. Once a dermatologist diagnoses your condition, he will be able to suggest if you need medication for your skin issues or if it needs a cosmetic nature treatment.

Besides, if you’re going through a medical nature of skin issues, it is essential to take care of them and visit a dermatologist as early as possible. On the flip side, a cosmetic nature issue may not create a sudden need of getting under a knife.

Coming back to our main question, does medical insurance cover dermatology? Several insurance providers do not suffice dermatology in their insurance plans. But there are some dermatology procedures that are covered by insurance.

Dermatology procedures covered by insurance

You can expect your medically needed skin issues to be covered by your medical insurance. For instance, if your dermatologist identified some serious skin issues like skin cancer, then they should be providing you with appointments for the visit. Along with the office treatment, the doctor may also prescribe you the medication while you select a plan with your insurance provider.

Insurance providers cover a range of dermatology services that pose serious health issues. Once you decide on your insurance plan, ensure that it covers skin-related treatments. Private insurance coverages, oftentimes, cover medically proven skin treatment but they still don’t cover cosmetic surgeries or procedures.

Dermatologists diagnose and treat skin disorders that take part in playing a significant role in damaging your skin, hair, and nails. For insurance coverage of such medically needed issues, your provider may or may not want a referral from your primary healthcare provider. Therefore, it is better to know your options prior to your treatment.

A medically required issue that qualifies for the conditions from your provider, will be covered. These issues may include autoimmune disorders, skin conditions, cancers, eczemas and other related chronic skin illnesses that are co-occurring or progressive.

A variety of medical-related skin issues covered by health insurance include;

  • Eczema
  • Dermatitis
  • Allergies
  • Hives
  • Hemangiomas
  • Keloid scars
  • Poison Ivy
  • Molluscum Contagiosum
  • Rosacea
  • Shingles
  • Vitiligo
  • Severe Acne
  • Rashes
  • Warts
  • Skin cancer
  • Other skin issues that pose risk to health

Whatever skin condition you are going through, it is not suggested to guess and decide what condition is severe and needs medical attention. Take notes by discussing with your insurance provider and talk to the insurer-approved dermatologist directly to make an informed decision about what is covered and what treatments you need.

In addition, as it is the end of the year and if it is too late to amend your plan for 2022, do all your homework and make a plan that covers dermatology procedures for the next year.

What type of insurance plan covers dermatology?

type of insurance plan covers dermatology

Several insurance plans and types of coverage are there that cover dermatology. The best insurance policy will be the one that offers flexibility to the holder to see whoever they wish to see while being covered by an affordable policy.

According to usual policy conditions, you can only see dermatologists that are dictated by your insurance provider. Oftentimes, some types of medical insurance plans under health maintenance organizations (HMOs) are significantly restrictive.

When you are covered under HMO, you need to see your primary physician first, identify the skin issues, and then they would refer a dermatologist. You need to see a dermatologist covered by an HMO list of healthcare providers to receive coverage for your skin treatment.

On the other hand, other insurance like point-of-service (POS) plans, offer partial and sometimes full coverage if you wish to see a dermatologist outside the approved healthcare practitioners. POS insurance plans are more flexible and offer great functionality to patients with health-related skin disorders.

No matter what type of insurance plan you choose for your skin treatment, the scope of your insurance plan is essential. Insurance plans that are more robust and provide a higher level of coverage for a range of treatments but then again, all this will be possible against an elevated monthly premium. Prior to enrolling in any insurance plan, know the essential details to shun the probability of surprises.

Ending note

Struggling to decide what plan to enroll? Make sure whatever you decide, enroll in a trustworthy and transparent working body that puts customer satisfaction first. When you are informed and understood everything that you are covered with, you’ll be in a better position to make timely decisions. This will eventually save you time and help you make your decision quickly.

Also Read:

  1. How much does a Dermatology Visit Cost?
  2. Challenges And Tips Of Dermatology Medical Billing
  3. What is COB in Medical Billing