Does Medicare cover dermatology & how to find a dermatologist that accepts Medicare

Last Updated : 09/10/20182 min read

Do you need to see a dermatologist, but you’re not sure what Medicare covers? Or you might be looking for a dermatologist who takes Medicare (that is, who accepts Medicare assignment).

Medicare and Dermatology

Medicare Part B (medical insurance) generally covers doctor services when medically necessary to evaluate, diagnose, or treat a medical condition.

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So if you’re going to a dermatologist to treat a medical skin condition, your visit might be covered. For most doctor visits, you pay 20% of the Medicare-approved amount if your health-care provider accepts assignment (meaning he or she agrees to accept the Medicare-approved amount as full payment for a service, and not bill you for any more than the Medicare deductible and coinsurance).

Medicare Advantage plans  cover dermatology visits in the same way as Medicare Part B covers them. That’s because Medicare Advantage plans deliver all your Medicare Part A and Part B benefits (except hospice care, which Part A covers) through a private, Medicare-approved insurance company. However, if you’re in an HMO (Health Maintenance Organization) plan, you may need a referral to see a dermatologist from your primary care doctor first. If you have another type of Medicare Advantage plan, you may not have to get a referral, but you might want to check with your plan to avoid paying any higher costs that might result from an unauthorized visit.

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Wondering about the rules for visiting dermatologists under various Medicare Advantage plans? I can help.

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