Does Medicare cover dermatology & how to find a dermatologist that accepts Medicare
This article was updated on: 09/10/2018
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. 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.
Wondering about the rules for visiting dermatologists under various Medicare Advantage plans? I can help.
- Use the links below to set up a phone call so we can talk. Or you can get a personalized email from me with plan information.
- Explore plans on your own now, using the Compare Plans buttons on this page.