Does Medicare Cover Mole Removal?
- Learn about Medicare coverage for mole removal and discover which dermatological procedures are deemed medically necessary and which ones are cosmetic.
Skin cancer is the most common form of cancer in the United States, with an estimated 3.6 million diagnoses of basal cell carcinoma alone each year. Luckily, it also has one of the highest survival rates, with early detection playing the biggest role in curing the disease. If you're worried a mole might be cancerous, Medicare might cover screening and treatment.
In this article, you'll find out if and when Medicare covers mole removal and discover more about coverage for dermatology.
Does Medicare Cover Mole Removal?
Medicare only covers the cost of mole removal if a health care practitioner deems it medically necessary. If you're unhappy with the aesthetic of a mole in any location, you'll have to cover the costs yourself.
Below are some of the instances when Medicare is likely to cover mole examination or removal.
- It is painful or growing quickly, itches intensely or bleeds.
- It's oozing, swelling or showing other signs of inflammation.
- It's obstructing your vision.
- It makes breathing through your nose challenging.
- It impacts your other senses or daily functions.
- It looks cancerous or malignant.
What Is Dermatology?
Mole removal falls under the medical umbrella of dermatology, which includes services such as examining the skin, hair, nails and other external bodily tissue. Dermatologists analyze and treat conditions that relate to these areas and provide cosmetic treatments.
Skin is one of the body's largest organs. It is responsible for protecting you from contamination and able to withstand the elements to keep you healthy. However, it can be prone to certain issues, such as mole growth, skin cancer and other diseases.
However, the majority of a dermatologists' work is cosmetic. In some cases, mole removal might be considered a cosmetic procedure. Other cosmetic services dermatologists perform include:
- Wrinkle or scar reduction
- Varicose vein treatment
- Botox injections
- Laser tattoo removal
- Hair transplants
- Laser hair removal
- Chemical peels
- Dermal fillers
The Cost of Mole Removal With Medicare
If your physician has referred you for a screening in view of removing a mole, Medicare will cover some or all of the costs. The exact cost of mole removal depends on your individual plan. If you have Medicare Part B, you'll need to meet the deductible before insurance kicks in, which is usually 20%. Medicare Part B, which is for outpatient services, covers the remaining 80%.
Individuals with Medicare Part C, or Medicare Advantage, get the same benefits as those with Original Medicare, but copayments and deductibles won't necessarily be the same. Out-of-pocket expenses vary depending on which Medicare-approved private insurer you're partnered with.
If you have Medicare Part D, or Medicare Advantage with prescription drug coverage, you'll also get help paying for any medications you're given following mole removal services.
Is a Skin Check Covered by Medicare?
Preventative melanoma screening or skin checks aren't covered by Medicare. However, if you go to a doctor and they refer you for a skin check because of a health concern, it should be covered by Medicare Part B. This federal health insurance benefit covers outpatient services such as those offered in a doctor's office or health care clinic.
Does Medicare Require a Referral to See a Dermatologist?
Screenings, services and treatments that are considered medically necessary are covered by Medicare. It covers chronic skin conditions and cancer, but some plans might require that you get a referral in advance. Certain Medicare Advantage Plans might require you to seek prior authorization from your insurer, so they can review and preapprove treatment.