Does Wellcare Cover Dermatologist Costs?
- Find out if Wellcare covers dermatologist costs, and understand what services are included and excluded. Get the information you need to choose the right plan.
Dermatologists diagnose and treat skin diseases. As you age, the chance of developing skin problems increases significantly, especially if you've spent a lot of time in the sun over the years. Having a dermatologist you can trust is essential to maintaining good health.
Most dermatologists are capable of treating a variety of skin issues. However, a growing number of dermatologists are now specializing in various areas, such as cosmetic surgery, laser treatment, Botox and Mohs surgery. Some of these treatments are considered medically necessary, but others aren't. The medical necessity of a dermatological service determines whether Wellcare and other Medicare plans cover it.
You can compare Wellcare Medicare Advantage (Part C) plans in your area to find a plan that may cover the dermatology benefits you need.
What Dermatologist Services Does Wellcare Cover?
Most insurance plans cover dermatologist services, but there are usually restrictions on the type of services they cover. In general, services needed to treat a diagnosed skin condition, such as skin cancer, eczema or acne, are covered. On the other hand, services considered elective or cosmetic, such as Botox or dermal fillers, aren't covered and must be paid for out of pocket.
Some Wellcare Medicare Advantage plans may cover the following dermatologist services:
Skin Cancer Treatment
Skin cancer is the most commonly diagnosed type of cancer. It will affect at least one out of every five people at some point in their lives. Skin cancer comes in three main forms: basal cell carcinoma, squamous cell carcinoma and melanoma. The first two are rarely lethal, but melanoma kills about 9,000 people in the United States each year.
Skin cancer treatment options depend on the type of cancer, the stage at which it's caught and other risk factors. The most common treatments include the following:
- Excision surgery
- Cryotherapy (freezing the cancer)
- Superficial radiation therapy (SRT)
- Topical chemotherapy creams
- Mohs surgery
All of these treatments are covered by Wellcare when deemed medically necessary.
Mohs surgery is considered the most advanced and precise technique for treating skin cancer. It's named after the doctor who developed it, Frederick Mohs. During Mohs surgery, the cancer is removed one thin layer at a time — the process is referred to by doctors as "bread loafing" the tumor — and then checked under a microscope to see if all the cancer has been removed. If any cancer cells are remaining, the surgery is repeated.
Compared to traditional cancer excision, Mohs surgery has a faster healing process and leaves a less noticeable scar. Wellcare covers Mohs surgery for treating skin cancer.
Acne affects people of all ages, not just teenagers. It can be treated through the use of over-the-counter and prescription medications. If your acne is severe enough to require prescription medication, Wellcare will typically cover it.
Treatment for Eczema, Psoriasis or Rosacea
Eczema, psoriasis and rosacea are chronic skin conditions that cause itching, bumps and redness. When severe, they can be debilitating, even impacting your ability to carry out daily living activities.
A variety of treatments are available for these conditions, both over the counter and by prescription. When prescription drugs are deemed medically necessary, Wellcare will cover them.
Treatment for Fungal Infections, Hives and Warts
Fungal infections, hives and warts are common skin problems. They might sound like mere annoyances, but in addition to being unsightly and uncomfortable, they can develop into major problems if left untreated. Fortunately, there are treatments available for all these conditions, but some require a prescription and can be expensive without insurance coverage. Wellcare covers these costs if treatment is medically necessary.
Preventative Dermatology Exams
Wellcare covers an annual preventative dermatology exam. This can help you catch any potential problems early on, which can save you a lot of time and money in the long run — and in the case of a condition, such as melanoma, it might even save your life. The doctor will examine your skin for abnormalities, and they might take pictures, so they can track any changes over time.
What Dermatologist Services Does Wellcare Not Cover?
The following services are examples of elective dermatological procedures that Wellcare and other Medicare Advantage plans don't cover.
Botox is a drug injected into the facial muscles beneath the skin. It's used to reduce wrinkles by temporarily paralyzing these muscles, creating a more youthful appearance. Because this isn't medically necessary, Wellcare doesn't cover it.
Dermal fillers are made from materials, such as collagen, and used to fill in wrinkles and lines on the face. Some people also get dermal fillers to increase the fullness of their lips.
Dermatological cosmetic surgery includes procedures, such as face lifts. These procedures aren't considered medically necessary and aren't covered by Wellcare.
What Do Dermatologist Services Cost With Wellcare?
A dermatologist is a specialist, which means you'll pay a copay at the specialist rate for an office visit. Your copay depends on the specific Wellcare plan you have. As of 2022, the copay to see a specialist under Wellcare's zero premium plan is $35.