Are Dermatology Services Covered by Insurance?

Insurance… The bane of many people’s lives—navigating what is and isn’t included in a policy is never easy. After all, who’s honestly got time to read through the reams of small print…? 

But read you should… It’s vital to understand what is and isn’t covered. Failing to claim when you can or assuming you’re covered when you’re not could leave you considerably out of pocket.

While no two policies are the same, the following provides a general overview of what is and isn’t covered regarding dermatology treatments.

Insurance, Dermatology, and What You Can Expect to be Covered

• What dermatology is covered by insurance (usually)
• What dermatology isn’t covered by insurance (usually)

What dermatology is covered by insurance (usually)

As a general rule, any skin, hair, or nail condition that needs medical treatment usually has a level of cover provided by most insurance policies. Dermatology covers a wide range of conditions, some of which are considered medical and others that are considered elective—the latter being that you choose to have them done—perhaps for aesthetic reasons—but not having them treated isn’t detrimental to your health.

Examples of dermatological conditions that insurance normally covers include:

• Treatment and/or removal of skin cancers.
• Acne treatment.
• Autoimmune skin conditions.
• Dermatitis.
• Viral skin diseases.
• Chronic skin conditions, such as psoriasis, eczema, and rosacea.
• Annual/preventative skin examinations.
• Hives, rashes, and other allergies.
• Warts.
• Fungal infections.
• Keloid scars.
• Reconstructive surgery.
• The removal/reduction of port wine stains.

Depending on the level and type of coverage you have, your insurance provider may pay for all of the treatment or a proportion of it. Every policy is unique as to what they apply as “deductibles”—meaning that you have to front some of the costs. These often apply on an annual basis, whereby you might have to pay a certain amount of any claims each year.

It's worth understanding what these are as if you’ve already paid some or all of them during a single year, then further treatment might come at no cost to you. Scheduling medical care before the next annual reset could result in significant savings.

What dermatology isn’t covered by insurance (usually)

As already mentioned, dermatology treatment that’s carried out for aesthetic reasons, rather than clinical, won’t normally be covered.

Examples include:

• Anti-aging treatments, such as skin peels, facial fillers, microneedling, and Botox. 
• Hair removal treatments.
• Facials, including photofacials, hydrafacials, etc.
• Fat removal—both surgical (liposuction) and minimally invasive, such as Coolsculpting.
• Skin treatments, including microneedling and dermaplaning.
• Tattoo removal.
• Non-accidental plastic surgery.
• Hair loss (unless it’s a medical condition, such as alopecia).

However, there are exceptions to the above. For example, when Botox is used to treat excessive sweating or skin treatments are needed for a chronic condition, such as rosacea.

These inclusions and exclusions are only a rough guide and it’s important to read your policy to see exactly what’s covered. One thing that has an effect is whether your plan is a Health Maintenance Organization (HMO) or a Preferred Provider Organization (PPO).

The former usually requires your primary doctor to make referrals to the specialist/s you need. The latter is a little more flexible and might not need a doctor’s referral to see a specialist. You must determine which yours falls under to ensure that you don’t book an appointment that might not be covered.

Contact Bayou City for All Your Insurance and Non-Insurance Dermatology Needs

Bayou City Dermatology is a leader in the most advanced dermatological treatments for both medical and aesthetic needs. Our experienced, medically-led team can help with virtually any dermatology and cosmetic requirements. 

Whether your treatment is going to be funded privately or via insurance (or a combination of the two) we’re the go-to provider in Texas, with outlets in Cypress, Houston, River Oaks, Houston, and Clear Lake, Webster.

Find out more at https://www.bayoucitydermatology.com/services