Dermatology is a medical specialty. Like traditional health care, most services a dermatologist offers are covered by insurance.
Coverage for dermatology services can vary from policy to policy. The guideline insurance companies use to determine whether they will pay for a service or not is medical necessity. To be considered medically necessary, the visit must be to evaluate, diagnose or continue treating a medical condition. Most major medical plans will cover medically necessary treatment by a dermatologist.
Some of the most commonly covered conditions are:
- Skin cancer
- Port wine stain removal
- Skin or fungal infections
- Skin allergies
- Keloid scars
Cosmetic treatment for things such as skin blemishes or tattoo removal are generally not covered.
Before going to the dermatologist you will need to make sure you are covered. If you have health insurance coverage through an employer, you can ask your Human Resources Manager or the person in charge of benefits. Or, you can contact the insurance company directly by calling the Customer Service Number that is usually located on the back of your insurance card.
If you determine that dermatology care is covered by your insurance, check to make sure that your dermatologist of choice is in network. Using physicians that are in network will usually save money over using an out of network provider. You can call the physician’s office with your health insurance information to verify whether or not that provider is in network or not. You may also be able to find this information on the insurance company’s website.
Some insurance companies require their subscribers to receive a referral from a primary care physician before seeing a specialist. If a referral is not secured before a specialist visit, the dermatology appointment may not be covered or might be paid at a lower rate leaving you more to pay out of your own pocket. This is also important to determine before scheduling your dermatology appointment.
To learn more about insurance coverage for dermatology services in Phoenix, contact The Center for Advanced Dermatology today at 602-867-7546 or mddermsolutions.com.