Original Medicare generally doesn’t cover dermatology services, except for medically necessary cases like cancerous skin lesion removal. Medicare Advantage (Part C) offers equivalent coverage, while Part D may cover certain skin medications.
Original Medicare (parts A and B) does not generally cover dermatological care. However, if the service is deemed a medical necessity for a specific condition, they may provide some coverage. This will not include any routine dermatology services or cosmetic procedures.
With a Medicare Advantage plan (Part C), a person may have dermatology coverage that goes beyond original Medicare, depending on the plan. In some cases, Part D may cover certain medications a person may require as part of dermatology services.
Glossary of Medicare terms
- Out-of-pocket cost: This is the amount a person must pay for care when Medicare does not pay the total amount or offer coverage. Costs can include deductibles, coinsurance, copayments, and premiums.
- Premium: This is the amount of money someone pays each month for Medicare coverage.
- Deductible: This is an annual amount a person must spend out of pocket within a certain period before Medicare starts to fund their treatments.
- Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, coinsurance is 20%.
- Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Medicare Part B, which is part of Original Medicare along with Part A, may cover any medically necessary dermatological service for a specific medical condition. This may include screenings or treatment options for medical conditions that impact the skin, hair, or nails. It may also include procedures like mole removal if medically necessary.
Additionally, there may also be coverage for an exam by a dermatologist if it directly relates to the diagnosis or treatment of a condition. This could include a skin exam to check for potential skin cancer or to decide if a person needs a biopsy.
It is important to note that Medicare Part B does not cover cosmetic services. This includes services to treat age spots or wrinkles. It is also important to remember that a person needs to see a dermatologist or other healthcare professional who accepts Medicare. Medicare’s Physician Compare tool can help a person find an appropriate dermatologist in their area.
Medicare Advantage (Part C)
Medicare Part C is offered by private insurance plans and provides the same coverage as Original Medicare. However, some plans may offer extra coverage and benefits, such as coverage for routine checkups and prescription medications.
A person can consult their insurance provider for more information on their coverage. They can also check their plan documents to see if they will require a referral from a primary care doctor to see a dermatologist. To avoid unexpected expenses, a person should first check that Medicare covers the service a dermatologist recommends.
It is important to note that with certain Advantage plans, to get coverage, a person may need to visit an in-network dermatologist or receive a referral from their primary care physician.
Medicare Part D
Medicare Part D provides coverage for prescription medications. As such, Part D may cover medications for managing skin conditions or drugs for treating skin cancer, such as chemotherapy drugs.
However, the exact drugs covered depend on the specific plan and whether they’re included in the plan’s formulary, which is a list of covered drugs.
When Medicare Part B covers dermatological services, the Part B deductible, which is $257 in 2025, applies. After a person meets the deductible, they will be responsible for 20% of the Medicare-approved amount for dermatological services.
This amount is the coinsurance. But, if the healthcare professional involved does not agree to Medicare’s rates, the out-of-pocket cost may be higher. In addition, a person has to pay the monthly premium for Part B, which starts at $185 in 2025, depending on a person’s income.
Part C
Meanwhile, Advantage plans have different deductibles, premiums, and coinsurance. In addition, to stay enrolled in a Part C plan, a person still has to pay the Part B premium. That said, some Part C may cover this cost.
Part D
Medicare Part D plans usually cover the costs of prescribed medications. These costs vary based on the tier in which a drug is classified within the plan’s formulary. Generally, the higher the tier, the higher the copayment.
A person should be sure that any drugs that their dermatologist prescribes are on their plan’s list. The insurer provides this information. To help save costs, a person can check if a generic version of a drug is covered or ask their doctor to prescribe an alternative drug that the plan covers in a more affordable tier.
Medigap
If a person has Medicare supplement insurance, also called Medigap, this can help them cover some of the out-of-pocket costs remaining after Original Medicare coverage kicks in. However, the specific coverage depends on a person’s Medigap plan, and these plans can only be used with Original Medicare and not with Medicare Advantage.
Medicare covers services to treat skin-related medical conditions, but does not usually cover cosmetic services. Examples of services considered cosmetic include treatment for acne, wrinkles, and other signs of aging. However, there can be exceptions, depending on a person’s exact plan and their specific skin condition.
Also, Medicare Part D does not usually cover prescription medications to promote hair growth or other medications that address concerns considered cosmetic.
As always, it is important to check ahead of time whether a service or procedure is covered. A person may also need to obtain prior authorization from Medicare or their Advantage plan administrator to ensure that their plan will cover the costs.
Medicare Part B covers one full-body exam within the first 12 months of coverage. This screening can include an examination of the skin.
Medicare will only cover acne treatment when it is medically necessary and not for cosmetic purposes. This may be the case if the acne is severe, but approval for coverage depends on the specific case and the specific Medicare plan.
Medicare does not cover cosmetic hair loss treatment, but may cover it when medically necessary. For example, it may cover a scalp hypothermia device to help with hair loss resulting from chemotherapy.
Dermatological services can be crucial for a person as they age, especially those used to detect and treat skin cancer. Medicare covers most costs relating to skin cancer and other skin conditions, such as psoriasis, rosacea, and eczema.
Medicare does not cover most preventive full-body exams or cosmetic treatments.
Before having a procedure, make sure that the dermatologist accepts the assignment from Medicare or is an in-network provider.
Sources
- Costs. (n.d.). https://www.medicare.gov/basics/costs/medicare-costs
- Drug coverage under different parts of Medicare. (n.d.). https://cmsnationaltrainingprogram.cms.gov/sites/default/files/shared/11315-P%20Drug-Coverage-Parts-Medicare.pdf
- How do drug plans work? (n.d.). https://www.medicare.gov/health-drug-plans/part-d/what-plans-cover/how-drug-plans-work
- How much does Medicare drug coverage cost? (n.d.). https://www.medicare.gov/health-drug-plans/part-d/basics/costs
- Initial preventive physical exam (IPPE). (n.d.). https://www.cms.gov/Medicare/Prevention/PrevntionGenInfo/medicare-preventive-services/MPS-QuickReferenceChart-1.html
- Medicare and you handbook 2025. (2025). https://www.medicare.gov/Pubs/pdf/10050-Medicare-and-You.pdf
- Reynolds RV, et al. (2024). Guidelines of care for the management of acne vulgaris. https://www.jaad.org/article/S0190-9622(23)03389-3/fulltext
- Scalp cooling for the prevention of chemotherapy-induced alopecia. (2023). https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=39573&ver=3
- Understanding Medicare Advantage plans. (2024). https://www.medicare.gov/publications/12026-understanding-medicare-advantage-plans.pdf
- What is Medicare Part C? (2024). https://www.hhs.gov/answers/medicare-and-medicaid/what-is-medicare-part-c/index.html
- What Part B covers. (n.d.). https://www.medicare.gov/providers-services/original-medicare/part-b