Medicare covers skin cancer screening as a preventive service at no cost to you
Medicare Part B covers a screening for skin cancer once every 12 months if your doctor refers you for one. You pay nothing for this visit — no copay, no coinsurance, no deductible. The screening must happen in a doctor's office or clinic, and your doctor has to document that there is a medical reason for the visit (such as a family history of skin cancer, fair skin, or a previous skin lesion).
If your doctor finds something during the screening that needs a biopsy or removal, that second procedure is treated separately. A biopsy or removal may have a copay or coinsurance depending on your plan, because it moves from prevention into treatment.
This coverage applies if you are enrolled in Original Medicare (Part A and Part B). If you have a Medicare Advantage plan, coverage varies by plan — you should call your plan to ask what it covers for skin cancer screening.
Key Takeaways
- Medicare Part B covers one skin cancer screening per year at no cost when your doctor refers you and documents a medical reason.
- The screening itself is free, but if your doctor removes or biopsies a lesion during that visit, you may owe a copay or coinsurance for the removal or biopsy.
- Medicare Advantage plans have different rules, so you need to check your specific plan's coverage before your appointment.
- Your doctor must order the screening — you cannot schedule one on your own and expect Medicare to cover it.
- Dermatologists and primary care doctors can both perform covered skin cancer screenings.
How the screening visit works under Medicare
During a covered screening, your doctor examines your skin for signs of melanoma, basal cell carcinoma, or squamous cell carcinoma. The doctor may use a dermatoscope (a magnifying tool) to look more closely at any spots. The visit is meant to catch skin cancer early, before symptoms appear.
Your doctor documents the reason for the screening in your medical record — for example, "history of atypical moles" or "fair skin with sun exposure." Medicare requires this documentation to pay for the screening as preventive care rather than as a problem visit.
If your doctor sees something suspicious but wants to watch it rather than biopsy it, that monitoring is still part of the preventive screening and covered at no cost. You do not pay extra for the doctor's judgment to wait and see.
What happens if your doctor finds something during the screening
If your doctor finds a spot that looks like it could be skin cancer, they may remove it or take a biopsy (a small tissue sample) during the same visit. This is where your costs can change. The removal or biopsy is considered a treatment procedure, not part of the preventive screening, so it may have a copay or coinsurance.
The exact amount depends on your Original Medicare plan and whether you have supplemental coverage (Medigap). If you have not met your Part B deductible for the year, you may owe the deductible before Medicare pays its share. Ask your doctor's office to tell you the expected cost before the procedure if you are concerned about out-of-pocket expenses.
Pathology fees — the cost of analyzing a biopsy sample in the lab — are also covered by Medicare Part B, usually with a copay or coinsurance. Your doctor's office can often give you an estimate of these costs ahead of time.
Differences between Original Medicare and Medicare Advantage
Original Medicare (Part A and Part B) covers the preventive skin cancer screening at no cost once per year. If you have a Medigap supplemental plan, it may cover some or all of your copay or coinsurance for any procedures that follow.
Medicare Advantage plans (Part C) must cover at least the same preventive services as Original Medicare, but they can structure the coverage differently. Some Advantage plans cover the screening at no cost; others may charge a copay. Some plans require you to see an in-network dermatologist or your primary care doctor. Call your plan's member services number (on the back of your card) to ask about skin cancer screening coverage before you schedule an appointment.
If you switch from Original Medicare to a Medicare Advantage plan or vice versa, your coverage for skin cancer screening may change. It is worth checking your new plan's rules during the transition.
When Medicare does not cover skin cancer screening
Medicare does not cover a skin cancer screening if your doctor does not refer you or does not document a medical reason for the visit. For example, if you call a dermatologist and ask for a routine skin check with no symptoms or risk factors, and the dermatologist agrees to see you without a referral, Medicare may not pay for that visit.
Cosmetic procedures — such as removal of a mole purely for appearance — are not covered by Medicare even if the mole is examined during the visit. If your doctor removes a spot for cosmetic reasons rather than medical reasons, you pay the full cost.
Screening by a nurse practitioner or physician assistant in a dermatologist's office is covered the same way as screening by a dermatologist, as long as the visit meets Medicare's requirements. Telehealth skin cancer screenings are generally not covered by Medicare because the doctor cannot perform a thorough in-person examination.
How to make sure your screening is covered
Before your appointment, tell your doctor that you want a skin cancer screening and ask them to document a medical reason — such as a family history of skin cancer, your skin type, or a previous abnormal mole. This documentation is what Medicare uses to determine coverage.
If you have Original Medicare, you do not need to call Medicare ahead of time. Your doctor's office will submit the claim after your visit, and Medicare will pay its share. If you have a Medicare Advantage plan, call your plan to confirm coverage before the appointment so you know what you will owe.
Ask your doctor's office to give you an estimate of any costs for removal or biopsy before the procedure. If you have a Medigap plan, call that plan too — it may cover costs that Original Medicare does not.
What to ask your doctor
Before your skin cancer screening appointment, ask your doctor these questions:
- Will you document a medical reason for this screening so Medicare covers it?
- If you find something during the screening, what would the removal or biopsy cost me?
- How long does the pathology report take if you do a biopsy?
- When should I come back for a follow-up screening?
- Are there any spots you want me to watch at home and report changes on?
Frequently Asked Questions
Do I need a referral from my primary care doctor to see a dermatologist for a skin cancer screening?
No. Medicare Part B does not require a referral to see a dermatologist. However, your dermatologist must document a medical reason for the screening (such as a history of atypical moles or fair skin) in order for Medicare to cover it as preventive care.
Can I get more than one skin cancer screening per year?
Medicare covers one screening per 12 months as preventive care at no cost. If your doctor wants to see you more often because of a known skin condition or high risk, those additional visits may be covered as treatment or monitoring rather than screening, and you may owe a copay or coinsurance.
What if I have both Original Medicare and a Medicare Advantage plan?
You cannot legally have both at the same time. If you are enrolled in a Medicare Advantage plan, that is your primary coverage. If you want to switch back to Original Medicare, you can do so during the annual enrollment period (October 15 to December 7) or if you have a may have access to life event.
Does Medicare cover removal of a mole just because I do not like how it looks?
No. Medicare covers removal only if there is a medical reason — such as concern about skin cancer, irritation, or infection. Cosmetic removal is not covered, and you would pay the full cost out of pocket.
What should I do if my doctor's office says Medicare will not cover my skin cancer screening?
Ask the office to explain why. It may be that the medical reason was not documented, or that the screening was coded incorrectly. You can also call Medicare at 1-800-MEDICARE to ask about coverage for your specific situation. Keep copies of any paperwork from your doctor's office.