Medicare Part B covers dermatologist visits, but only for medical skin conditions — not cosmetic ones

Yes, Medicare Part B covers dermatologist visits and treatment for skin conditions that affect your health. The key word is medical. If you see a dermatologist for a mole that could be skin cancer, a rash that won't heal, or an infection, Medicare will typically pay its share. If you see one for wrinkle removal, age spots you want gone for appearance, or hair loss that is not causing a medical problem, Medicare will not pay.

You pay a copay (usually $20) at the visit, and Medicare covers 80 percent of the approved amount for the dermatologist's service after you have met your Part B deductible for the year. The dermatologist must be enrolled in Medicare for this to work smoothly — if they are not, you may owe more out of pocket.

Key Takeaways

  • Medicare Part B covers dermatologist visits for medical skin conditions such as suspicious moles, infections, rashes, and precancerous growths.
  • Cosmetic treatments — wrinkle removal, age spot removal for appearance only, and hair loss treatment — are not covered by Medicare.
  • You will owe a $20 copay at the visit, and Medicare covers 80 percent of the approved charge after your Part B deductible is met.
  • Check whether your dermatologist accepts Medicare assignment before your visit, because out-of-pocket costs are higher if they do not.

What Medicare covers at a dermatologist

Medicare covers the office visit itself and any medical procedures the dermatologist performs during that visit. This includes skin biopsies (removing a small piece of skin to test for cancer), removal of precancerous lesions, treatment of fungal or bacterial infections, and evaluation of rashes or other skin conditions that affect your health or function.

If the dermatologist diagnoses you with skin cancer or a precancerous condition and removes it during the visit, Medicare covers that removal. If they prescribe a topical medication or oral medication for a skin condition, the medication itself is covered under Part D (your prescription drug plan) if you have one, not by the dermatology visit.

Certain procedures that treat a medical problem are also covered — for example, removal of a cyst or growth that is infected or causing pain, or treatment of severe acne that is affecting your skin health. The dermatologist's documentation has to show the medical reason for the procedure, not a cosmetic one.

What Medicare does not cover

Medicare does not cover any treatment done primarily for appearance. This includes Botox, dermal fillers, chemical peels for wrinkles, laser resurfacing, and removal of age spots or sun spots when the only reason is how they look. Hair loss treatment is not covered unless the hair loss is a symptom of a diagnosed medical condition (such as alopecia areata, an autoimmune disease) rather than male or female pattern baldness.

Mole removal is a gray area. If a mole is suspicious for skin cancer or is changing in size or appearance, Medicare covers removal. If you want a mole removed only because you do not like how it looks, Medicare does not cover it. The dermatologist has to document the medical reason in your chart.

How much you will pay out of pocket

Your costs depend on whether you have met your Part B deductible ($240 in 2024, though this amount changes yearly) and whether the dermatologist is enrolled in Medicare.

If the dermatologist is enrolled in Medicare and accepts assignment, you pay a $20 copay at the visit. Medicare then pays 80 percent of the approved amount, and you owe 20 percent coinsurance. For example, if the approved charge is $200, you pay $20 copay plus $40 coinsurance (20 percent of $200), for a total of $60.

If the dermatologist is not enrolled in Medicare or does not accept assignment, they can charge you more than the Medicare-approved amount. You may owe the full difference out of pocket on top of your copay and coinsurance. Always call the dermatologist's office before your visit and ask: "Do you accept Medicare assignment?" If they say no, ask what they charge and whether you can see a Medicare-enrolled dermatologist instead.

How to find a Medicare dermatologist

Use the Medicare Provider Search tool on Medicare.gov. Go to the home page, select "Care Providers," and search by location and specialty. Type "dermatology" in the specialty field. The results will show you dermatologists in your area, their office addresses and phone numbers, and whether they accept Medicare assignment.

You can also call your Medicare Advantage plan (if you have one) and ask for a list of in-network dermatologists. If you have Original Medicare with a Medigap or Part D plan, call your Medigap or Part D plan to confirm they cover dermatology visits the same way.

When you call to make an appointment, tell the office staff that you have Medicare and ask them to confirm the dermatologist accepts assignment. Some offices will also ask you to bring your Medicare card and photo ID to the visit.

When to see a dermatologist

You should see a dermatologist if you notice a new mole or a change in an existing mole — size, color, shape, or texture. The ABCDE rule helps: A (asymmetry — one half does not match the other), B (border irregularity), C (color variation), D (diameter larger than a pencil eraser), E (evolving or changing). Any of these warrants a visit.

You should also see a dermatologist for a rash that does not go away in two weeks, signs of infection (warmth, redness, pus, swelling), severe acne, or any skin condition that is painful, itchy, or spreading. If you are unsure whether something needs a dermatologist, start with your primary care doctor, who can refer you if needed.

Frequently Asked Questions

Does Medicare cover skin cancer screening?

Medicare covers a dermatologist visit if you have a suspicious mole or lesion that needs evaluation. Medicare does not cover routine skin cancer screening (a full-body check with no symptoms) as a preventive service. However, your primary care doctor can do a basic skin check during an annual wellness visit, which Medicare covers.

Will Medicare pay if my dermatologist removes a mole I have had for years?

Only if the mole has changed or is suspicious for cancer. If the mole is stable and you want it removed only for appearance, Medicare will not pay. The dermatologist's notes must document a medical reason — change in appearance, itching, bleeding, or concern for malignancy — for Medicare to cover removal.

What if my dermatologist wants to do a biopsy?

Medicare covers skin biopsies when there is a medical reason — a suspicious lesion, rash, or infection that needs diagnosis. You will owe your copay and coinsurance, but the biopsy itself is covered. The lab work to analyze the biopsy is also covered under Part B.

Can I use my Medigap plan to lower my out-of-pocket costs at the dermatologist?

Yes. Most Medigap plans cover some or all of your copay and coinsurance after Medicare pays. Check your Medigap plan documents or call the plan to confirm what dermatology costs are covered. Your Medigap plan will pay the insurance company directly, not the dermatologist's office.

Does Medicare cover dermatology if I have a Medicare Advantage plan?

Yes, but your copay and coinsurance may be different from Original Medicare. Medicare Advantage plans must cover the same services as Original Medicare, but they set their own copays and deductibles. Check your plan documents or call your plan to find out what you owe for a dermatology visit.