As 2021 draws to a close, it may be time to make use of your available insurance benefits before you lose them. If you’ve been putting off a dermatology service, now is the time to schedule your procedure before the end of the year. according to dr. amreen sitabkhan from united states dermatology partners in dallas and carrollton, texas, “many people know that their insurance benefits don’t necessarily carry over from year to year, but they don’t know that they may be missing out on the opportunity to use their coverage for services of dermatology. If you have a chronic skin condition, need dermatological medical treatments, or it’s just time for your annual preventive skin cancer exam, your insurance may offer coverage for these services.” in this blog, dr. sitabkhan will discuss some of the dermatology services that are covered by insurance benefits and how to use your coverage before the end of the year.
understand your insurance benefit plan
Before scheduling your dermatology visit, it’s important to understand what type of insurance you have and what dermatology services these types of plans typically cover. There are typically two types of health insurance plans: health maintenance organization (HMO) plans and preferred provider organization (PPO) plans. hmos are structured around health care coordinated by a primary care physician who provides referrals to specialists, such as dermatologists, as needed. PPOS often offer more flexibility and discretion in treatment to the person covered by the plan. Under the ppo plan, you may not need a referral to see specialists and receive coverage. Before you make your appointment with your dermatologist, make sure you understand whether or not you need a referral from your primary care doctor. In many cases, you can still receive reimbursement coverage, but it’s usually easier to follow the policies outlined by your benefit provider if plans require a referral or other procedures before treatment is covered.
What dermatology services are covered by insurance?
Insurance coverage is complex. no two insurance plans are exactly alike. Insurance providers offer companies or individuals a choice of plans. In many cases, your employer will make coverage elections and you will be given a variety of coverage options at different prices to choose from. that means your coverage may not be the same as other people in your office. according to dr. sitabkhan, “when people ask me whether or not insurance covers their dermatology services, i almost always have to give them a very frustrating answer: maybe. insurance is really an extremely complex thing. Your benefit plan may not have the same covered services as others, so it’s important to research your benefit plan before scheduling a visit.”
While insurance coverage varies between insurance providers and individual benefit plans, it’s a good rule of thumb that medically necessary treatments will generally receive some coverage. Dermatology services considered medically necessary by many insurance providers include:
- acne treatments
- treatment of skin cancer
- elimination of skin cancer
- dermatological drugs
- treatment for chronic skin diseases (eczema, psoriasis, rosacea)
- treatment for hives, warts, fungal infections and other skin conditions
- annual or regular preventative skin exams
- Does my plan include dermatology services?
- Can I see any dermatologist or do I need a referral?
- what services are covered?
- What is my coverage and do I have to pay a copay or deductible?
- Any copays or deductibles related to covered dermatology medical services
- acne treatments and medications offered in the office and for use at home
- costs for visits and treatments for common skin conditions such as rosacea, eczema, psoriasis, and rashes
- botox for hyperhidrosis (excessive sweating)
- removal and treatment of scars, warts, skin tags and other lumps or bumps
- sunscreens and lip sunscreens bought from a dermatologist
- retinoids, aloe vera, and other prescription or medication skin care products
When it comes to insurance benefits for covered services, dr. sitabkhan reminds clients, “Coverage doesn’t necessarily mean you won’t have to pay anything out of pocket for your dermatology appointment. it simply means that your insurance provider will cover part of the cost of the treatment. you may still be responsible for a deductible or copay. deductibles typically reset at the end of the year, so if you’ve already paid all or part of your 2021 deductible, be sure to take advantage and schedule your dermatology visit before the new benefit year begins.”
How do I know if a dermatology service is covered by my insurance?
before scheduling your appointment at u.s. dermatology partners, we recommend calling your insurance provider and asking the following questions to make sure your visit to the dermatologist is covered:
dr. sitabkhan recommends, “once you have your coverage details from the insurance provider, call us. uu. location of dermatology partners you want to visit. our individual dermatologists and practices may vary in the insurance benefits they accept. make sure the location and provider you want to work with can help you maximize your benefits before you schedule a visit.”
Are there ways to make dermatology services affordable that are not covered by insurance?
In addition to insurance benefits, clients whose benefit plans include flexible spending accounts (fsa) or health savings accounts (hsa) can generally use these benefits to cover out-of-pocket costs of treatment. In addition, non-covered and elective dermatological procedures, including cosmetic dermatology, can usually be purchased with FSA and HSA funds, so this is a great solution if your insurance plan includes these options. Like insurance benefits, HSA and FSA funds can also be reset at the end of the year, so if you have these funds available, now is the time to use them.
Some of the many dermatology services covered by FSA and HSA funds include:
according to dr. sitabkhan, “we understand that it can be stressful and frustrating planning dermatology services only to find out they are not covered by insurance benefits. Our knowledgeable staff members can help you budget your out-of-pocket costs for your treatment, so you won’t be surprised by any unexpected expenses. feel free to reach out if you have questions.”
do you need to use your 2021 insurance benefits before the end of the year?
if you have insurance benefits or hsa and fsa funds that you want to use for dermatology services before the end of the year, the us. uu. the dermatology partner team would love to hear from you. feel free to contact your local practice if you have questions about covered services. You can also start scheduling a visit at any time by completing our online scheduling request form. Once we receive your request, a member of our team will contact you to finalize the details of your visit.
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