WHY DO I NEED A DERMATOLOGIST?
After completing their 4 year medical degree and an internship, dermatologists receive 3 more years of training dedicated to your skin, hair and nails. Dermatologists dedicate their skills and energy to treating many common conditions of the skin including acne, rashes, rosacea, psoriasis, warts and several forms of skin cancer. Dermatologists can use their skills to diagnose possible problems that can range from minor to life threatening. When dealing with concerning skin condition, it is beneficial to your health to see a medical doctor who specializes in these conditions and can provide safe and effective treatment from right inside the office.
WILL MY INSURANCE COVER BEING SEEN BY A DERMATOLOGIST?
You should contact your insurance company and ask them whether a specific procedure or appointment will be covered by your insurance. Look for a phone number or website address on your insurance card to find the appropriate contact information, your dermatologist has limited information about what a patient’s insurance covers. It is important to be aware that your insurance provider cannot fully guarantee coverage until the appropriate claim is filed and reviewed.
WHAT IS A CO PAY?
A co-pay is the amount of money you pay EACH time you receive medical care, your copay can vary between visits to a primary care physician, emergency rooms and specialist’s such as your dermatologist. Copays can change annually so it is beneficial to contact your insurance company to determine what this copay will be before making an appointment with a dermatologist as you will be required to pay this amount at each visit.
WHAT IS A DEDUCTIBLE?
A deductible is the amount of money that you are required to pay out of pocket before your insurance company begins to pay towards your medical treatment. Your dermatologist will bill your insurance company first, you will owe any remaining money that must be paid towards your deductible. Be aware that your deductible starts again on a specified date each year as stated on your insurance card. Should you have money remaining on your deductible at the time of visit, you will be asked to pay towards this while in office. A normal office visit can range anywhere between $100 to $200. A statement can be mailed to you for any remaining balances.
WHAT IS THE DIFFERENCE BETWEEN A COSMETIC TREATMENT AND MEDICAL TREATMENT?
A medical treatment is considered medically necessary including treatment for skin cancers or conditions that are symptomatic and require treatment such as common skin conditions like psoriasis or eczema.
Cosmetic procedures on the other hand are not considered medically necessary and mainly performed to enhance a person’s appearance. These types of procedures are not covered by insurance and will be an out of pocket expense. Insurance companies vary in how they determine which procedures are medically necessary or considered a cosmetic treatment, your insurance contract explains what your insurance will cover.
WHAT WILL MEDICARE NOT COVER WHEN VISITING A DERMATOLOGIST?
Medicare will not cover cosmetic procedures. This includes procedures to remove unwanted hair, treatment to diminish the appearance of wrinkles, removal of non-cancerous moles/growths that do not interfere with the normal function of your body, unwanted facial veins, fillers or skin peels.
Dermatologists can not file a medicare claim for a procedure that is not considered medically necessary. If medicare does not cover a procedure, you will be asked to fill out an Advanced Beneficiary Notice (ABN) form. The purpose of this form is to help you make an informed decision on whether you would like receive treatment or a medication, knowing that you may have to pay for it.
HOW DO I KNOW WHAT COVERAGE I HAVE FOR PRESCRIPTIONS?
Before filling a prescription, make sure you have all of your insurance cards on hand. Some insurance companies work with other businesses to manage medication coverage. The pharmacist will be able to provide you with up to date information on your coverage and determine what you will be required to pay. If you have questions on concerns about what is covered, you should contact your insurance company.
When visiting Michigan Dermatology. Make sure to provide the office with accurate insurance information. Your dermatologist can keep in mind what may not be covered when prescribing a medication for your skin. If a prescription that has been sent is not covered by your insurance, you are encouraged to contact the office so further treatment options can be discussed or a replacement medication that is covered can be sent instead.