Common Questions

Does Medicaid Cover Dermatology?

Medicaid may cover some dermatology services in your state, but it depends on where you live. Each state can offer optional Medicaid benefits in addition to federally required benefits, and in some states, dermatology may be one of those services.

Medicaid may cover dermatology services in some states as an optional benefit. But because acupuncture is not a mandatory Medicaid benefit, it may not be covered in all states. 

Each state has two sets of Medicaid benefits: those that are required by the federal government to be offered (mandatory) and those that the state chooses to offer on its own (optional). 

Dermatology is not a required benefit, so whether or not dermatology is covered by Medicaid is up to each individual state Medicaid program to decide.

When might Medicaid pay for dermatology?

If your state Medicaid program covers any dermatology treatments, you will likely need to get a referral letter from your primary care doctor stating that the dermatologist treatment is medically necessary.

If the condition is something like simple acne, there’s less of a chance that the treatment will be approved for Medicaid coverage because it’s likely to be considered a cosmetic treatment rather than something that’s necessary for your health. 

Some of the skin conditions that may be considered medically necessary – and therefore may in some instances be eligible for Medicaid coverage – include skin cancer, psoriasis, eczema and severe birthmarks.

If dermatology is covered by Medicaid in your state, you will need to see a dermatologist who accepts Medicaid. If the dermatologist does not accept Medicaid, you may be charged more or not receive any coverage at all.  

How do I find a dermatologist who accepts Medicaid?

To find out if dermatology is covered by Medicaid where you live, contact your state Medicaid program directly to ask if dermatology is covered and for any additional information you need to know about the benefits that are covered. 

If dermatology is covered in your state, your state’s Medicaid website may have a doctor search tool that allows you to find doctors near you who accept Medicaid. According to Doctor.com, nearly 6,000 dermatologists in the U.S. accept Medicaid.

Medicaid-Medicare plans and dermatology

Some Medicaid beneficiaries are also eligible for Medicare. Some “dual-eligible” beneficiaries may be able to enroll in a certain type of Medicare Advantage plan called a Dual-eligible Special Needs Plan, or D-SNP.

These plans are designed specifically for those who are eligible for both Medicare and Medicaid, and they can include additional benefits that are not traditionally offered by either Medicare or Medicaid. Some of those additional benefits may include coverage for dermatology or over-the-counter health products that can include certain dermatology creams and other treatments. 

If you are eligible for Medicare, speak to a licensed insurance agent to find out if Dual-eligible Special Needs Plans are available in your area and how they might cover dermatology and other benefits. 

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Christian

About the author

Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.

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