At the Center for Dermatology & Laser Surgery, we answer a wide variety of questions about skin conditions, but we also answer a number of questions about insurance coverage for dermatology care in Hillsboro and Portland, Oregon. In hopes of providing patients with the insurance information for dermatology care they need, we have created this guide for frequently asked questions.
Frequently Asked Questions about Insurance Coverage for Dermatology
Will my appointment be covered by my insurance company?
Major health insurance providers cover medically necessary dermatology treatments, such as skin cancer treatment and skin cancer removal. Insurance will not cover cosmetic treatments, such as laser hair removal and Botox. Patients should check with their insurance providers to learn if their policy covers evaluation and treatment for their condition.
Does Center for Dermatology & Laser Surgery accept my insurance plan?
Center for Dermatology & Laser Surgery accepts most insurance plans. We also accept CareCredit®, the healthcare credit card that provides special financing on purchases of $200 or more. Exclusively designed for cosmetic dermatology and other healthcare services, CareCredit® allows you to use your card repeatedly for any follow-up appointments or procedures you may need.
Will there be a copay?
Maybe – it depends on whether or not your individual insurance policy requires a copay. To learn if your insurance policy requires you to make a payment for appointments and follow-ups, contact your insurance provider.
Why do I have a copay for a follow up visit?
Your insurance provider may require a copay for all visits, including follow up visits. Contact your insurance company to learn whether your contract requires you to contribute payment for follow-ups, and to determine how much the copay would be.
Who should I contact to understand whether my insurance will cover the visit?
Your insurance provider is always a great place to start when determining what services your individual policy will cover. Of course, our billing professionals at Center for Dermatology & Laser Surgery are always glad to help – we have exceptional relationships with all the major insurance providers in the nation.
What types of insurance do you accept?
We accept major insurance providers, such as:
- First Health – Group Health Only
- First Choice Health Network
- Great-West Healthcare
- Humana Medicare
- Kaiser Permanente – Added Choice
- Managed Health Care NW (MHN)
- Pacific Source
- Providence Health Plan – Medicare – EPO – PPO
- Providence Preferred
- RailRoad Medicare
- Regence BCBS
- United Healthcare
Which services are covered by my insurance?
While the details of coverage vary between insurance providers, most insurance companies pay for medically necessary evaluations and treatments, and do not pay for cosmetic evaluations and treatments.
Insurance benefits usually cover treatment for the following dermatology conditions:
- Severe acne
- Skin Cancer
- Fungal, bacterial, or viral skin infections
- Keloid scars
- Poison ivy
- Hives and skin allergies
Depending on the condition and insurance provider, insurance covers standard treatment for these conditions. Your insurance carrier may cover laser treatments for skin cancer, rashes, acne, scar removal, psoriasis, and certain types of skin infections, for example.
What types of dermatology treatments aren’t covered by insurance?
Insurance carriers typically do not cover elective or cosmetic dermatology procedures. That means your insurance company may not pay for services, such as dermal fillers, Botox, and chemical peels. However, many insurance companies are expanding the list of services they will cover; some now pay for the treatment of milder forms of acne, for example. Others are now offering coverage for laser procedures that remove certain discolorations from skin.
What is co-insurance?
Co-insurance is the amount you may be required to pay after you pay your deductible. Coinsurance is usually a percentage of the cost – for example, you may need to pay 20 percent of the cost of the visit, even if you have already met your deductible.
What is a deductible?
The deductible is the amount that you must pay for before your insurance begins to cover any costs at all. Depending on the terms of your individual contract, your deductible may change every year, so it is always worth reviewing your insurance policy when renewing it.
What is copay?
Copay, which is short for co-payment, is the amount you must pay for health care services even after you have met your deductible. It is different from co-insurance in that copayment is usually a set amount, rather than a percentage. Your policy might require that you pay a $15 office copay, for example.
Determining which treatments your insurance company will pay for can be complex, so we always recommend scheduling a consultation with one of our dermatologists to provide an accurate diagnosis and help you determine if your insurance will pay for treatment. Our team at Center for Dermatology & Laser Surgery is always glad to answer any questions that help you navigate your insurance coverage. For more information, please feel free to call The Center for Dermatology & Laser Surgery and speak with one of our representatives today.