Your visit to the dermatology office can sometimes require medical procedures to be performed. Some common procedures include: mole removal, skin sample testing, and biopsies for suspicious skin formations. Any procedure that takes place during your appointment is not covered by the initial visit fee paid when you first checked-in. There is always a separate fee for a procedure - sometimes your insurance company will pay for it, sometimes it won’t. This can be quite frustrating and difficult to understand for many patients. These exclusions can still surprise you, even when you think you have the best insurance for a dermatology visit. This variability in insurance is a nationwide issue, and not just related to Houston Dermatologists.
Insurance companies are particularly finicky when it comes to covering the costs of dermatology visits. They will usually deny coverage for any kind of treatment they do not consider to be “life-saving,” or “medically necessary” meaning, they will only cover medical fees for health issues and health conditions that they deem as “not cosmetic.” But the issue is, a dermatology office visit can often involve procedure, and although that procedure may not be “life-saving,” it is still important to the patient’s overall health and well-being (no one wants an ugly mole on the face). A lot of times, a dermatology surgery or procedure is classified by your insurance as an “elective” or “optional” treatment - but what the insurance company doesn’t take into consideration is the fact that the procedure is still vital to your day-to-day life and work place success.
If you are planning your dermatologist visit in Houston or elsewhere, the best thing to do is call your insurance company first and ask them some key questions like:
1 - what will my specialist copay be(this is different from the general copay)
2 - What is my deductible and how far am I from meeting it
On the other end of things, patients also encounter issues with the deductible. This is a scenario in which your insurance does cover the procedure or visit but only after you have paid a certain amount out of pocket for medical care (this amount is called the deductible). As an example, you may have to pay the first 2,000 dollars of any medical care before your insurance kicks in for procedures.
So, you’re probably wondering what insurance company is best to be covered by when it comes to dermatology. The answer is: there is no answer. It’s a complicated predicament, and there doesn't seem to be an easy solution.