February 29th 2024
By Ari Parker
Learn about Medicare coverage for skin cancer screenings. Find out what services are covered and how to ensure you receive the care you need.
Did you know that most skin cancer diagnoses occur in people aged 65 and up? While skin cancer is one of the more prevalent types of cancer, it’s also preventable if you take the right measures. It’s also highly treatable. In fact, the five-year survival rate of stage 1, localized melanoma (before it spreads to other parts of the body) is over 99%. Early detection is the key to treating skin cancer and preventing it from spreading.
While Medicare doesn’t cover regular preventive skin cancer screenings, it will cover services related to skin cancer if your doctor recommends them.
Unlike other preventative screenings, Medicare doesn’t cover regular skin cancer screenings.
Medicare does cover doctor visits and any screenings to diagnose, treat, and prevent a condition if it’s medically necessary.
There are three main types of skin cancer to look out for, and each looks a little different.
Melanoma is the most dangerous type of skin cancer. It occurs in the cells that produce the pigment in your skin, hair, and eyes. Checking for melanoma is particularly important because it has a higher chance of spreading to other parts of your body than other kinds of skin cancer.
Symptoms of melanoma include:
Itching, tenderness, or pain on the skin
Moles that bleed or ooze
Moles that are raised, have an uneven surface, or irregular border
Smaller lesions around a main mole
Moles that are not symmetrical
Moles that change in shape, size, or color over time
Basal cell carcinoma (BCC) is the most common type of skin cancer, and it occurs in the outer layer of the skin.
Symptoms of BCC include:
Shiny, pearly bump or nodule on the skin
Visible blood vessels
Red or irritated patch of skin
Squamous cell carcinoma (SCC) is a type of skin cancer that happens in the squamous cells, which are located on the outer layer of the skin. While less common than BCC, SCC can spread quicker if you don’t intervene early.
Signs of SCC include:
Scaly, red patch on the skin
Firm, raised bump with crusty surface
Tenderness around the affected area
Although anybody can develop any of the three types of cancers, people who have fair features, a history of sunburns, a genetic history of skin cancer, weakened immune system, or constant exposure to UV radiation are more at risk.
You can lower your risk of skin cancer by avoiding too much direct sunlight, using sunscreen regularly, and wearing protective clothing, like hats and long sleeves. Some Medicare Advantage plans have over-the-counter (OTC) benefits that you can use towards sunscreen and other care for skin cancer prevention.
For an easy way to check the balance of your Medicare Advantage OTC benefits and get free delivery on eligible items, visit MyOTC.com.
During a skin cancer screening, your doctor will examine your skin for any abnormalities or signs of skin cancer. The goal of the screening is to find skin cancer at an early stage when it’s easier to remove and treat it.
Doctors can detect skin cancer in a few different ways:
Clinical skin exam: A healthcare professional can do a thorough examination of your skin during a routine checkup. They may use devices to magnify and check for skin irregularities.
Demoscopy: Dermoscopy involves using a dermatoscope (a handheld device with magnification and light) to examine skin lesions more closely. This helps doctors see if your mole or skin lesion is cancerous or not.
Total body photography: For people with a high risk of developing melanoma, doctors could use total body photography. This involves taking photographs of your entire skin surface to monitor changes over time.
You may want to conduct a self-examination if you’re worried about your skin. You can stand in front of a mirror and check for any changes in size, shape, color, or texture of moles or skin lesions that you see. If you see any changes, it may be time to schedule an appointment with your doctor.
Medicare provides coverage for many regular preventive tests, but it doesn’t cover regular skin cancer screenings. That said, Medicare does cover dermatology services when they’re medically necessary.
Medicare Part B covers appointments and follow-ups with your doctor that are used to diagnose and treat a condition. If your doctor recommends screening for skin cancer, Part B will help cover it.
If you have not paid your Part B deductible yet, you’ll have to pay 100% of the cost of the doctor visit and skin cancer screening until your deductible is met. Once you meet your deductible, you’ll be responsible for 20% of the cost for the services. This payment standard also applies to any procedures that you may need to treat skin cancer, like removing a lesion. If you have a Medigap plan, it will cover some of your out-of-pocket costs.
Medicare Advantage plans will also cover skin cancer screenings if your doctor recommends them, but what you pay out-of-pocket can vary with your plan and service. Check your summary of benefits or get in touch with your insurance carrier to see what costs you’d be responsible for.
It’s always a good idea to understand your Medicare benefits for preventative care. You can get the following screenings covered by Medicare:
Cardiovascular disease screenings
Cervical and vaginal cancer screenings
Lung cancer screenings
Depression screenings
Diabetes screenings
Prostate screenings
Hepatitis B and C screenings
HIV screenings
STI screenings
Alcohol misuse screenings
Your annual Medicare “Wellness” visit is also a good time to bring up any concerns you may have about skin cancer. Your doctor can order tests for you and give you personalized prevention advice.
Have more questions about your Medicare coverage? Give us a ring at (855) 900-2427 or schedule a chat. A Chapter Medicare Advisor would be happy to help you make the most out of your benefits.
