Does Medicare Cover Skin Cancer Screening?

 Medicare does not cover a yearly skin exam, but it does cover diagnostic testing for new skin growths or other unexpected changes.

Generally speaking, Medicare does not fund screening for skin cancer in persons who are asymptomatic, or without symptoms.

What are the requirements for coverage?

Part B is medical insurance. It covers a visit to the doctor to address any unexpected symptoms, such as new skin growth or changes in the look of a mole.

It may even cover an unrelated session if your healthcare practitioner discovers something unexpected or uncommon on your skin.

What symptoms should you watch for?

Use the ABCDE rule to check for some of the most common melanoma symptoms. Basal and squamous cell carcinomas are more prevalent than melanomas and can cause:

• Flat, firm, pale, or yellow scar-like areas of skin
• Rough, raised, or scaly patches
• Shiny or pearly bumps with blue, brown, or black discolouration.
• lumps or growths with elevated edges and sunken centres
• open sores with ooze or crust
• Sores that don't heal or heal and come back

Will Medicare cover a biopsy for diagnosis?

If your dermatologist believes a growth or sore is cancerous, they will perform a biopsy to look for abnormal cells. Part B usually covers 80% of the cost.

Medicare may also pay for additional testing and the removal of any precancerous lesions.

How much does skin cancer screening cost?

Your out-of-pocket expenses vary depending on whether you have Part B coverage through Original Medicare or a Medicare Advantage plan.

In 2024, most persons will pay a monthly premium of $174.70 for Part B of Original Medicare. Your premium may be greater based on your income.

After meeting a $240 deductible, you will typically pay 20% of all Medicare-approved expenditures for covered procedures.

Each Medicare Advantage plan determines its own cost and coverage amount. The amounts you pay for premiums, deductibles, copayments, and coinsurance vary depending on your plan.

Staying in the network, which means receiving care from a set list of healthcare providers and facilities, is typically less expensive than going out of network.

The bottom line

Medicare does not pay for routine skin cancer screenings, but it does cover appointments with a doctor, dermatologist, or other healthcare professional to assess uncommon skin concerns.