The use of chemical peels in medical settings is on the rise. They can be used for either cosmetics or medicine. Inquiring minds want to know if chemical peels are covered by health insurance. Yes, no, and it depends are all possible responses. In this article, we’ll go over what factors insurance companies use to decide whether or not to pay for chemical peels.
Dermatologist Chemical Peel Insurance
You can use chemical peels on your face, hands, and neck to improve your appearance. You can use them to make your skin look and feel better. Chemical solutions will be applied to the treatment area, triggering exfoliation and peeling of the skin. When this occurs, the underlying skin is often younger looking, less damaged, and less wrinkly.
Chemical peels are a great way to get glowing skin. This procedure involves applying a chemical solution to the skin, causing it to “blister” and then peel off. The new skin typically has fewer wrinkles and feels smoother than the old skin.
What is a chemical peel?
A chemical peel is a cosmetic or therapeutic procedure in which a chemical, typically an acid, is applied to the skin. The peel promotes exfoliation, clears out blocked pores, and raises collagen production.
What do chemical peels help with?
Problems as diverse as acne, sun damage, wrinkles, acne scars, melasma, ingrown hairs, hyperpigmentation, and more can all be treated with chemical peels.
Chemical peel insurance coverage
The purpose of health insurance is to pay for medical care provided by licensed medical practitioners. Both the medical and cosmetic fields make use of chemical peels. Chemical peel coverage from insurance companies is conditional on the following factors:
1. First, why are we doing a chemical peel?
Insurance companies typically won’t cover the cost of a chemical peel if it’s being done for esthetic reasons alone, like reducing the appearance of wrinkles or sun damage. Sometimes it will cover medical conditions, but not cosmetic ones.
2. What condition is the chemical peel intended to treat?
Whether or not your chemical peel is covered by insurance is also dependent on the nature of your diagnosis. Acne, hyperpigmentation, melasma, and actinic keratoses are frequently diagnosed and covered by insurance (precancerous lesions).
3. Type of chemical peel
Another consideration for payment by your health plan is type of chemical peel such as superficial or medium depth peel. The type of peel also must be paired with a covered diagnosis. For example, a plan may pay for a superficial chemical peels for acne, but not hyperpigmentation.
4. What else can be done?
In some cases, the insurance will pay for a chemical peel for a particular problem only after certain other treatments have failed. An example would be an insurance plan requiring that someone has tried field therapy before they agree to covering medium depth peels for actinic keratoses.
5. When to get a chemical peel
In some cases, the chemical peel must be scheduled for a separate office visit from the consultation or other service. This simply means that the peel will require its own appointment with the patient.
6. Who is doing the chemical peel?
Some peels are performed by aestheticians (estheticians) in addition to licensed healthcare professionals like doctors, PAs, NPs, and RNs. However, aestheticians require a cosmetology license because they practice a branch of the science of aesthetics. Insurance companies will pay only for care rendered by licensed medical personnel. However, unless the aesthetician also holds a healthcare license, such as a nurse aesthetician, the chemical peels they perform cannot be billed to insurance.
7. Is insurance always going to pay for a chemical peel? No.
Chemical peels are not covered by all medical insurance policies, even when performed by a doctor or other licensed medical professional for a medical condition. The chemical peel can help the patient, but the patient will be responsible for the cost.
8. Chemical peels are covered by my insurance, but I still got a bill.
Even if a chemical peel is covered by your insurance, you may still be responsible for paying a deductible or coinsurance. This means the patient and the insurance company each pay a portion of the peel’s cost, as outlined in the policy.
Common dermatological procedures (and their costs)
Acne, wrinkles, and other skin issues can all be treated at a dermatologist’s office.
Dermatological procedures often covered by insurance
- Steroid injections: A cortisone injection can quickly reduce redness and flatten painful acne nodules or cysts. Keloids and other types of scars can also be reduced with this type of shot. Although insurance may cover this procedure, you may be responsible for the full cost if you haven’t yet reached your deductible. A copayment or coinsurance might be required after that. These injections can cost more than $100 without health insurance.
- Surgery: A surgical procedure may be recommended by your doctor if a pimple refuses to go away. Skin tags, moles, keloids, and other types of scars can sometimes be removed surgically as well. This surgery is typically covered by health insurance because health plans consider it to be medically necessary. You may have to pay a deductible in addition to your copayments or coinsurance. However, surgical procedures are not always paid for. In most cases, mole removal surgery is considered cosmetic if the mole in question poses no health risks. Without medical insurance, the cost to have a mole removed can range from $150 to over $1,500.
- Light therapy: Psoriasis, eczema, and vitiligo can all be treated with light therapy or phototherapy, which involves exposing the skin to various wavelengths of ultraviolet (UV) light. Most patients require multiple, continuous sessions of treatment to see improvement. Without health insurance, the cost of phototherapy per session is around $65, but some patients require as many as 36 sessions spread out over several weeks. One viable and less expensive alternative is UV light therapy that can be performed at home. A handheld phototherapy unit for the home can cost several hundred dollars, while a full-body lamp panel can cost several thousand. Some home phototherapy units and professional light therapy sessions may be covered by your health insurance.
Dermatological procedures usually not covered by insurance
- Chemical peels: In addition to reducing the severity of acne and its scars, chemical peels can reduce the appearance of fine lines and wrinkles. Most insurance companies will not pay for these peels because they are considered experimental or investigational. A chemical peel can cost anywhere from $100 to $6,000, depending on the severity and length of the procedure. The price typically increases with peel depth. The American Society of Plastic Surgeons estimates that the typical price of a chemical peel is over $500.
- Facials:A facial should only be done by a trained esthetician. This could take place at a spa or dermatologist’s office. Scrubbing, steaming, masking, and extracting clogged pores are the standard components of a facial. Depending on the services you require, costs can be anywhere from less than $100 up into the hundreds.
- Laser therapy: Acne scars and discoloration can be reduced or eliminated with laser skin resurfacing. Costs per visit to a dermatologist range from $600 to $2,500.
- Microdermabrasion:Microdermabrasion can lighten dark spots, even out skin tone, and revitalize a lackluster complexion. The average price of a microdermabrasion treatment is $167, as reported by the American Society of Plastic Surgeons. In order to see optimal results, you may require multiple sessions.
Costs you may incur if your insurance doesn’t cover dermatological care
Most medical health insurance plans, as was previously mentioned, will cover dermatological care if it is deemed medically necessary. Commercial insurance, Medicare, Medicaid, and Tricare will typically pay for dermatology services.
Your commercial health insurance or Medicare plan won’t start paying for anything until you’ve met your deductible. After that, regular doctor visits may necessitate a copay or coinsurance payment. Some medical professionals, such as dermatologists and plastic surgeons, charge more than others for patient visits. Members of Medicaid and Tricare typically have few out-of-pocket costs.
Health savings accounts and flexible spending accounts frequently pay for acne treatments and other dermatological procedures. These funds can be used to buy any topical skin care product, whether it be a prescription or not.
How to locate a dermatologist who accepts your insurance and what services are covered
Review the summary of benefits and coverage that comes with your insurance policy to learn what is and is not covered (SBC). An SBC is a document provided by health insurance companies that details the services covered by the plan, those that are not, and the distinction between in-network and out-of-network care. Your SBC will be listed in your patient portal or you can get it by calling your insurance company.
Make sure the doctor you want to see participates in your health insurance network by using the online provider search tool provided by your health plan.
If you have any questions, you should consult with your provider or insurance company.
How to proceed if an operation is not covered
If your healthcare provider recommends a dermatological service but your insurance won’t pay for it, you and your provider can talk about other options. If you have exhausted all other avenues, you should inquire with your doctor’s office about any applicable discounts. If you pay for the entire procedure in advance, for instance, you may be eligible for a discount. Medical credit cards and other forms of medical financing may allow you to make manageable monthly payments if you don’t have the money on hand. A payment plan arranged with your service provider is another option.
The bottom line
Medically necessary dermatological services, such as steroid injections, surgery, and light therapy, are typically covered by insurance. Insurance plans rarely pay for cosmetic procedures like chemical peels, facials, laser treatment, or microdermabrasion. Find out what dermatological services are covered by your plan by reviewing your summary of benefits and coverage. If you need to pay out of pocket for a procedure, talk to your doctor about arranging a payment plan or looking into a medical credit card.