Does Medicare Cover Mole Removal?

Moles are often harmless, but if you see changes in color or size, or if the mole begins to itch, bleed, cause pain or become inflamed, it’s a good idea to bring it to your doctor’s attention. The primary concern with moles is the potential for melanoma.

It’s important to see your doctor without delay if you suspect melanoma. If found in the early stages, this type of cancer is highly treatable. A dermatologist can usually remove moles in the doctor’s office.

Medicare typically doesn’t cover the costs of mole removal or other dermatology services. However, if the mole removal is deemed medically necessary, outpatient surgery is covered under Medicare Part B.

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Mole Removal Medicare Benefits

If you have a mole removed because you find it unattractive, Medicare would view the procedure as cosmetic surgery. Medicare does not cover cosmetic surgery unless necessary because of an accidental injury or a malfunctioning body part.

If the mole removal procedure is medically necessary, Medicare Part B covers:

• Your doctor’s services
• Outpatient surgery
• Diagnostic and treatment services

Your share of the cost:

• Part B deductible: $233 in 2022
• 20% of the Medicare-approved amount
• Copayment to the hospital outpatient facility where the procedure was performed, if applicable

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Skin Cancer Prevention Tips

An article in the National Academies Press explains two types of prevention strategies adopted by healthcare professionals:

• Primary prevention: counseling and educating patients, such as advice on limiting sun exposure and using sunscreen
• Secondary prevention: promoting self-examination and awareness of risk factors

The acronym, ABCDE, is an easy way to remember what you should look for during your self-examination. Alert your doctor if you observe any moles with one or more of the following characteristics:

• Asymmetrical: dissimilar halves and irregular shape
• Border: jagged, ill-defined, or scalloped
• Color: assorted colors in various shades
• Diameter: greater than 6 millimeters (pencil eraser or pea size for reference)
• Evolving: changing size, color, or shape

TIP: Read our companion blog on Medicare coverage for skin cancer treatment.

Skin Cancer Mole Screening

Are you wondering if Medicare covers routine skin cancer screening and mole checks? Clinical screening is when a healthcare provider examines someone who displays no symptoms.

Though Medicare does not cover routine melanoma screenings, Medicare Part B will cover your doctor’s examination of a suspicious mole, such as a change in color or a new growth on the skin. Schedule an appointment with your primary healthcare provider if you have any concerns about possible skin cancer issues.

If you visit your doctor for another medical reason, and the doctor extends the visit to investigate a worrisome mole, Medicare Part B will cover the extended visit. If your doctor refers you to a dermatologist for diagnosis and treatment, Medicare Part B will cover the specialist’s services as well.

TIP: Try the Medicare plan finder to find out which Medicare Advantage plans offer the best coverage for dermatology services and compare it against your existing coverage.

Resources

Browse these websites to find user-friendly information about moles and skin cancer:

• American Academy of Dermatology Association (AAD)
• Centers for Disease Control (CDC)