Mohs surgery is highly effective in the diagnosis and treatment of certain types of skin cancers. Here’s what Medicare covers and how to qualify.
Mohs Micrographic Surgery is a technique used to treat types of skin cancers. If you have a mole or skin discoloration that your healthcare provider is concerned about, they may recommend Mohs surgery. As with all things Medicare, coverage depends on a variety of factors. Here’s what you need to know about Medicare coverage of Mohs surgery.
What is Mohs surgery?
Mohs surgery is a precise method for treating skin cancer lesions.
During this procedure, a Mohs surgeon removes thin layers of skin – one layer at a time – and examines each one under a microscope to look for cancer cells. If cancer cells are detected in the sample at the on-site laboratory, another layer of skin is removed. The Mohs surgery typically ends when no cancer cells are found in the sample.
Mohs surgery is named after Frederic E. Mohs, MD, the surgeon who developed the technique.
When is Mohs surgery used?
Your doctor may use Mohs surgery to address skin cancer that is large, aggressive, or located on a sensitive body part, where it is crucial to minimize the removal of normal healthy tissue, such as the head, face, neck, fingers, toes, or genitalia.
The procedure may also be used for people with a suppressed immune system or when the skin cancer returns after a previous treatment.
Mohs surgery can treat many forms of skin cancer, including the following:
**Basal cell carcinoma
Squamous cell carcinoma
No matter what type of skin cancer you have, Mohs surgery is only effective for certain patients. Your dermatologist will let you know if this form of cancer treatment is effective for your type of cancer.
Is Mohs surgery effective?
The American Academy of Dermatology Association states that Mohs surgery has a high cure rate and is extremely effective for certain types of cancer cells.
Mohs surgery is effective because it thoroughly evaluates the tissue surrounding the cancer and only ends when healthy tissue remains.
Please note that even though the Mohs surgery is effective – and skin cancer is easily treated when caught early – cancer cells can travel throughout your body and metastasize to other areas through your circulatory system.
If you notice a new spot or mole or a change in a mole’s color or appearance, have your mole evaluated by a dermatologist. You also should have moles checked if they bleed, ooze, itch, appear scaly, or become tender or painful.
Does Medicare cover Mohs surgery for skin cancer?
Medicare covers medically necessary Mohs surgery. It’s important to note that Medicare does not cover cosmetic surgery – or skin surgery done solely for cosmetic reasons. But the program will cover Mohs surgery if the skin being removed is suspected of being cancerous – but turns out not to be.
Here’s how Medicare coverage works for medically necessary Mohs surgery.
Medicare Part B (medical insurance)
Most of the time, Mohs surgery is performed in an outpatient setting – such as a doctor’s office, which means that Medicare Part B covers it.
After paying your Medicare Part B deductible, you will only be responsible for 20% of the Medicare-approved amount.
Medicare Part A (hospital insurance)
If, for some reason, you have a Mohs medical procedure while you are a hospital inpatient, Medicare Part A will cover the surgical procedure after you pay the deductible for the benefit period.
You may be required to take post-surgery medications to improve healing or prevent infection. A Medicare Part D plan may cover needed medications, but the copays depend on the plan and pharmacy.
A Medicare Advantage plan offered by a private health insurance company must provide the same coverage as Original Medicare. But these plans also offer additional coverage, such as a yearly melanoma screening. Additionally, a Medicare Part C plan may enable you to save on out-of-pocket costs for your procedure.
Medicare Supplement Insurance helps cover your out-of-pocket costs when you have Original Medicare. How much is covered depends on which plan you choose (but they all cover at least half of your coinsurance for covered services).
You can compare Medicare plans quickly and easily with our Find a Plan tool. All you need to enter is your zip code to start reviewing the costs and benefits of Medicare plans in your area. Or, call us toll-free at 888-992-0738 and one of our licensed agents will answer your questions and help you choose the right Medicare coverage for your unique needs.
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