Does Medicare Cover Skin Cancer Screening?

Does Medicare Cover Skin Cancer Screening?

Skin cancer screening starts at home. Protect yourself with monthly self-checks and see your doctor if you notice any changes.

Skin cancer is incredibly common in older adults. Most skin cancer cases (including melanoma) are diagnosed in people older than age 65.

Unfortunately, while the biggest risk factor for skin cancer is exposure to ultraviolet (UV) light, research has found that few older adults take recommended preventive measures when outdoors. Plus, because UV exposure is cumulative, the frequency and intensity of your exposure adds up over the years and increases your risk as you age.

The good news is that more than 80% of melanoma cases (the most common type of skin cancer among older adults) are diagnosed early, before the cancer has spread to other parts of the body and before it causes more harm.

Understanding Medicare’s coverage for skin cancer screenings, detection, and treatment, as well as ways to protect your skin on a regular basis, can help you lower your risk of skin cancer and detect any problems early when it’s most likely to respond to treatment. Read on to learn more.

What is skin cancer?

Skin cancer is cancer in the actual cells of the skin. There are three common types of skin cancer: Basal cell, squamous cell, and melanoma.

Basal cell carcinomas occur in the cells of the lower epidermis. These cancer cells grow slowly and, when untreated, can invade other tissue or bone nearby. This is the most common type of skin cancer, accounting for about eight in 10 skin cancer diagnoses. It tends to develop in the face, head, and neck.

Squamous cell carcinomas form in the cells of the outer epidermis that are more likely to spread in deep layers of the skin and other parts of the body. These are most common on the face, ears, lips, neck, and back of the hands.

Melanoma grows in the pigmented cells of the skin that, when left untreated, can quickly grow and spread throughout the body.

Other less common types of skin cancer include skin adnexal tumors, cutaneous lymphoma, Merkel cell carcinoma, and soft tissue sarcomas.

Medicare coverage for skin cancer screenings

If you are asymptomatic, meaning you do not have any symptoms or signs of skin cancer, a skin cancer screening is not covered by Medicare. While Medicare does cover a number of preventive screenings and tests for beneficiaries, skin cancer screenings and routine dermatology services are not included.

That said, if you notice a change in the size, shape, or color of a mole or lesion or notice a new skin growth, Medicare Part B covers a visit to your primary care provider to have the spot examined. Or, if you are having an exam for another reason and your provider notices a sign of possible skin cancer, an extension of the appointment to examine the spot may also be covered.

If you are referred to a dermatologist as a result of the exam, this specialist appointment would likely be covered by Part B. (If you have Medicaid, we explain Medicaid coverage for dermatology here.)

Skin cancer risk factors

Exposure to UV light is the biggest risk factor when it comes to developing skin cancer.

Those with pale complexions have greater risk of developing skin cancer than those with darker complexions, as do those with a family history of skin cancer or genetic conditions that negatively impact the skin’s ability to repair itself.

Age, lifestyle choices (like using tanning beds or smoking), exposure to certain chemicals, and certain health conditions can also increase your chances. Men are also at a higher risk of developing skin cancer than women are.

Signs of skin cancer

An easy way to remember the signs of melanoma are the ABCDEs.

  • “A” is for asymmetrical, if the mole or spot has an irregular shape with two parts that look different.
  • “B” is for border, if the border of the mole is irregular or jagged.
  • “C” is for color, if the color is uneven.
  • “D” is for diameter, if the mole or spot is larger than the size of a pea.
  • “E” is for evolving, if the mole or spot has changed during the past few weeks or months.

Examine your skin at least once per month, and if any of the above apply or you notice any other changes to your skin, such as new growth or a sore that doesn’t heal, talk to your healthcare provider.

Does Medicare Advantage (Medicare Part C) cover skin cancer screening?

Although private insurance companies sell Medicare Advantage plans, they are required by law to cover everything Medicare covers. They aren’t limited to that coverage, though, and most Medicare Advantage plans provide additional benefits.

Since Original Medicare covers them, Medicare Advantage plans are also required to cover all skin cancer exams and treatments that Original Medicare covers. Your Part C plan may offer additional benefits, though, so check with your plan provider to be sure. You will likely need a referral to see a specialist (such as a dermatologist).

If your doctor prescribes medication for you to take orally or a topical medication, this may be covered by your Medicare Part D prescription drug coverage. Part D is available as either a standalone prescription drug plan or a Medicare Advantage prescription drug plan. Make sure you look at the plan’s formulary to see whether the medication you’ve been prescribed is covered.

What about Medigap?

Medicare Supplement Insurance, more commonly known as Medigap, helps pay your out-of-pocket expenses when you have Original Medicare (Part A and Part B). You don’t get extra benefits like you do with an Advantage plan. Instead, your Medigap plan will cover most of your copayments and coinsurance. How much is covered depends on which plan you choose.

You can compare Medicare plans easily with our Find a Plan tool. Just enter your zip code to review costs and benefits of Medicare Advantage, Part D, and Medigap plans in your area. Or, call us toll-free at 888-992-0738 to speak to a licensed Medicare agent. We’ll answer your questions and help you find the right Medicare plan for your unique needs.

Treatment for skin cancer

The type of skin cancer you have, as well as your overall health, helps determine which treatment will be recommended by your doctor. However, one of the most standard treatment options include surgical procedures such as surface excisions and dermabrasions. Radiation, chemotherapy, or immunotherapy can also be options, as can targeted therapies that work directly on the cancer such as chemical peels, photodynamic laser therapy, or certain topical drugs.

Does Medicare cover treatment for skin cancer?

Yes, if you are diagnosed with skin cancer, treatment would be covered by either Medicare Part A or Part B.

If you need a melanoma or lesion removed from your skin, this can be done in an outpatient setting so it would typically be covered by Part B. Outpatient chemotherapy would also be covered by Part B.

Should you need inpatient treatment because of skin cancer, Part A would cover inpatient hospital costs. Inpatient chemotherapy would also be covered by Part A.

How to prevent skin cancer

There are several ways you can reduce your risk of skin cancer, but the best one is to protect your skin from UV radiation year-round. For example, avoid the sun (or stay in the shade) between the hours of 10 a.m. and 4 p.m. when UV exposure is most dangerous. Wear clothing that covers your arms and legs, a hat to shade your face, head, ears, and neck, and sunglasses. Finally, apply and re-apply sunscreen and lip balm with sun protector.

Additionally, avoid indoor tanning.

Additional resources

Florida native Eric Ruge lives by one rule: Do the right thing. His goal as a Medicare agent is helping people find the right Medicare coverage for their unique medical needs and budget. He believes everyone deserves the peace of mind they get knowing they made the right decision about their Medicare coverage. When he's not working, Eric enjoys spending time with family and friends, watching Tampa sports, and playing the occasional round of golf.


Find a Medicare Plan in your area

It’s FREE with no obligation

Speak with a Licensed Insurance Agent

M-F 8:00am-10:00pm | Sat 9:00am-6:00pm EST