Is a Dermatologist Covered by Health Insurance?
Date: Sep 2018
Are you wondering whether your health insurance will cover a visit to a dermatologist? The answer will depend on the exact policy you have, but most comprehensive policies should pay for any skin treatments that are recommended by your doctor for medical reasons.
Understanding Your Insurance Policy
Around 11% of us in the UK have some form of private health insurance. Some of these policies only cover certain types of care. For example, many policies exclude mental healthcare and GP services. Other polices will provide broader coverage so you will be able to get all of your care privately through your insurer.
The insurance company should have made it clear which types of care are covered when you took out the policy. However, it’s easy to forget the details if it’s been a while since you chose your cover. I think it’s always worth checking your policy before you try to use it, just to make sure your care will be covered. Make sure you keep the insurance documents somewhere safe but easy to access so you can do this quickly. If you have a restricted policy then it will specify which types of care are covered. With a broader policy, there should be a list of any treatments or specialties that are excluded.
It is also important to check how much cover you have and what the deductible will be. The amount of coverage is the maximum amount your insurer will pay and it may depend on the type of care you are receiving. Your policy might provide less cover for seeing a dermatologist than an oncologist, for example. The deductible is the amount you will have to pay yourself before the insurer will pay out. If your deductible for dermatology is £200 then you will have to pay the first £200 of any treatment. The insurer will then cover any additional costs above this. It’s good to know this before you get the bill so that you don’t get a shock.
Health Insurance and Dermatology
If you haven’t seen a skin specialist before then you might think of dermatology as somehow less serious than other kinds of medical care. Some people will dismiss skin problems like acne as mild or superficial. However, dermatologists are just as highly trained as any other medical specialist and the treatment they provide can be just as important. In cases of skin cancer
, a dermatologist could even save your life. Most medical insurance will cover dermatology just like any other speciality, such as cardiology.
Even though dermatology is likely to be covered to some extent, it’s important to note that some kinds of treatment might still be excluded. The most obvious example of this is cosmetic mole removal
. If you want to get rid of a mole for purely cosmetic reasons, then your insurer is very unlikely to pay out. However, if your doctor suspects that the mole could be cancerous, then the insurance should cover its removal. As long as your doctor says that there is a medical need for the treatment, your insurer will usually cover it.
Insurance documents aren’t always the easiest to understand, so I’d recommend contacting your insurer if you’re unclear on any of the details. If you want to know whether a certain specialist is covered then they should be able to give you a clear yes or no before you start the treatment.
Paying for Your Dermatologist
1. Get a referral through the NHS:
If you are eligible to use NHS services then you can still access them even if you have private health insurance. In order to see a dermatologist you would need to visit your GP first. You would then need to wait for an appointment with the consultant. Many skin conditions aren’t considered urgent, so you could be waiting up to 18 weeks to see a dermatologist. In contrast, a private dermatologist will often be able to see you within the next few days.
2. Get a referral to a private dermatologist:
If you decide to use your health insurance to get a faster appointment with a private dermatologist
, then you may still want to see your GP first. The GP may be able to help with some minor skin conditions. If not, they will write a referral letter explaining the situation for your dermatologist. Some insurers will only cover specialist care if you get this referral letter first, so this is usually the best route to choose if you have health insurance.
3. Make an appointment directly:
You can arrange a consultation with a private dermatologist without seeing your GP first. However, it’s important to check if this is OK with your insurer. The policy may specify that you need a referral before seeing any kind of specialist, so make sure you check before booking the appointment.
All three of these routes are still open if you don’t have health insurance or if the policy won’t cover your care, but you‘ll need to cover the costs by yourself.
If you plan to use your insurance then you should check:
- How much cover you have for dermatology
- The size of the deductible you will need to pay
- Whether anything is excluded from your policy
- For any extra requirements, such as getting a GP referral
It is also essential to bring your insurance details with you when you visit the dermatologist so that you’ll be able to arrange the payment. If you have a good health insurance policy then it should cover any care that is needed for medical reasons, including from a dermatologist. However, it’s important to understand exactly what cover you have so that you can take advantage of it.
Do you already know if your health insurance covers dermatology or will you have to check the details before making your first appointment at the clinic?