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does Medicare cover mole removal

Does Medicare Cover Mole Removal?

There are a number of dermatology services that are considered cosmetic in nature. And Original Medicare does not cover cosmetic procedures. However, even though Original Medicare does not provide coverage for routine dermatology, they will provide coverage for dermatology services that are considered medically necessary. Is mole removal surgery medically necessary? 

Or, put another way, “does Medicare cover mole removal?” In this article, we answer that question in clear, plain English. You will also find the average costs of mole removal and other helpful info.

Does Medicare Cover Mole Removal?

The short answer is yes; Medicare will cover the cost of mole removal. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your mole removal. Below we look at what these are so you know what to expect.

Original Medicare

Original Medicare (Medicare Part A and Part B) provides coverage for mole removal. Coverage for mole removal is provided by Medicare Part B. However, Medicare Part B will only provide coverage for a mole removal procedure if it is considered medically necessary.

You meet the conditions for mole removal to be considered medically necessary if the mole: 

  • Has been susceptible to the following symptoms
    • Bleeding
    • Rapid growing
    • Severe itching
    • Pain
  • Has shown signs of inflammation
  • Is swelling or oozing

Medicare Part B will also provide coverage for a mole removal procedure if the mole:

  • Gets in the way of your vision
  • Makes breathing through your nose or mouth difficult
  • Affects your other senses or other daily functions

Medicare Part B covers 80 percent of the costs of your mole removal surgery. You will pay for the remaining 20 percent. 

Part C Coverage for Mole Removal

Medicare Advantage plans (Medicare Part C) also provide coverage for mole removal surgery. These plans, by law, have to cover everything Original Medicare covers. However, they also offer their members coverage for things that Part A & B do not. Each Part C plan is different though. So exactly what each one covers and what the costs are depends on the plan.  

How Much Does It Cost To Have A Mole Removal Procedure?

A mole removal procedure usually costs somewhere from $150 to $400. The exact cost of a mole removal surgery will vary depending on the doctor who will perform the procedure as well as the type of procedure. 

There are two ways in which a doctor can remove your mole. The first is through the use of a scalpel by shaving the mole and applying liquid to prevent bleeding. The other way is through cutting the mole along with parts of the skin then stitching the wound. 

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.

Additional Info on Medicare Coverage

This article is part of our series on “What does Medicare cover?”

Also, you can check out other articles in this series including: Does Medicare cover OB-GYN?

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