Ask a doctor

Is Mole Removal Covered by Insurance?

I have a mole bigger than the size of a pencil eraser above my butt. Someone please tell me the cost to remove it. I have Medi-Cal and not sure if that will help or not.

Doctor Answers (15)

INsurance coverage for Mole Removal

+2

You would need to check with your specific insurance provider to determine if this may be covered under your individual plan. Every insurance company and every plan is different.


Columbus Facial Plastic Surgeon
5.0 out of 5 stars 42 reviews

Is mole removal covered by insurance?

+1
Hello! Thank you for your question! Surgical procedures for aesthetic purposes, to improve appearance, are not covered by insurance. Typically, these as well as complications resulting from such procedures are the responsibility of the patient. Procedures that are meant to correct functional issues and those which cause health-related issues should be covered by your insurance as a medical necessity, with proper examination and documentation. Some insurance plans have exclusion criteria for certain procedures. Also, it is an obligation of the surgeon not to attempt to authorize purely cosmetic procedures through insurance.  Excision of suspicious lesions may be covered.

Discuss your issues and complaints with a board-certified plastic surgeon to discuss these as well as to examine and assist you in deciding which procedure(s) will be the best for you. A discussion of the advantages and disadvantages will take place along with the risks and benefits. Insurance companies will vary on coverage and is always reasonable to discuss your issues with your surgeon and primary care. It would behoove you to get as much information as possible and even call your insurance yourself. Certainly, pay in advance prior to your surgical procedure and options such as financing are available if you qualify. Hope that this helps! Best wishes!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

Mole removal and insurance

+1
Each insurance carrier and plan has different rules about what is considered medically necessary and covered.  You have to check with your individual plan.  Cosmetic mole removal is generally not covered by any plans.

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 33 reviews

You might also like...

Mole removal

+1

A mole removal can be covered by insurance if there is medical necessity for removal.  If there is concern of it being cancerous, this can be covered.  

Sam Naficy, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 147 reviews

Mole Removal Covered by Insurance

+1

Mole removal may be covered by insurance, depending on its characteristics, your skin history, and family history for skin conditions. If it is a cosmetic concern, often the excision will not be covered but you should be able to discuss this with your surgeon and your insurance provider.

Gregory J. Vipond, MD, FRCSC
Inland Empire Facial Plastic Surgeon
4.5 out of 5 stars 5 reviews

Mole removal and insurance.

+1

Mole removal is usually covered by insurance, especially if your dermatologist is worried that the mole is abnormal. If the spot is wanted to be removed for cosmetic reasons, the procedure is usually not covered.

Gary Goldenberg, MD
New York Dermatologist

Mole removal and health insurance

+1

Generally, if a lesion is suspicious or has a history of growth,bleeding or irregular borders, it will be covered,. Your plastic surgeon should confirm the applicable rules established by your insurance company prior to the procedure to alleviate any financial concerns. Some carriers require preauthorization which is a simple matter for an experienced office staff.

Robert L. Kraft, MD
New York Plastic Surgeon
5.0 out of 5 stars 13 reviews

It Depends

+1

Insurance typically covers mole removals under certain circumstances.  For example, if a mole is suspicious looking or changing or getting irritated, they will cover the removal.  If you want to remove a mole for purely cosmetic reasons (in other words you just don't like the way it works), you will have to pay out of pocket.

 

Lisa Benest, MD
Burbank Dermatologist
4.5 out of 5 stars 3 reviews

Does Insurance Cover Mole Removal?

+1

Every insurance company has their own criteria as to whether mole removal is covered by insurance. That always has to be initially determined by a process known as pre-determination. Many physicians, however, do not take insurance for mole removal due to the very low reimbursements for doing it. Even in those who do, most physicians will not remove more than one or two at  time as insurance stops paying for more than one or two at a single treatment session. From a cosmetic fee standpoint, most moles can be removed for a few hundred dollars apiece in most practices.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.5 out of 5 stars 32 reviews

Mole Removals and Insurance

+1

Each insurance company and policy will cover different medical conditions and procedures based on the guidelines of the plan signed up for.  Mole removal may or may not be based on your policy.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 76 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.