Is Mole Removal Covered by Insurance?

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.

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.

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.

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.  

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... more

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.

Each insurance company has its own standards on what it will cover.  You may want to contact them prior to seeing a physician to understand your coverage.

You should get the mole evaluated by your dermatolgist/cosmetic surgeon to see if it meets the criteria for the removal to be covered by your insurance company

A mole that is cut out is usually covered by insurance. some insurance companies will not pay for someone lasering the mole etc.. You need to call and discuss with your insurance company what they cover.

It does not matter where the mole is, insurance nearly always covers it. I say nearly because a few years ago, we had routine denials from one of the HMO's. My classic story was someone with a history of melanoma ( with three family members with melanoma) who had four atypical moles biopsied. They all came back as severe atypia, advise re-excision with clear margins. These were denied as being " for cosmetic reasons". However, this is truly an exception and that HMO has not... more