Is Acne Surgery Covered by Insurance?

Doctor Answers 26

Acne Surgery and Insurance

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Hello, yes generally acne surgery for the treatment of active acne is covered by most insurance plans.  That being said, to avoid surprises it would be a good idea to double check with your insurance company to see if there will be any cost to you (deductible, copayment, etc).  Now, if the procedure is for treatment of acne scars or pigment left over from previous acne, this is considered a cosmetic procedure and insurance does not cover this.

Acne surgery and insurance

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Treatment of active acne can be covered by insurance and is best managed by a dermatologist.  Acne scar management is not covered by insurance and is best treated by a multimodal approach (eg lasers, fillers, surgery, etc.).

Is acne surgery covered by insurance?

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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.  Typically this is not covered by insurance.

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!

Coverage for acne surgery depends from your insurance carrier.

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Because health insurance carriers change their policies from day to day, I would always call them in advance if acne surgery is covered. Most of them do cover cystic acne.  Despite the changes in insurance laws, it is still necessary to ask an insurer if any of their policies have a dermatology benefit or if it includes acne medication. 

Acne surgery vs. Treatment of acne scars

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While some procedures performed to treat active acne may be covered by insurance, treatment of the scars left by acne including subcision, punch excision, dermal grafting, and laser resurfacing are not covered by insurance.

Brian Biesman, MD
Nashville Oculoplastic Surgeon
4.8 out of 5 stars 41 reviews

Insurance Coverage for Acne Surgery

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For treating acne flares and medical treatment, most insurance companies cover many of these expenses.  When it comes to improving acne scars and the cosmetic portion through acne surgery, insurance companies generally do not cover these expenses. You should always inquire with the particular insurance companies that you are covered under and their particular policies.  When it comes to active lesions which require some procedures such as incisions and drainages, extractions, and surgically treating active lesions, insurance companies are more likely to treat these.

Acne surgery and insurance

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Treatment of acute acne by a dermatologist may be covered by insurance.  But treatment of the late, dreaded, deep scars caused by acne is not covered.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.9 out of 5 stars 138 reviews

Acne Surgery Insurance Coverage

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Acne surgery including extractions of comedones (blackheads and whiteheads), incision and drainage of  pustular or cystic lesions, and steroid (Kenolog) injections into inflamed, cystic acne lesions is usually covered by most insurances.  Treatments for discoloration and scarring secondary to acne are considered cosmetic and therefore, are out of pocket expenses.  Such treatments include laser treatments, dermabrasion, chemical peeling, electrosurgery and acne scar filling to name a few.  

Acne surgery

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In Canada, acne surgery is not covered by insurance as it's considered a cosmetic issue.  Some people who have health spending account can get it covered.

Anatoli Freiman, MD
Toronto Dermatologist

Acne Treatment and Insurance

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Acne scars, when treated with surgery, are typically not covered by insurance in my experience.  However, there may be exceptions, particularly depending on if there are functional problems, such as around the eye.

Jeff Scott, MD
Everett Plastic Surgeon

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.