FAIR Health Consumer Access

Coverage for Healthy Winter Skin

As the air gets drier and colder in the winter, skin problems can start or get worse. Winter can make your skin feel rough, flaky and itchy. That’s because winter changes the top layer of your skin. The top layer of skin usually holds water with the help of natural oils. But in cold weather, that water escapes and your skin becomes dry. Also, as we get older, our natural oils lessen. This means skin gets even drier in cold weather.

Cold weather can also make other skin problems worse. Some of these skin problems include eczema, psoriasis, rosacea and seborrheic dermatitis. Skin problems like these are life-long health issues. And they can be treated by your doctor. Your health plan can help keep your skin healthy this winter by covering some dermatology care. Some of this care includes medicines, testing, phototherapy, laser treatment and medicated lotion.

Coverage for Dermatology Services
Your health plan should cover a trip to your doctor about any skin concerns. Most health plans also offer some coverage for dermatology care if needed. You might need a referral to see a specialist like a dermatologist.

Medicines and testing
Your health plan will likely cover most skin condition services, such as prescription medications. It will also likely cover allergy tests. Your doctor might prescribe pills, such as antibiotics or anti-inflammatories. Check your plan’s drug list to see what medicines are covered.

Phototherapy and laser treatment
Most health plans cover phototherapy. Phototherapy involves shining ultraviolet (UV) light on your skin. Phototherapy can be used to treat some skin conditions such as eczema and psoriasis.

Laser treatment involves shining a high-energy light beam onto your body. The American Academy of Dermatology says laser therapy can help treat some skin conditions. That includes rosacea. However, your health plan might not cover laser therapy treatment. Most plans will only cover it if your doctor writes that it’s medically necessary for your skin condition.

Be sure to check your plan to see what they’ll cover. Even if they’re covered, some services might need prior authorization from your health plan. That means your plan has to approve treatment before you get it.

Medicated lotion
Lotion can help keep your skin from getting dry this winter. But most health plans won’t cover a lotion you can buy over the counter. You might be able to use your flexible spending account (FSA) or health savings account (HSA) for it. But only medicated lotions may be FSA/HSA-eligible. Medicated lotions, creams or ointments contain an active ingredient (a drug) to help your skin feel better. Your doctor may prescribe the lotion. In that case, it should be covered by your health plan’s prescription benefits. Or your doctor may provide a letter of medical necessity. That could help you use your FSA/HSA funds to buy it.

Medicare and Medicaid Coverage for Healthy Winter Skin
Medicare covers doctor visits, lab tests and other care for skin conditions like eczema. It also covers phototherapy for psoriasis. Find out more about Medicare in our article here.

Medicaid coverage varies by state, but all plans cover services that are medically necessary. This can include dermatology. Check your state’s Medicaid plan to find out about coverage for skin treatments such as phototherapy. Find your state’s Medicaid agency here.