Does Health Insurance Cover Mole Removal?

Moles are growths that develop on the skin. Usually, they are brownish or blackish in color, they can appear anywhere on the skin, and they can range in size from minute to massive. Prominent moles that develop in highly visible locations, such as the face, can be unsightly and make an individual feel embarrassed. In many cases, moles can be dangerous and linked to skin cancer.

If you have a mole and you want to have it removed, you are probably wondering if your insurance company will cover the procedure. Whether or not your provider will cover it depends on your specific policy. Typically, if it has been determined that a mole is dangerous and linked to cancer, removal will be deemed medically necessary and the procedure will be covered by your health insurance; however, if mole removal is considered cosmetic, your health insurance may or may not cover the cost. Below, we’ll dive deeper into insurance coverage for mole removal.

Moles Explained

health insurance mole removalFormally known as melanocytic nevus, moles are a collection of cells that form on the surface of the skin. These cells contain more melanin (pigment), hence the reason why they are darker than the rest of your skin. As mentioned, they can range in size, as well as shape; some may be flat and form a perfect circle, while others may be raised and have an irregular shape.

Moles are very common, as the majority of people will have upwards of 20 moles on their bodies. Exposure to the sun and genetics can increase the amount of moles a person develops. Additionally, the more moles a person has, the greater he or she is at risk of developing skin cancer. For this reason, if you have moles, it is important to have them checked by your healthcare professional on a regular basis. Skin cancer is highly curable if it’s caught early enough.

How Much does it Cost to have a Mole Removed?

Like most medical procedures, the cost of mole removal varies. There are a few factors that affect the cost, including the reason for mole removal and the medical professional who is performing the procedure. Since dermatologists charge different fees and because every mole is different, it’s difficult to pinpoint the price of mole removal. Typically, however, smaller moles that are located in hidden areas will cost less to remove than larger moles that are situated in visible locations. That’s because the removal of larger, visible moles is more complex.

Pathology also affects the cost of mole removal. Doctors should assess any moles that are removed – even those that are removed for cosmetic purposes – to determine if any malignant cells are present.

The Process of Mole Removal

There are two ways that moles can be removed. The first method involves cutting the mole from the skin, which may or may not require stitches to close the area where the mole was located. The second method also involves both cutting and cauterizing the mole from the skin. Both procedures are done using local anesthesia, which numbs the affected site. If there a doctor believes that the mole is malignant, skin surrounding the mole may also be removed.

If you are having a mole removed, your doctor will discuss the details with you prior to the procedure.

Will Insurance Cover the Cost?

Whether or not mole removal is covered by health insurance depends on the specifics of the procedure. As was discussed, if your doctor believes that the mole contains malignant cells and removal is medically necessary, it will likely be covered by your insurance; however, if it is a cosmetic procedure, in other words, you are only having it removed to improve your appearance, than it may or may not be covered by your insurance. Before having the procedure done, review your policy to find out if it will be covered by your insurance. If you aren’t sure, contact your health insurance provider; they will be able to let you know whether or not the procedure is covered, and if it is, how much will be covered.

If mole removal isn’t covered by your insurance provider, you will have to pay for the procedure out of your own pocket. Speak to your doctor, as you may be able to set up a payment plan. It’s important to note that even if your health insurance does cover mole removal, you may have to pay out-of-pocket expenses, such as copays and deductibles.

The Bottom Line

If you have moles, it’s important to have them assessed by a doctor regularly to ensure that they are not cancerous. If you are going to have a mole removed – whether it’s medically necessary or not – make sure you speak to your health insurance provider to find out whether or not the procedure will be covered by your policy.

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