What Are Some of the Most Common Skin Treatments?
Skin treatments can be required for health reasons, or to improve the appearance of your skin. The range of skin treatments is broad and goes from minimally invasive to more comprehensive treatments. The most common minimally invasive procedures include Botox injections, laser skin resurfacing, intense pulsed light therapy, chemical peels, ambulatory phlebectomy, laser hair removal, micro pigmentation, soft-tissue fillers, microdermabrasion, injectable hyaluronic acid, micro-needling, and cryosurgery.
Many of these procedures are used both for medical purposes as well as cosmetic purposes. As an example, cryosurgery can remove potentially hazardous skin growths as well as treat early-stage skin cancer or squamous cell carcinoma. Intense pulsed light therapy can treat hyperpigmentation, rosacea, and facial veins, along with dark spots, wrinkles, and enlarged pores. Ambulatory phlebectomy is a procedure that treats severe varicose veins, while micro-needling can not only minimize enlarged pores and improve skin texture, but it can also reduce the appearance of scars. Micropigmentation is a treatment that also helps reduce the appearance of scars by “filling in” with pigments.
Are Skin Treatments Covered by Insurance?
When it comes to skin treatments, your biggest impediment to getting the treatment approved by your insurance company is whether it is a cosmetic procedure or a medically necessary procedure. Few insurance companies will cover cosmetic procedures, deeming them “elective,” rather than medically necessary. Since many skin treatment procedures can be used both medically and cosmetically, your doctor may need to clarify this if your procedure is denied. If you have scars on your face that cause emotional trauma and prevent you from fully living your life, then treatment is medically necessary even though it could be considered a cosmetic procedure. Laser treatment for a port wine stain on your face would likely be approved, while laser treatment for lines on your face would probably not.
What if Your Insurance Company Won’t Approve Treatments for Dermatitis, Psoriasis, Eczema, or Other Skin Disorders?
Chronic skin issues like psoriasis, eczema, or dermatitis may benefit from topical as well as oral medications. Topical therapies can include corticosteroids, retinoids, calcineurin inhibitors, salicylic acid, coal tar, and anthralin. Drug therapies can include biologics, Apremilast, Cyclosporine, oral retinoids, Methotrexates, or certain drugs used “off-label.” Biologics can be expensive and are often denied by insurers.
An insurer may require you to try many other cheaper alternatives before approving a biologic drug or may deny it altogether. Biologics like Dupixent, Enbrel, and Remicade interact with the body’s immune system to treat psoriasis. Unfortunately, even the least expensive online price for either of these is around $6,000, with an approximate $1,800 co-pay for four doses. Because biologics are relatively new, your insurer may claim the drug is “experimental,” or “investigational,” even though patients have seen good results.
What Are the Types of Dermatitis that Health Insurance Should Cover?
Dermatitis is a general term for any condition that results in inflammation of the skin. Symptoms include rashes, itching, and dry, flaky skin. Dermatitis can be caused by infections, irritating substances, allergies, or an overactive immune system. Dermatitis does not spread through contact with other people; it is not an infection, and it is not the result of poor hygiene. Some of the more common types of dermatitis include:
- Contact dermatitis
- Neurodermatitis
- Nummular dermatitis
- Diaper dermatitis (diaper rash)
- Dyshidrotic dermatitis
- Atopic dermatitis (eczema)
- Perioral/Periorificial dermatitis
- Stasis dermatitis
- Seborrheic dermatitis (dandruff, cradle cap)
Anyone, regardless of age, can get dermatitis. While eczema usually begins in childhood, anyone at any age can be diagnosed with the condition. Contact dermatitis involves skin-to-substance contact, while babies with sensitive skin are susceptible to diaper rash and cradle cap. Risk factors for atopic dermatitis include being African American, being female, having a family history of dermatitis, having hay fever, or having asthma. Risk factors associated with periorificial dermatitis include being female and being between the ages of 15 and 45.
Contact dermatitis is generally caused by working around certain chemicals often found in factories, restaurants, and gardening centers. The risk factors for dyshidrotic dermatitis include sweating a lot, exposure to water or irritants, and living in a warmer climate. Atopic dermatitis affects only two to three percent of adults and about 25 percent of all children. About 15 to 20 percent of all adults will suffer from contact dermatitis at some point in their lives. If your insurer has issued a dermatitis health insurance denial, you need experienced assistance from the Law Offices of Scott Glovsky.
How Can Dermatitis Impact Someone’s Life, and Why Can Treatment for Dermatitis Be Medically Necessary?
If you or someone you love lives with atopic dermatitis or eczema, you know what a toll it can take on mental health. The itching can seem relentless, leading to sleepless nights. Anxiety and stress are common triggers for atopic dermatitis flare-ups. In turn, this lack of sleep, anxiety, and stress cause dermatitis to worsen, creating even more adverse mental health issues. The cycle continues, with dermatitis and mental health issues worsening.
Almost a third of all those with atopic dermatitis have also been diagnosed with a mental health issue, which is significantly more than the general population. Chronic dermatitis can also lead to feelings of hopelessness, restlessness, insomnia, weight changes, less energy, difficulty concentrating, loss of interest in activities once enjoyed, and even thoughts of suicide.
Some medications prescribed for atopic dermatitis use the medication montelukast, which has been linked to mood-related changes. Dermatitis in a prominent area of the face, neck, or arms can result in embarrassment and lessening human contact. Many people with dermatitis find themselves staying home, making conscious decisions to avoid others, and giving up many of the things they once enjoyed.
After receiving dermatitis treatment health insurance denial, mood issues can get even worse. After all, a doctor has prescribed a treatment that could potentially improve or cure the symptoms of dermatitis, yet an insurance company is now refusing to pay for the treatment. Denial of dermatitis treatment from a health insurance company can seriously escalate depression, anxiety, and thoughts of suicide.
While it may feel like it is simply easier to give up and just avoid people, there is an alternative. Speaking to an attorney who fights for those in your situation can make all the difference. Attorney Scott Glovsky is ready to take on your insurance company and force it to pay for a treatment your doctor has prescribed for your dermatitis. It can feel as though you are all alone in this, but the Law Offices of Scott Glovsky is ready to take away those lonely feelings and help you return to your life.
Why Are Some Skin Treatment Claims Denied?
If your insurer denies your skin treatment claim—and it is not due to an error in the submission—the reason is likely to be either that the treatment is not medically necessary or that it is still experimental. An insurance company can make you and your doctor jump through a long series of hoops, trying one skin treatment after another to prove to the insurance company that the treatment is medically necessary in your case. In reality, the insurance company is likely balking at the price of the skin treatment that will actually help your medical condition. Your doctor can re-submit your claim along with an explanation as to why the treatment is necessary for you.
What Should You Do if You Receive a Skin Treatment Insurance Denial?
If your doctor re-submits your claim with an explanation and the claim is still denied, you may need to file an appeal. Your insurer must deny your claim in writing with an explanation of why it was denied. The insurer must also outline the appeal process and the time deadlines associated with the process. You will first file an internal appeal, asking your insurance company for a full and fair review of the adverse decision. If your case is urgent (i.e., your health could substantially deteriorate during the appeal process) then the insurance company is required to accelerate the process.
If your internal review is not successful, you have the right to take your appeal to an independent third party for review. This is known as an external review, meaning your insurer no longer has the final say over whether a claim is paid. You can also file a lawsuit against your insurer to force it to pay for your skin treatment. While any insurance company can deny a claim, companies like Anthem Blue Cross, Blue Shield, Health Net, Kaiser, UnitedHealthcare, Aetna, and others may do so for California residents.
How Attorney Scott Glovsky Can Help with Your Skin Treatment Insurance Denial
If your health insurance company won’t approve dermatitis treatment or you have received a skin treatment insurance denial, you may feel frustrated and overwhelmed. At the Law Offices of Scott Glovsky, we are passionate about fighting to make sure America’s most powerful insurance companies hold up their end of the bargain. Attorney Scott Glovsky and his legal team are ready to fight for you, understanding that the system has left you discouraged and unsure of how to secure the best treatments for your health. We believe the work we do is important and will continue to advocate for those who are faced with healthcare treatment denials. Contact the Law Offices of Scott Glovsky for a consultation regarding your denial.