Is Dermatology Covered by Private Health Insurance? What You Need to Know

General Medical

Tammy George

A woman is being examined by a doctor in a dermatology clinic.

What is Dermatology?

Dermatology is a branch of medicine focused on the diagnosis and treatment of skin conditions. The most common conditions include eczema, psoriasis, alopecia areata, acne, and vitiligo. These conditions can cause pain, itching, anxiety, depression, and social isolation. 

Around 4% of the Australian population suffers from a long-term skin condition. There are around 600 specialist dermatologists in Australia (roughly 2 per 100,000 Australians), so waiting lists can be long and appointments expensive. Demand for dermatology services is growing due to our ageing population, increasing obesity rates, and co-morbidities and immunosuppressed patients. 

To make an appointment with a dermatologist, you should visit your GP and ask for a referral. The referral is required as a pre-authorisation for your dermatology consultation. 

Dermatology Services Covered by Private Health Insurance

Private health insurance doesn't generally cover dermatologist appointments. However, eligible Australians with a Medicare card can claim part of the cost of a consultation with a dermatologist. When making an appointment, the dermatologist’s office staff will be able to tell you how much Medicare covers and your out-of-pocket expenses in advance.

If your dermatologist orders a pathology test, such as taking a tissue sample, Medicare will cover the cost of a pathology test if the specialist chooses to bulk bill (the test, not the consultation). 

HIF Rebates for Skin Screening

Under our Healthy Lifestyle service, HIF members with some Extras policies can claim skin cancer screenings. Healthy lifestyle services are available on Value Extras, Simple Extras, Essential Extras, Advanced Extras and Top Extras. The benefits members can claim can vary between 60-100% of the total cost and the annual limit per person on the policy.  

Other Healthy Lifestyle Services include gym membership, health assessments, weight management programs, and quit-smoking plans.

A woman is being examined by a doctor in a dermatology clinic.

General Hospital Vs. Extras Health Cover

HIF offers Hospital cover and Extras cover. Hospital cover means you don’t need to rely solely on the public hospital system. You may be able to skip a long queue at a public hospital and choose your own hospital and doctor.  HIF has 6 hospital and inpatient levels of hospital cover for Australian citizens and permanent residents - Basic Plus, Bronze, Bronze Plus, Silver, Silver Plus, and Gold Top Hospital cover. 

Members can choose to have a hospital-only policy, extras only, or both hospital and extras cover. Some Australians choose to take out private hospital cover because of the added benefit of avoiding the Medicare levy surcharge. The surcharge is an additional tax paid by those Australian residents who earn more than $93,000 a year as a single and $186,000 as a couple. The surcharge was introduced to encourage people to take out private hospital health coverage to take the demand off the public health system.        

Extras cover allows members to claim for everyday health services like dental, optical, chiro, remedial massage, ambulance, pharmacy, speech therapy, psychology, hearing aids, and healthy lifestyle programs, depending on your level of coverage. 

Hospital Cover for Skin Conditions

Thousands of Australians need care in hospitals every year for skin-related conditions. Surgery to remove skin cancer is one of the most common. Depending on your level of hospital cover, you may be able to claim for the surgeon, anaesthesia, and hospital, whether it’s day surgery or a longer stay.   

For help in familiarising yourself with your insurance coverage and to discuss any questions or concerns, call us on 1300 134 060 or contact us online. This will allow you to ensure that you receive the necessary dermatological treatments while maximising your insurance benefits.

Tammy George

Please note: Tammy's blog is general advice only. For further information on this topic please consult your healthcare professional.

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