Health insurance carriers & criteria for coverage
Heath insurance coverage varies depending on the carrier and your chosen plan. Speaking with a representative from your health insurance company will give you the most accurate information when it comes to determining whether your tattoo removal procedure will be covered, but here is a general look at various health plans and their criteria for coverage.
HMO & PPO health care
Both HMO's and PPO's have two categories under which treatments may fall:
- Cosmetic procedures
- Medically necessary procedures
The majority of laser resurfacing procedures will fall under the category of cosmetic procedures, and are thus usually not covered by insurance providers. Surgical procedures are more likely than injection treatments or laser resurfacing procedures to be covered as medically necessary procedures.
Insurance companies use certain criteria to determine if they consider a treatment to be medically necessary. One or more of the following may be considered to decide on medical necessity:
- Lifestyle disruption: daily activities of patient must be disrupted significantly
- Pain: patient must be experiencing pain as a result of the condition
- Failure of conservative measures: other methods of treatment have failed to provide adequate relief
- Complications: infection or other health threats may increase the chance that an insurance company will consider treatment medically necessary
Medicare will generally not reimburse for laser resurfacing procedures. Contact local tattoo removal facilities to determine if they participate in Medicare to find out if treatments may be covered. Usually secondary and supplemental insurance companies will require Medicare to decline coverage before they will consider reimbursement. Most tattoo removal clinics offer patients a variety of payment options. Please ask the tattoo removal specialist about such options during consultation to find the one that best suits you. For further insurance information, contact your insurance provider for coverage options.