Medicare coverers medically necessary dermatology care, including eczema treatments. You can get coverage for creams, oral tablets, injections, and phototherapy.
Eczema, also called atopic dermatitis, is a very common skin condition that causes an itchy red rash.
However, you may need medical treatment for your eczema. Medicare will help cover the cost of all these treatments, especially if over-the-counter methods don’t help your eczema. Which part provides coverage depends on the treatment.
Medicare will cover the treatments and care you need if you have eczema as long as the care is considered medically necessary.
Medicare Part A mainly covers hospital stays. Unless your eczema is severe, most of the eczema-related coverage should come from Medicare Part B or Part D.
Medicare defines “medically necessary” services as those used to diagnose, treat, or prevent a condition. Medicare also requires that treatment is proven for your condition. This means it won’t pay for any experimental treatments.
However, as long as your treatment is proven and your doctor verifies it’s to treat your eczema, Medicare should cover it.
Your eczema treatment will depend on the type and severity of your eczema. Different treatments are covered differently by Medicare and under different Medicare parts.
Here are your eczema treatment options and what Medicare covers for each:
- Medications: creams such as corticosteroids, antibiotics, calcineurin inhibitors, as well as oral corticosteroids and antibiotics should be covered by Part D. Your coverage depends on whether they’re included in the formulary of your plan and their tier.
- Wet dressings: In cases of severe eczema, your skin can be covered with corticosteroid creams and wrapped in wet bandages. If done in the hospital, Medicare Part A or an Advantage plan should cover it, while at home, it will be covered under Part D or an Advantage plan that covers a prescription for the cream.
- Phototherapy: Also known as light therapy, this may be recommended if other treatments for eczema are ineffective. It’s typically done in a doctor’s office and may be covered by Medicare Part B or an Advantage plan.
- Injectables: The FDA has approved two biologic drugs for eczema: Dupilumab (Dupixent) and Tralokinumab (Adbry). Part B typically covers drugs that need to injected by a healthcare professional, but because these drugs can be self-administered, they fall under Part D.
Learn more: The best treatments for severe eczema
Eczema costs can vary widely, depending on the treatment option you need and the specific Medicare plan you choose.
The Part B premium for 2024 is $174.70 each month. In addition, you’ll have to reach a deductible of $240 before Medicare will cover 80% of the cost.
With Part C (Medicare Advantage), you should get all the same coverage as Original Medicare (Parts A and B), but your costs will vary depending on your specific plan. Some Part C plans also include Part D coverage.
Similarly, if you need a prescription medication, your premium and deductible, as well as your out-of-pocket cost, will depend on your specific Part D plan in your area.
You may be able to get a Medigap plan, which can help you cover the out-of-pocket costs of parts A and B.
Here are estimates of the costs of common treatments.
How much do eczema treatments cost out-of-pocket?
Your actual out-of-pocket cost will depend on your insurance coverage. That said, the following are general pharmacy costs for common eczema treatments.
| Treatment | Cost without Medicare (approximate cost as per GoodRx) |
|---|---|
| Corticosteroid creams (Prices are for Fluticasone, a commonly prescribed cream.) | ~$7 to $15 per tube |
| Calcineurin inhibitor creams (Prices are for Tacrolimus, a commonly prescribed cream.) | ~$22 to $63 per tube |
| Antibiotic creams (Prices are for Mupirocin, a commonly prescribed cream.) | ~$6 to $13 per tube |
| Oral antibiotics (Prices are for Amoxicillin, a commonly prescribed antibiotic.) | ~$3 to $6 per 30 capsules |
| Oral corticosteroids (Prices are for Medrol, a commonly prescribed oral corticosteroid.) | ~$4 to $14 per pack |
| Wet dressings | Costs vary widely depending on whether you do the treatment at home or in the hospital. At-home treatment costs similar to corticosteroid creams. Hospital treatment done inpatient includes hospitalization, and the average cost for a three-day hospital stay is around $30,000. |
| Phototherapy | ~$3,000 a year on average |
| Injectable dupilumab (Dupixent) | The listed cost is $3,803.20 per box, but most people won’t be charged this price. |
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You’ll need to be eligible for Medicare to get coverage for eczema. You can gain Medicare eligibility in one of three ways:
- by turning 65 years old
- by having a diagnosis of end stage renal disease or amyotrophic lateral sclerosis at any age
- by having a diagnosed disability that you’ve received 24 months of Social Security Disability Insurance (SSDI) for at any age
Once you’re eligible for Medicare, you can use your coverage to help treat your eczema.
There are a few ways to enroll in Medicare if you’re eligible.
In some cases, you’ll be enrolled automatically and won’t have to take any steps. This happens when you’ve received 24 months of SSDI or if you retire before age 65 and receive Social Security retirement benefits.
In both cases, you’ll receive information about your Medicare enrollment in the mail. You can then decide which parts of Medicare you want to enroll in.
If you’re not enrolled automatically, you’ll need to apply. You can do this in a few ways:
- filling out an online application
- calling Social Security (800-772-1213)
- visiting your local Social Security office
- writing a letter to your local Social Security office
You might have to provide information about your work history and finances along with your application. Once your application is approved, you can decide which parts of Medicare you want to enroll in.
Learn more: Medicare enrollment periods.
Does Medicare cover dermatology issues?
Medicare won’t cover dermatology treatments if these are done for aesthetic reasons. It may cover medically-necessary treatments.
What is the most effective treatment for eczema?
The most effective treatment for eczema can vary from person to person. That said
Medicare will cover your eczema treatment. The part of Medicare that provides coverage depends on the type of treatment.
Most prescriptions should be covered under Part D, or a Part C plan that includes prescription coverage, but specific coverage depends on your plan. Other treatments will be covered under Part A or B or an equivalent Part C plan, depending on whether you need to be hospitalized or can get the treatment out-patient.
A Medigap plan could reduce your treatment copayments.