Insurance Coverage of Dermabrasion and Chemical Peel Procedures: A Critical Analysis of 58 American Insurance Companies.

Abstract

Introduction Dermabrasion and chemical peels are infrequently utilized methods of treatment for medical-grade conditions despite demonstrations of favorable outcomes. Insurance coverage status has previously been shown to impact availability and accessibility to specific treatments. The purpose of this study is to evaluate the rate of insurance coverage provided for dermabrasionand chemical peel procedures in the treatment of acne, acne scarring,and non-melanoma skin cancers (NMSC). Methods A cross-sectional analysis of 58 insurance companies by web-basedsearch or phone interview determined the number of insurers with a publicly available policy on dermabrasion or chemical peels. Coverage status and any corresponding criteria were extracted from existing company policies. Results Thirteen (22%) and 22 (38%) policies discussed dermabrasion in the treatment of basal cell carcinoma and actinic keratosis, with 62% and 73% of these policies providing coverage. Acne scarring was discussedin significantly more dermabrasion policies than basal cell carcinoma (45% vs 22%; p=0.018). However, significantly more insurers denied coverage of dermabrasion for active acne and acne scarring when compared to dermabrasionto treat basal cell carcinoma or actinic keratosis (p<0.001).Eighty-seven percent of companies (n=20) with a chemical peel policy for premalignant lesions would providecoverage, with required criteria present in 95% (n=19) of thepolicies that would coverchemical peels for actinic keratosis specifically. Of the 25 companies (43%) that discussed the treatment of acne with chemical peel procedures, 14 (56%) provided coverage, and 11 (44%) denied coverage. Coveragewas denied by significantly less insurersfor the treatment of active acne with chemical peel procedures compared to treatment with dermabrasion(44% vs 83%; p<0.006). Conclusion Significant discrepancies were noted in both the presence of a publicpolicy and the coverage status of dermabrasion or chemical peel proceduresamong the United States health insurance companies. These inconsistencies, along with multiple criteria required for coverage, may create an artificial barrier to receiving care for specific medical-grade conditions.