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

Abstract

Background: Dermabrasion and chemical peels are infrequently utilized methods of treatment for medical grade conditions despite demonstrations of favorable outcomes. This may be due to the discrepancy of insurance coverage for these procedures. Objective: To evaluate the frequency of insurance coverage for dermabrasion and chemical peel procedures in the treatment of acne, acne scarring, and non-melanoma skin cancers (NMSC). Methods and Materials: A cross-sectional analysis of 58 insurance companies by web-based search or phone interview determined the number of insurers with a publicly available policy on dermabrasion or chemical peels. For each policy, the coverage status and any corresponding criteria were extracted. Results: Dermabrasion to treat basal cell carcinoma and actinic keratosis was discussed by 13 (16%) and 21 (36%) insurers respectively. Twenty of twenty-three companies (87%) with a chemical peel policy for premalignant lesions provided coverage. Of the 25 companies (43%) that discussed treatment of acne with chemical peels, 14 (56%) provided reimbursement and 11 (44%) denied coverage. Coverage of acne was denied significantly less for chemical peels than for dermabrasion (p<0.006). Conclusion: Inconsistencies in both inclusion and coverage between insurance companies may create an artificial barrier to receiving care.