Coverage, referrals, and what to check before your visit to Paradise Medical Center in Westchester, Miami.
Call (786) 738-9515Blue Cross Blue Shield generally covers medically necessary dermatology — acne, eczema, psoriasis, rashes, mole checks, skin cancer screening — while cosmetic treatments are paid out of pocket.
Questions about your own scalp? Call the dermatology clinic at (786) 738-9515.
In most cases, yes — Blue Cross Blue Shield plans cover dermatology visits when the reason for the visit is medical. That includes acne, eczema and dermatitis, psoriasis, rosacea, rashes, infections, hair loss evaluation, suspicious moles, and skin cancer screening.
What you pay depends on your plan's specialist copay, your deductible, and whether the clinic is in network. Two people with a BCBS card can have very different out-of-pocket costs, which is why we verify benefits individually rather than quoting a number online.
It depends on your plan type. PPO and most EPO plans generally let you book a dermatologist directly with no referral. HMO plans usually require a referral from your assigned primary care physician before the visit is covered.
If you are not sure which you have, look at the front of your card — it usually says PPO, HMO, or EPO — or call the member services number on the back. Because Paradise Medical Center runs both a primary care clinic and a dermatology clinic, we can often handle the referral internally for patients who see us for both.
The dividing line insurers use is medical necessity. Treating a painful cystic acne flare, a spreading rash, or a changing mole is medical. Improving the appearance of healthy skin is cosmetic.
That means Botox for wrinkles, dermal fillers, laser hair removal, chemical peels for glow, and anti-aging facials are self-pay. Our aesthetics services are priced separately for that reason. There are exceptions — for example, Botox for chronic migraine or excessive sweating is sometimes covered with prior authorization.
Paradise Medical Center accepts a range of commercial and marketplace plans, including Blue Cross Blue Shield of Florida (Florida Blue) products. Network participation can change, and plan names on the marketplace change every year.
The reliable answer for your specific policy is on our insurance page, or by calling us. See also our dedicated page for patients searching for a dermatologist accepting Blue Cross Blue Shield in Miami.
Call the member services number on the back of your card and ask four questions: Is this clinic in network? Do I need a referral for dermatology? What is my specialist copay? How much of my deductible have I met?
Then call us at (786) 738-9515 with your member ID and we will confirm what we see on our end. Doing this before your appointment prevents the most common billing surprise we see — a covered visit that needed a referral nobody requested.
Full-body skin exams for patients with risk factors, mole evaluations, and biopsies of suspicious lesions are medical services and are typically covered. Pathology on a biopsy is billed separately by the lab, which occasionally surprises patients.
If you have a spot that is new, changing, bleeding, or not healing, do not wait on insurance questions. Book the visit — see our skin cancer screening and mole evaluation pages.
Yes, BCBS plans generally cover medically necessary dermatology such as acne, eczema, psoriasis, rashes, mole checks, and skin cancer screening. Cosmetic treatments are not covered.
Most plans do, subject to your specialist copay, deductible, and network status. Coverage varies by individual plan.
PPO plans usually do not require one. HMO plans typically require a referral from your primary care physician.
No. Cosmetic treatments are self-pay. Botox for medical conditions such as chronic migraine may be covered with prior authorization.
Call the number on the back of your insurance card and ask about network status, referral requirements, your specialist copay, and your remaining deductible.
Medically reviewed by Dr. Teresa Moreno, DNP, founder of Paradise Medical Center. This article is patient education, not a substitute for an in-person evaluation. Always follow the specific instructions given to you at your appointment.
Paradise Medical Center Dermatology & Aesthetics — 8364 SW 8th St, Westchester, Miami, FL 33144.
Call (786) 738-9515