Dermatological services can qualify for coverage within health spending account (HSA) if the category "Professional Service - Dermatologist" is included among the covered items listed on your account dashboard!
While dermatologists are recognized as eligible practitioners by the CRA, the eligibility of the services they offer often requires additional criteria to establish their medical necessity. It's important to note that while consultations with a dermatologist are typically considered eligible, certain procedures they perform may not automatically qualify without further documentation to demonstrate their medical necessity, especially when they're potentially cosmetic.
To comply with the CRA standards for an HSA, our adjudicators need specific criteria included in the claim to verify the eligibility of any dermatological services:
Prescription:
The patient must have a Prescription from a doctor or their dermatologist stating it is Medically Necessary and not for cosmetic reasons, and a clear medical reason is included in the claim. This procedure must be specified in the prescription for the treatment of the condition or disease. Please note that the Doctors' prescription/letter must show the practitioners name, credentials, and the date they wrote it.
Specific Procedure Indication:
The prescribed procedure should be explicitly stated in the prescription, designated for treating a diagnosed condition or disease. For example : "I am prescribing Surgical Mole Removal for Jane Smith, as the mole could have a risk of cancer and it is medically necessary to remove it."
Moreover, the documentation provided by the prescribing doctor or dermatologist must contain their information, including the practitioner's name, credentials, and the date that they wrote it.
Ensuring that the documentation meets the above criteria is crucial for individuals seeking coverage for dermatological services through their HSA. Failure to comply might result in the denial of claims for procedures deemed cosmetic rather than medically necessary.
Please note that any over-the-counter skincare is also not eligible, even with a prescription. In order for skin care to be eligible it would have to be dispensed by a pharmacist and accompanied by an official prescription receipt (like the attached here)