Eczema Treatments: what Does Medicare Cover?

Many people treat their eczema with over-the-counter remedies like antihistamines or moisturizing lotion. For some people, though, eczema is severe and doesn’t respond to those treatments.

In this case, you may need medical treatment for your eczema. These treatment options include:

  • medicated creams
  • oral tablets
  • injections
  • phototherapy

Medicare will help cover the cost of all these treatments, especially if over- the-counter methods don’t help your eczema.

What does Medicare cover if you have eczema?

Medicare will cover the treatments and care you need if you have eczema, as long as the care is considered medically necessary.

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.

  • Part A. You’ll need a Medicare Part A plan to cover hospital stays.
  • Part B. Medicare Part B will cover your doctor’s office visits and any specialist visits you need.
  • Part C (Medicare Advantage). A Medicare Advantage plan will cover everything that parts A and B do. It might include additional coverage. Prescription coverage is often included. Copayments, deductibles, and coinsurance might also be lower.
  • Part D. You’ll need a Part D plan to cover the cost of prescriptions, including creams, oral tablets, and injections.
  • Medicare supplement (Medigap). Medigap plans help you cover the out-of-pocket costs of parts A and B. This could save you a lot of money if you need phototherapy for your eczema.

Which eczema treatments does Medicare cover?

Your eczema treatment will depend on the type of eczema you have and on its severity. Different treatments are covered differently by Medicare and under different Medicare parts.

Here are your eczema treatment options and what Medicare covers for each:

Corticosteroid creams

These prescription creams are used to control itching and rebuild your skin. They’re covered by Medicare drug plans.

That means you’ll need a Part D plan or a Part C plan that includes Part D coverage.

Calcineurin inhibitor creams

Calcineurin inhibitor creams help calm your skin and reduce:

  • redness
  • swelling
  • itching

You’ll need Part D or an Advantage plan to cover these creams, just like corticosteroid creams. Medicare might also require your doctor to verify that other treatments for your eczema haven’t been successful.

Antibiotic creams

You might be prescribed an antibiotic cream if you have a bacterial infection on your skin that’s causing or aggravating your eczema.

Antibiotic creams are covered by the same rules as corticosteroids or calcineurin inhibitors. You’ll need a Part D or an Advantage plan for coverage.

Oral antibiotics

Oral antibiotics can help you fight an infection. You’ll generally take these for only a short time.

Coverage for all prescription medications, including oral antibiotics, comes from a Part D or a Medicare Advantage plan.

Oral corticosteroids

Corticosteroids can help bring down serious inflammation. Your doctor might prescribe them if your eczema is severe. Oral corticosteroids can’t be taken as a long-term solution.

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You’ll need a Part D or an Advantage plan for coverage. You’ll also need verification from your doctor that your eczema is severe and not responding to other treatments.

Wet dressings

Wet dressings can help when your eczema is severe. The affected parts of your skin will be covered with corticosteroid creams and wrapped in wet bandages.

You could receive your wet dressings at home or in the hospital.

You might have this treatment done at a hospital if your eczema is widespread. If you receive wet dressings in the hospital, your coverage will come from Medicare Part A or an Advantage plan, if you have one.

Wet dressings you do at home will be covered under either Part D or an Advantage plan, since you’ll need a prescription for the corticosteroid cream.

Injectable dupilumab (Dupixent)

Injectable dupilumab (brand name Dupixent) is a new treatment option for severe eczema, approved by the Food and Drug Administration (FDA) in 2017.

Dupilumab is used to help lower inflammation levels in people who don’t respond well to other eczema treatments.

According to GoodRx, about 53 percent of Part D and Medicare Advantage plans cover dupilumab. Check with your individual Medicare plan provider if your doctor recommends dupilumab for your eczema.

How much do eczema treatments cost?

Eczema costs can vary widely, depending on the treatment option you need and the specific Medicare plan you choose.

Here are estimates of the costs of common treatments.

Who’s eligible for Medicare coverage for eczema?

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.

How do you enroll in Medicare if you have 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.

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