Medicare covers medically necessary treatment for eczema. This includes phototherapy and medications, which consist of creams, pills, or injections, such as dupilumab (Dupixent).

Original Medicare with a Part D plan or an Advantage plan that includes prescription drug benefits may provide coverage, although there are out-of-pocket costs.

This article examines Medicare coverage of eczema and the out-of-pocket costs, along with programs that help pay the costs. It then discusses eczema and each type of treatment.

Glossary of Medicare terms

We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:

  • Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
  • Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
  • Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
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Several parts of Medicare provide coverage for eczema in specific areas.

Original Medicare

Original Medicare comprises Part A, which involves hospitalization insurance, and Part B, which involves medical insurance. Because eczema treatments do not require an overnight hospital stay, the coverage falls under Part B.

Coverage of Part B relating to eczema includes:

  • doctor visits
  • lab tests
  • outpatient treatment

Learn more about Original Medicare.

Medicare Advantage

Medicare Advantage is the alternative to original Medicare, so the plans include the benefits of parts A and B. Many Advantage plans also offer prescription drug benefits, which would cover creams and pills for eczema.

Part D

A person with Original Medicare does not have prescription drug benefits, but they may get this coverage with a Part D plan. Each plan includes medications in all the classes doctors commonly prescribe, including those for eczema.

Out-of-pocket costs are the costs that Medicare does not cover and include deductibles, copays, and coinsurance. There is no limit to out-of-pocket costs for Original Medicare (Part A and Part B).

Part A

Eczema treatment does not fall under Part A coverage, so there are no costs in this area.

Part B

If a person gets treatment for eczema in an outpatient setting, 2024 Part B costs include:

  • $174.70 monthly premium, or more, depending on a person’s income
  • $240 annual deductible
  • 20% coinsurance

Parts C and D

Parts C and D costs include deductibles, copays, coinsurance, and monthly premiums. These costs vary widely with the Part C or D plan and the company that offers it, although in 2024, Part D’s out-of-pocket maximum is $545, and Part C’s out-of-pocket maximum is $8,850. These might be lower depending on individual plans.

Medicare offers several options to help with out-of-pocket costs.

  • Medigap: This is Medicare supplement insurance, which is available to those with enrolment in Original Medicare. The plans pay between 50% and 100% of Part A and Part B costs, so they would help with Part B eczema treatment expenses.
  • Extra Help: This provides assistance in paying Part D costs for people with limited income and resources. It helps with approximately $8,000 of medication expenses per year, which would assist with the cost of lotions and pills for eczema.
  • Medicaid: This is a state-federal program that helps people with low income pay healthcare costs.
  • Medicare savings programs: These help individuals with low income pay for certain parts of Medicare.

Eczema is a medical term for several types of skin-swelling conditions. Most types cause itchy, dry skin, but the condition is not contagious. If a person scratches the rash, the skin becomes inflamed and may itch more than before.

The rash may appear on the following body parts:

  • face
  • hands
  • feet
  • inside the elbows
  • behind the knees

Causes and complications

While eczema’s cause is not known, it may stem from both environmental and genetic factors.

Eczema is often chronic, but it can either worsen or get better with time. A person with the condition may also develop asthma and hay fever.

According to the National Eczema Association, the most common type of eczema is atopic dermatitis. Although it often occurs in babies and children, adults may also develop the condition.

Eczema has no cure, but treatment includes lifestyle changes, such as:

However, despite lifestyle changes, a person may need treatment, which ranges from topical, oral, and injection medications to phototherapy.

Read about the 7 types of eczema.

A person applies topical medications to the skin in the form of a cream, ointment, lotion, or spray. This section outlines the topical medications for eczema.

Topical steroids

Corticosteroids, sometimes called steroids, reduce itching and inflammation, which promotes skin healing. They come in different potencies or strengths. Common side effects include:

Rare side effects may include glaucoma and cataracts.

Topical phosphodiesterase 4 (PDE4) inhibitors

PDE4 inhibitors block an enzyme involved in the inflammation of eczema. Crisaborole (Eucrisa) is an ointment that can reduce signs and symptoms of atopic dermatitis, such as changes in skin color, itching, and thickened skin. Side effects may include stinging or burning upon application.

Topical Janus kinase (JAK) inhibitors

JAK inhibitors target certain immune system messengers, or cytokines, involved in inflammation. Topical JAK inhibitors target specific types of cytokines that contribute to skin inflammation.

However, these medications are not suitable for people with weakened immune systems.

Topical calcineurin inhibitors (TCIs)

TCIs stop some immune system cells from activating, which can prevent itching, skin discoloration, and inflammation. Two TCIs are available: pimecrolimus (Elidel) cream and tacrolimus (Protopic) ointment.

Common side effects are mild burning or stinging when a person first applies the medications to the skin.

Oral medications are drugs that someone takes by mouth that then undergo absorption into the bloodstream. The oral drugs for eczema are immunosuppressants, which are medications that prevent overreaction of the immune system.

Traditional immunosuppressants

Some of the most common prescription immunosuppressants are:

  • azathioprine
  • mycophenolate mofetil
  • methotrexate
  • cyclosporine

Because of possible complications, doctors generally only prescribe immunosuppressants for a short time until the eczema is under control. These medications may cause side effects, such as:

  • nausea and vomiting
  • increased risk of infections
  • increased risk of some types of cancer

Oral steroids

For people with a severe case of eczema, doctors may prescribe an oral steroid, such as prednisone, to control inflammation. However, the drugs may have a rebound effect, where the symptoms return and may worsen after a person discontinues their use.

Long-term use of oral steroids may have serious side effects, such as:

  • increase in infections
  • weight loss
  • high blood pressure
  • weakening of bones
  • gastrointestinal problems

Oral JAK inhibitors

Oral JAK inhibitors work in the same way as topical JAK inhibitors. Examples of these medications include upadacitinib (Rinvoq) and abrocitinib (Cibinqo)

Doctors may recommend them for people when other systemic treatments, including biologic drugs, have not worked.

Biologic drugs, or biologics, use human DNA to treat conditions involving immunity. They help prevent the overreaction of the immune system, which results in less inflammation and reduced symptoms of atopic dermatitis. -The drugs are injectable through the skin or into a vein.

The Food and Drug Administration (FDA) has approved the biologic drug dupilumab (Dupixent). Doctors prescribe it for people with moderate to severe atopic dermatitis when topical treatments do not manage the condition well.

Common side effects include:

Tralokinumab-ldrm (Adbry) is another biologic drug the FDA has approved for moderate to severe atopic dermatitis when topical treatments are unable to manage the condition. It may cause side effects similar to those of Dupixent.

Phototherapy, or light therapy, involves treatment with different wavelengths of ultraviolet light. The most common form doctors recommend for treating eczema is ultraviolet B (UVB) light. Another option involves ultraviolet A (UVA) light.

Doctors use UVB or UVA light to reduce the itching and inflammation of many types of eczema. They generally prescribe it for people with eczema that has spread all over the body. It may also be suitable for those with eczema limited to a certain body part, such as the hands, but has not improved with topical drugs.

Possible side effects include:

If people have Original Medicare, Part B covers phototherapy and injection treatments for eczema. To get Medicare coverage for pills and lotions, a person would need a Part D plan, which provides prescription drug benefits.

A person with an Advantage plan also receives coverage for phototherapy and injections because the plans must provide at least the basic coverage of Original Medicare. If an Advantage plan includes prescription drug benefits, it will cover eczema pills and lotions.