According to a report from The American Journal of Managed Care, investigators have uncovered racial disparities in insurance coverage—reporting that patients with conditions such as melasma and postinflammatory hyperpigmentation may receive the same insurance coverage as those with other dermatologic disorders like rosacea and acne. In a research letter—published by Tilahun and Lester in the Journal of the American Academy of Dermatology—the investigators conducted a literature review on first-line treatments for melasma, postinflammatory hyperpigmentation, vitiligo, rosacea, and acne, as well as reviewed the formularies of Medicare, Medicaid, and four private insurance companies in California to determine coverage status. They found that none of the insurance companies covered first-line therapies for melasma or postinflammatory hyperpigmentation. However, treatments for acne were covered. The investigators explained that the lack of insurance coverage for certain skin conditions may have been mostly tied to their classification as cosmetic conditions instead of medical concerns. Because of this, insurance companies could deny coverage, ultimately leaving patients to pay out of pocket or skip treatment. Additionally, the investigators noted that melasma disproportionately affected patients with darker skin tones and—as a result of melasma’s classification as a cosmetic condition—these patients were less likely to receive care. The investigators stressed that their findings demonstrated the limitations of the current insurance paradigm for dermatologic conditions and their treatments and illuminated health-care disparities caused by a lack of insurance coverage.
June 22, 2023