Why skin checks matter as you get older

Your skin changes over decades. Sun exposure adds up, and the risk of skin cancer rises sharply after age 65. A skin check — also called a skin cancer screening — is a straightforward exam where a doctor or dermatologist looks at your entire body for spots, moles, or growths that might be cancerous or precancerous.

Most skin cancers are highly treatable when caught early. The three main types are basal cell carcinoma, squamous cell carcinoma, and melanoma. Melanoma is the most serious, but all three respond well to treatment in early stages. A screening takes 10 to 15 minutes and requires no needles, blood work, or special preparation.

Medicare covers skin cancer screenings as a preventive service with no copay if your doctor refers you for a specific concern. If you want a routine screening without a specific symptom, you may pay out of pocket, though many plans cover it anyway.

Key Takeaways

  • Skin cancer risk increases significantly after age 65, especially if you spent time in the sun when younger.
  • A skin check takes 10 to 15 minutes and a doctor or dermatologist examines your entire body for suspicious spots or moles.
  • Medicare covers screenings referred by your doctor for a specific concern, but routine screening coverage varies by plan.
  • You can start with your primary care doctor, who can refer you to a dermatologist if needed or if anything looks unusual.
  • Between screenings, watch for new moles, changes to existing moles, or spots that itch, bleed, or don't heal.

Who should get a skin check and how often

If you are over 65, a skin check is worth discussing with your doctor, especially if you have fair skin, spent significant time outdoors, or have a personal or family history of skin cancer. People with a history of severe sunburns, those who used tanning beds, or anyone with many moles should be checked regularly.

How often you need screening depends on your risk. Low-risk individuals may need a check every few years. Higher-risk people — those with a history of skin cancer, many atypical moles, or a family history — may need annual or even more frequent checks. Your doctor can recommend the right schedule for you.

Even if you have never had skin cancer, starting a baseline screening in your 60s or early 70s gives your doctor a reference point for future visits. Changes over time matter more than any single spot.

What happens during a skin check

You will undress completely or wear a gown so the doctor can see your entire body, including your scalp, between your toes, and behind your ears — places people often miss. The doctor uses their eyes and sometimes a magnifying tool called a dermatoscope to look closely at moles and spots.

The doctor may take photos of concerning areas to compare at future visits. If they see something that needs closer inspection, they may perform a biopsy — a small sample of skin removed with a local anesthetic and sent to a lab. A biopsy is painless and takes a few minutes. Results usually come back within a week.

If nothing suspicious is found, you are done. The doctor will tell you when to return for your next screening and what to watch for between visits.

Where to get a skin check

Start with your primary care doctor. Many can perform a basic skin check during a regular visit. If they find something concerning or if you have a high-risk history, they will refer you to a dermatologist — a doctor who specializes in skin.

Dermatologists have more training in spotting skin cancer and can perform biopsies and treatment if needed. You can also request a dermatology referral directly from your primary care doctor without waiting for a problem to appear.

To find a dermatologist in your area, ask your doctor for a referral, check your insurance company's provider directory, or call your local hospital for a list of specialists. Many dermatologists have wait times of a few weeks to a few months, so schedule early if you know you want a screening.

What Medicare and insurance cover

Medicare Part B covers a skin cancer screening with no copay if your doctor refers you because of a specific concern — a new mole, a changing spot, or a family history of skin cancer. The screening must be done by a doctor or dermatologist, not a nurse or physician assistant.

If you want a routine screening without a specific medical reason, Medicare may not cover it, and you could owe the full cost. However, many Medigap and Medicare Advantage plans cover routine preventive screenings, so check your plan documents or call your plan's customer service line to ask.

If you have private insurance through a job or spouse's job, most plans cover skin cancer screenings as preventive care. Medicaid coverage varies by state. Call your plan or your state Medicaid office to confirm what is covered before you schedule.

What to watch for between screenings

Learn the ABCDE rule for spotting changes in moles: Asymmetry (one half does not match the other), Border (edges are jagged or blurry), Color (more than one shade or very dark), Diameter (larger than a pencil eraser), and Evolving (changing in size, shape, or color). A spot that itches, bleeds, or does not heal is also worth reporting.

Take photos of moles or spots you want to track. A smartphone photo with a ruler or coin for scale helps you and your doctor see changes over time. If you notice anything new or different, contact your doctor rather than waiting for your next scheduled screening.

Protect your skin going forward: wear sunscreen with SPF 30 or higher daily, seek shade during peak sun hours (10 a.m. to 4 p.m.), and wear protective clothing like long sleeves and hats when outdoors for extended periods. Sunscreen does not prevent all skin cancer, but it reduces risk significantly.

What happens if skin cancer is found

If a biopsy shows skin cancer, your doctor will discuss treatment options. Basal cell and squamous cell carcinomas are usually treated with a straightforward outpatient procedure — removal of the spot and a small margin of surrounding skin. Most are cured with this single treatment.

Melanoma requires more aggressive treatment and may involve removal of a larger area, lymph node testing, or other procedures depending on how deep the cancer has grown. Your dermatologist or an oncologist will explain your options and the likely outcome.

Early-stage skin cancers have cure rates above 95 percent. Even melanoma caught early has a much better prognosis than melanoma found at a later stage. This is why regular screening matters.

Frequently Asked Questions

Do I need a referral from my doctor to see a dermatologist?

It depends on your insurance. Many Medicare Advantage plans and private insurance plans do not require a referral. Medicare Part B does not require one either. However, some plans do, so call your insurance company before scheduling to confirm. Your primary care doctor can provide a referral if you need one.

Will a skin check hurt?

No. The doctor looks at your skin with their eyes and sometimes a magnifying tool. If a biopsy is needed, the area is numbed with a local anesthetic first, so you feel pressure but not pain. You may feel a small pinch when the anesthetic is injected, but the biopsy itself is painless.

What if I have a lot of moles — does that mean I have cancer?

Having many moles increases your risk of skin cancer, but most moles are not cancer. People with 50 or more moles should have regular screenings, but the presence of moles alone does not mean you have cancer. Your doctor will watch for changes in existing moles and look for new ones that look different from the rest.

Can I get a skin check at an urgent care or walk-in clinic?

Some urgent care centers offer basic skin checks, but a dermatologist or your primary care doctor is better equipped to spot early skin cancer. Urgent care is appropriate if you have a spot that is bleeding, painful, or changing rapidly and you cannot reach your regular doctor quickly.

How much does a skin check cost if insurance does not cover it?

Costs vary widely by location and provider. A basic skin check by a primary care doctor may cost $100 to $200 out of pocket. A dermatology screening typically costs $150 to $300. If a biopsy is needed, add another $200 to $500 depending on the lab and location. Ask for a cost estimate before your appointment.