Morenz AM, et al. - Via a mixed-methods study of 27 dermatology clinics and 49 teledermatological programs, experts assessed the driving distances and insurance coverage for dermatological care and the current availability of teledermatological programs within the Indian Health Service (IHS) or tribal hospitals system. Twenty-five responded to the survey, six did not accept patients with Medicaid, and six did not accept IHS referrals for patients without insurance out of the 27 dermatology clinics in closest proximity to rural IHS or tribal hospitals. Forty-five responded and 14 were no longer active, out of the 49 teledermatological programs. Ten teledermatology programs were recently partnering (n = 6), formerly partnered (n = 2), or were setting up services (n = 2) with an IHS or tribal site. Only 9% (n = 27) of the 303 rural IHS or facility in the continental United States listed receiving teledermatological services. Thus, for American Indian individuals in rural communities, substantial geographic and insurance coverage barriers to dermatological care existed and teledermatological innovations could exhibit a significant step toward decreasing the disparities in dermatological care access and outcomes.