Medicare and Allergy Treatments: How Are You Covered?
Do you suffer from allergies? Chances are that you do: In the United States, there are over 50 million allergy sufferers.
Allergies can come in the form of skin allergies, food allergies, asthma, and seasonal airborne allergies. Allergic rhinitis (or hay fever) affects 25 million Americans, making it the most common form of allergies in the United States.
So, does Medicare cover allergy treatments? It sure does. Here is how Medicare pays for allergy treatments.
Medicare Allergy Testing
Our bodies are often the first to tell us we have allergies when symptoms begin flaring up. The trick is finding out what we’re allergic to—and allergy testing is the best way to do it.
Multiple testing options are available depending on what kind of symptoms you have. There are two types of skin tests (patch and intradermal tests) and also a blood test. However, does medicare cover allergy testing?
Medicare would categorize these tests as diagnostic tests and they would be covered by Medicare Part B. Medicare typically covers any medically necessary diagnostic test or procedure. Once you’ve met the yearly Part B deductible ($185 in 2019), Medicare will begin covering 80 percent of your medical services including allergy testing.
Additional Allergy Treatments
Depending on the severity of your allergies, your doctor may feel that over-the-counter (OTC) medications, sublingual therapy, or Elisa IgG tests will be the best option for treating your symptoms. In this case, no part of Original Medicare will cover your costs.
Unfortunately, Medicare does not consider Elisa IgG tests to be medically reasonable and necessary, so it is not covered.
However, there are some Medicare Advantage plans that do offer a yearly allowance specifically for OTC medications. The costs of OTC medications can add up dramatically so it’s important to consult your doctor about the best long-term solution.
Last, if you deal with life threatening allergies or asthma, you may be prescribed prescription medication such as an EpiPen and/or an inhaler. These medications should be covered under your Medicare Part D plan, but you may have to use a specific brand or type. Your doctor can work with you to prescribe one covered by your plan or help you file a formulary exception.