If you suffer from allergies, you are not alone. According to the Centers for Disease Control and Prevention, millions of people endure uncomfortable symptoms caused by everyday exposure to allergens such as dust mites, cat dander and pollen. Some people face seasonal allergies while others suffer from symptoms year round. Although there are allergy medications sold over the counter, many people find they need to visit a physician who specializes in allergies. Treatment for severe allergies may include prescriptions medications and allergy shots. If you are eligible for Medicare, you may be wondering what care may be covered by your insurance, and what you’ll be responsible paying for out-of-pocket.
Medicare Coverage for Treating Allergies
Coverage for allergy-related services may be covered by Medicare Part B (Medical Insurance). You may need to visit your primary care physician or a specialist. Your specific coverage will likely depend on the nature of the allergy and the medical necessity of treatment.
Medicare may pay for medically necessary services and treatments when allergies are chronic or lead to other complications such as asthma or respiratory illness. Medicare Part B may help cover the costs of doctor visits, outpatient services, in-hospital physician services and most medicines administered in a doctor’s office, which may include allergy shots.
Medicare Part D may help cover the costs of prescription drugs prescribed by your physician to treat allergies. If you have Original Medicare, you can enroll in a stand-alone Prescription Drug Plan (PDP). You can also choose to enroll in a Medicare Advantage plan. Medicare Advantage plans are required to provide the same Part A and Part B benefits as Original Medicare, but many include prescription drug coverage.
Medicare Coverage for Allergy Testing
Testing varies based on your symptoms and health history. Medicare may help cover screenings when allergy symptoms are persistent and clinically significant despite efforts to manage them in other ways, such as with over-the-counter medication.
There are a range of tests your doctor may suggest. The skin test is popular, credited with speed and accuracy, of which there are several forms. In the scratch test, allergens are positioned under the surface of the skin to see how the body reacts. The blood test and food elimination diet are other strategies. An oral food challenge is a test monitored closely by an allergist who gives the patient small amounts of food to ingest, gradually adding more to check for symptoms.
Discuss your concerns with your doctor to find the most appropriate and medically necessary testing. Once you have been diagnosed with an allergy, treatments will be designed to meet your specific needs.
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