Immunology is defined as the study of the immune system and its physiological functioning. In other words, it works to figure out the reason for a particular illness, what it is doing to the body, and what can be done to fix it. Immunology services provide care to both adults and children that are suffering from allergy or immune disorders. In many cases, Medicare benefits will provide coverage for most immunology services, but it is important to make sure your specific needs qualify.
What are Immunology Services?
Immunologists work to diagnose and treat a wide variety of immune disorders and allergic reactions using various technologies and medical techniques. In the case of allergic reactions, your body can react to many different items and substances, and the severity of the reaction can vary significantly.
Some of the most common allergic reactions include allergies to food, latex, environmental toxins, insect bites, drugs or medications, and anesthetics. Testing can be done for each of these reactions to determine the presence of an allergy. Skin testing is the most common procedure and often involves penetrating, scratching, or pricking the skin and applying an allergen to a specific spot. Then, this spot can be monitored to determine if an allergic reaction occurs.
In the case of food, different testing methods may be used. One of these methods involves starting with a bland, basic diet and introducing various foods in small amounts to the diet. By slowly adding different foods, physicians can recognize an allergy and the symptoms that occur.
Immunology can also help diagnose various medical conditions, including asthma, sinusitis, autoimmune diseases, immune deficiencies, and immunosuppression. Each of these conditions requires special care, and recognizing a condition early helps to limit the negative effects and prevent it from worsening.
These diseases and deficiencies can be recognized by using genetic testing, evaluating laboratory blood samples, examining metabolic panels, and more. Imaging techniques, biopsies, and other testing measures may also be needed to make or confirm a diagnosis, rule out a possible health condition, or further evaluate a specific part of the body to gain a better understanding of a disease or issue.
Medicare Coverage for Immunology Services
Medicare benefits will cover the majority of costs associated with immunology services as long as they are deemed to be medically necessary. Allergy testing is most often covered, especially when a patient has a history of allergies or if they have severe reactions that are difficult to manage with their current medications and treatments.
Because of this, it is necessary for those suffering from allergies to try various over-the-counter and prescription treatments prior to undergoing allergy testing. The physician must also indicate that the testing is necessary for coverage to be provided by Medicare.
Medicare often covers food testing as well. Testing that involves slowly reintroducing foods to a patient’s diet is most often conducted in a hospital setting so that diet and reactions can be monitored closely. Once again, a doctor must deem this testing to be medically necessary.
As far as the other immune conditions are concerned, Medicare Part B generally provides coverage for the required outpatient diagnostic and laboratory testing as long as these tests are ordered by a physician who accepts assignment.
If you are receiving treatment or testing in an inpatient hospital setting or skilled nursing facility, your immunology care will be covered by Medicare Part A. Part A helps cover all inpatient care, testing and procedures. You will likely have to pay your deductible, and any co-insurance/copayments.