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Does Medicare Cover Allergy Testing, Medications, and Treatment?

Does Medicare cover allergy treatment?

Are you wondering what coverage is available through Medicare for allergy treatment? Call (800) 950-0608 to speak with one of our licensed agents to learn more about Medicare plans offering allergy treatment coverage that meets your needs.

Just the Essentials:

  • Coverage through Original Medicare for allergy treatment and allergy testing is available, but somewhat limited.

  • Medicare Part B offers coverage for allergy shots and testing if your doctor deems these treatments “medically necessary”.

  • Medicare Part D Prescription Drug plans offer coverage for some prescription medications that help combat allergies.

  • Medicare Advantage (Medicare Part C) offers the same coverage for allergy treatment as Original Medicare, but may offer more.

  • Use our free plan finder to research and compare Medicare plans in your area offering comprehensive allergy treatment coverage!

Will Your Medicare Plan Cover Allergy Treatment?

Spring is rapidly approaching, and that means a number of things! The days get longer, the weather gets warmer, and plants begin to bloom. As plants begin to bloom, that also means pollen and other allergens make their way into the air.

That’s right, as plants begin to bloom, allergy season is on the horizon.

Senior citizens all across the country deal with seasonal allergies. Even if you’ve never had an issue with allergies before, it isn’t uncommon for them to develop suddenly. While seasonal allergies are typically benign and mild, they can pose a threat to your health at times, especially if you live with a compromised immune system.

So, let’s say you’re in need of treatment for seasonal allergies and you’re a Medicare beneficiary. Will Medicare cover your allergy treatment? Let’s take a look at the options for Medicare allergy treatment coverage that are available to you.

Does Medicare cover allergy testing?

I Need An Allergy Test - Will Medicare Cover It?

Allergies share symptoms with a variety of other illnesses, ranging from mild to severe. For instance, your allergy symptoms may actually be symptoms of any of the following:

  • A common head cold
  • Upper respiratory infections
  • Sinusitis
  • Influenza
  • Chronic rhinitis

To rule out the possibility of having any of the above, you’ll need to take an allergy test. Allergy testing can help your primary care physician figure out what you’re allergic to, which can help them treat your allergies more effectively. If you’re a Medicare beneficiary, you may wonder if there’s available Medicare coverage for allergy testing.

The short answer is, yes, there is Medicare coverage for allergy testing. However, in order for your Medicare plan, whether you have Medicare Part B or a Medicare Advantage plan, to cover allergy testing, your physician must find the test to be medically necessary. They must also accept Medicare assignment.

If you’re able to have your allergy tests covered by your Medicare coverage, you’ll still probably need to pay some costs out of pocket. As a beneficiary, you may be responsible for up to 20% of the costs of your allergy testing. Those of you who have Medigap plans may actually avoid paying out-of-pocket for your testing costs altogether.

Does Medicare cover allergy medications?

I Need Allergy Treatment - What Will Medicare Cover?

You’ve officially been diagnosed with severe environmental allergies. After your diagnosis, you’re likely asking any of the following questions:

  • “Does Medicare cover allergy shots?”
  • “Does Medicare cover allergy pills?”
  • “Does Medicare cover skin conditions related to allergies?”

The answer to the above questions isn’t a one-size-fits-all type of thing. Yes, Medicare will cover most common allergy treatments. What Medicare will or will not cover pertaining to allergy treatments depends on the type of plan you have.

If you have Medicare Part B or a Medicare Advantage plan, your plan will cover allergy shots, but only if they’re seen as being “medically necessary” by your physician. For instance, someone who suffers from relatively mild symptoms (light sneezing, a slightly itchy throat, little coughing, etc.) likely won’t be able to have their allergy shots covered by their Medicare plan. If you suffer from more severe symptoms, such as a swollen tongue or chest pain, related to allergies, your physician is more likely to deem allergy shots to be medically necessary for you. Therefore, your allergy shots will be covered by your Medicare plan*.

Prescription medications to help allergy sufferers tame their symptoms won’t be covered by Original Medicare, or by most Medicare Advantage plans. Those of you who require prescription medications to keep your allergies in check may be able to get coverage for needed medicines through a Medicare Part D plan. Part D plans will not cover traditional allergy shots, but they can help you cover the costs of an EpiPen if one is needed. 

Do you suffer from skin conditions related to allergies, such as hives or rashes? If so, you may need to see a dermatologist for specialized treatment. Seniors enrolled in Medicare Part B plans unfortunately may not be able to receive coverage for dermatological treatments related to allergy symptoms. It all depends on whether the treatment you need is seen as medically necessary or as cosmetic. This doesn’t mean you should give up hope, though! A Medicare Advantage plan may cover dermatological allergy treatments that Original Medicare will not.

If you’re a beneficiary of a Medicare Part B plan, you’ll still need to cover up to 20% of coinsurance costs for allergy shots. Those of you with Medicare Advantage plans will only pay a fixed copay for allergy shots.

How Can I Get the Best Available Medicare Coverage for Allergy Testing?

Honestly, there is no “best” option for coverage. “Best” is a subjective term, meaning that what’s best for you may not be a good option for someone else. To get Medicare coverage for allergy testing that works best for you, it’s going to take some research and comparing to find Medicare plans in your area that offer the type of coverage that you need.

When you’re ready to look for Medicare plans in your area that offer coverage for allergy testing, we can help! Enter your zip code into our free plan finder below to find and compare available Medicare plans in your area that offer the types of coverage you may be looking for. When you’re ready to talk about Medicare plans, our licensed insurance agents are just a phone call away.

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