Allergy Services & Your Insurance
Because of the varied ways that insurance companies
cover allergy testing and treatment, this guide has been created to assist
you in understanding your coverage for allergy treatment. It is not a
guarantee of your benefits. It is important to note that the only complete
reliable source for determination of coverage is your insurance companyís
Customer Service department. You should not use this guide as a substitute
for benefit verification by your insurance company.
Allergy Office Visits (the patient history, physical
exam, and evaluation by the physician) are generally considered a separate
benefit from a patientís procedures, therapies, and treatments (including
allergy shots). For patients with insurance, office visits are usually
covered by the insurance company, with the patient responsible for some
predetermined co-payment. Usually, there are no limitations on the number
of office visits per year, as long as they are deemed necessary by your
physician, and the patient has obtained any necessary referrals.
Allergy treatment at The Asthma & Allergy Institute
enerally refers to allergen immunotherapy (allergy vaccine shots/injections).
These services are usually considered separate benefits from a patientís
office visit benefit. Allergy treatment is covered by many insurance
companies to some extent. Check with your insurance carrier in order to
determine how much coverage your policy provides. These services are
usually subject to a deductible.
Questions To Ask Your Insurance Company
1. Do I have a benefit for office visits to an allergist?
2. Do these visits require a referral?
3. Does my policy cover allergy treatment?
If so, are there any limitations on:
o The number or type of tests or treatments?
o Annual benefit maximums (dollar limits per contract year)?
o Limits on medical conditions or diagnoses (only cover certain diagnoses)?
o Do I have a deductible? Does my deductible apply to allergy treatment?
Our staff is available to assist you in determination of benefits, but you are
ultimately responsible for understanding your insurance coverage and limitations.
We have much experience with Blue Cross and Blue Shield, United Healthcare,
Medicare, TriCare, and various commercial insurances and PPOs. Please feel free
to ask for assistance.