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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.

Office Visits

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

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.

Allergy Testing:

Intradermal Testing & Allergy Injections

Allergy Services & Your Insurance



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