Because of the varied ways that insurance
companies cover allergy testing and treatment, this guide has been
assist you in understanding your coverage for allergy testing and 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 company’s Customer Service department. You should
not use this guide as a substitute for benefit verification by your
Office Visits: Allergy
Office Visits (the patient history, physical exam, and evaluation by
considered a separate benefit from a patient’s procedures, therapies,
and treatments (including allergy skin testing and 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 Testing: Allergy
testing at The Asthma & Allergy Institute includes prick and intradermal
skin testing techniques. These services are usually considered separate
benefits from a patient’s office visit benefit. There are many
variations in allergy testing benefits between payers, and between
policies. Some policies cover testing at a percentage of the fee, while
others impose a limit on the number and type of tests which can be
administered. These services are usually subject to a deductible before
the insurance company will cover any charges.
Allergy Treatment: Allergy
treatment at The Asthma & Allergy Institute generally refers to
allergen immunotherapy (allergy vaccine shots/injections). These services
are usually considered separate benefits from a patient’s 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:
Do I have a benefit for office visits to an
Do these visits require a referral?
policy cover allergy testing and allergy treatment?
The number or type of tests or
Annual benefit maximums (dollar
limits per contract year)?
Limits on medical conditions or
diagnoses (only cover certain diagnoses)?
Do I have a deductible? Does my
deductible apply to allergy testing
Our staff is available to assist you in determination of benefits,
but you are ultimately responsible for understanding your insurance
and limitations. We have much experience with Blue
Cross and Blue Shield, United Healthcare, Medicare, TriCare, and
insurances and PPOs. Please feel free to ask for assistance.