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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 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 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 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:

  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 testing and allergy treatment?
    If so, are there any limitations on:
    • The number or type of tests or treatments?
    • 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 and 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.

 

Acceptable Insurance

 

 

 
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