Does Insurance Cover Allergy Tests?

Does Insurance Cover Allergy Tests

Allergies are a very common occurrence these days, with many people coughing and spluttering their way through them.

Allergies come in many different shapes and sizes and they can sometimes be difficult to diagnose. Whether you suffer from food allergies, seasonal allergies or environmental allergies, you will need some treatment in some form.

So, does health insurance cover allergy tests? Or even shots and medication? Read on to find out. 

Does Medicare Cover Allergies?

Allergy tests are covered by Medicare under Medicare part B. This is the ‘clinical diagnostic laboratory services’ category.

You have to meet all of the criteria below in order to access the cover.

  • You must be prescribed the allergy test by your physician.
  • Your physician must be part of Medicare.
  • The test has to be medically needed and you must have a  note from your physician to confirm. 
  • The testing must be Medicare approved.
  • You should have tried other therapy alternatives and confirm you haven’t been able to match your allergies. 
  • The best should lead on to other Medicare approved treatment.

Medicare may not cover all allergy tests, so you must check which tests are covered. If you are part of Medicare Advantage, you should check with your plan provider to see if the tests are covered. 

What Allergy Tests are Included? 

If you’ve hit all the criteria above and have confirmed that you are eligible for allergy tests under medicare, the next step is to understand which allergy tests are covered under Medicare Part B.

There are some which are not covered, so check with your plan provider for more information on those! 

The following tests are covered under Medicare Part B:

  • Skin procedures: These check for allergies to food, insects, pollen or animals. 
  • Blood tests: These tests look for antibodies in the blood which would be there to fight against what your body considers allergens. 
  • Food challenge testing: This looks for allergic reactions to foods such as nuts. 

Allergy Symptoms 

If you are experiencing any of the following symptoms you should consider visiting your physician to check if you may be suffering from allergies.

  • Red and itchy eyes
  • Coughing, wheezing, or shortness of breath
  • Sneezing, runny nose, or booked nasal passages  
  • Dry and cracked skin
  • Hives 
  • Swelling on the face, lips, eyes, or tongue 

Allergy Treatment on Medicare

While allergies can be a very irritating problem, many people manage their symptoms very well and their allergies don’t come in the way too much.

When you have completed your allergy testing and your results have come back in, Medicare Part D is where you will need to look next.

This is where you can find all the information you need about covering your prescriptions and providing you with the treatment you need.

Some allergy medications will be included and some won’t so you will need to go through this with your physician.

However, some insurance companies will not cover all types of allergy relief because a lot of them are available over the counter.

If you are taking antihistamines then you will likely be expected to buy these yourself. However, if you need some kind of shot, then this will usually be covered on the insurance.

Does Insurance Cover Allergy Tests (1)

What is the Usual Treatment? 

While there is no cure for allergies, there are lots of ways to reduce your symptoms. There are over the counter medications available to you if you have a runny nose, congestion, and itchiness.

Antihistamines are very common and effective in easing these symptoms. There are also many other options for allergy medication.

Another way you can avoid the symptoms is by avoiding the allergen. For instance, if it’s dust that you are allergic to, ensure you stay clear of particularly dusty rooms. 

If you aren’t Covered 

If your insurance doesn’t cover your allergy testing, then you will have to pay for this yourself. Depending on the type of test and where you go to have it, allergy tests can cost anywhere from $60 to $300.

Blood tests cost between $200 and $1000. This can be very expensive, however, it is important that you get the diagnosis and treatment you need if your allergies are affecting your quality of life.

There are lots of over the counter medicines that are available for treatment at quite a low cost.

Frequently Asked Questions

Will allergy testing hurt?

Skin testing for allergies will not hurt. It is a very non-invasive procedure and there are no needles involved!
All that will happen during the skin test is that you will have a testing device placed on your skin with allergy extracts on it.
If you do experience an allergic reaction then you may have a small bit of itching on the point where the test was applied, but this will not last very long at all.

What side effects do allergy medications have?

There are a few different types of allergy medications which differ from each other. However, in general, allergy medications are considered safe and most are non-drowsy.
If you do experience any side effects from one medication, there are plenty of other options to try so you will never have to continue to suffer. 

Can my child have allergy tests?

Children can have allergy tests if they are experiencing symptoms of allergies. While a child under two is less likely to be tested because their immune system has not yet fully developed, if there is a need for it then they will be tested.
Many people find out about their allergies in childhood because this is when they start to suffer from them. There are lots of cases where people don’t find out about them until adulthood, though.

Final Thoughts

Allergies are a very common problem that can be irritating and come in the way of your everyday life. Most insurance companies will cover allergy testing as long as you meet the criteria for it.

There are some exceptions, however, as not all types of test will be covered.

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