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Does Medicare Cover Allergy Testing?

Medicare will cover you for medically necessary healthcare procedures. Therefore, if your doctor declares that allergy testing is essential for your health, you’ll be covered. But there is much more that goes into it than allergy testing and Medicare coverage. For example:

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  • Medicare allergy testing requires not only being medically necessary but also the use of physicians and a testing lab that are enrolled in the Medicare program.
  • It’s also likely that you’ll need to show that other forms of management have been taken to take care of your allergies. Additionally, your testing will also likely need to be a part of a larger healthcare plan.

If you meet these criteria, you can enjoy coverage from Original Medicare benefits, specifically Medicare Part B. But allergies can often require many different types of healthcare ranging from shots to various therapies to prescription medications.

Furthermore, allergies can often be connected with other conditions or negatively enhance their effects, such as eczema, asthma, and hay fever. These issues create a domino effect and can lead to even further healthcare needs.

Allergies come in many forms, and there’s a big difference between seasonal sniffles and a deadly allergic reaction to food. Regardless, healthcare options are available to help you live your life to the fullest. Below, we’ll explore a range of healthcare options and how your Medicare benefits can help you deal with allergies.

Does Medicare Cover Allergy Shots?

Yes, similar to testing, allergy shots receive Medicare coverage when deemed medically necessary by your healthcare provider. Allergy shots covered by Medicare receive their coverage from Medicare Part B, also known as Medical Insurance.

Original Medicare is comprised of both Medicare Part A and Part B benefits, with allergy shots receiving 80% coverage once you’ve reached your yearly deductible, thanks to Part B. The remaining 20% will be paid by you, the beneficiary unless you have additional coverage.

If you’re looking to receive Medicare allergy shots without paying at the time of service, you can also enroll in a Medicare Supplement plan (Medigap). Offered through 12 different lettered plans, you’ll receive benefits that help you cover the leftover costs that occur when using Original Medicare alone.

Does Medicare Cover Allergy Immunotherapy?

Allergy immunotherapy Medicare coverage is available under Part B benefits. Because allergy immunotherapy is considered preventive care, you can count on your coverage to help you with the expenses. Furthermore, because Medicare Supplement plans pick up where your Original Medicare benefits let off, allergy immunotherapy is also covered by Medigap coverage.

For enrollees with a Medicare Advantage plan, you’re also covered. Advantage plans are required to cover the same healthcare services provided by Original Medicare benefits, including preventive care.

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Grass pollens, house dust mites, and bee venom are prime examples of substances that can be treated through allergic immunotherapy. The idea is to expose allergy sufferers to more and more doses of the allergen gradually to prevent allergic reactions by causing immune systems to be less sensitive to what would ordinarily irritate them.

It’s an important therapy technique that comes about after identifying allergic reactions through testing. If your allergies are causing you discomfort and affecting your health, speaking with your doctor can help you devise a plan that may include allergy immunotherapy.

Does Medicare Cover Allergy Serum?

Yes, Medicare Part B covers allergy serums when medically necessary and is provided in an outpatient setting by your healthcare provider. Of course, your doctor will need to be a part of the Medicare program to qualify for coverage, but serums are another form of allergy treatment that can be effective for patients.

The idea when using allergy serums as part of an immunotherapy plan is to incrementally expose you to allergens over time. By doing so, your body can build up immunity. Although provided through shots, serums may also be drops and differ from allergy shots in this way.

Typically, serums can take longer than phototherapy but much shorter than allergy injections. Patients should expect serums to take as much as a year. Therefore, it’s important to speak with your doctor about all available treatments and understand that for Medicare to cover the costs of your serums, they likely need to be a part of a larger plan to deal with your allergies altogether.

Does Medicare Cover Food Allergy Testing?

Testing and therapy for food allergies are excluded from Medicare coverage because the data provided to the Centers for Medicare & Medicaid Services (CMS) showed that they are not effective treatment options.

With that being said, there are still instances in which food allergy testing Medicare coverage is still available, and the conditions will look identical to other types of allergy testing. You will have to have your doctor declare the procedure as medically necessary and likely try other options beforehand.

If your healthcare providers decide food allergy testing is necessary and is part of the Medicare program, along with the labs used for testing, you can receive coverage through Part B benefits and additional coverages if you are enrolled in either Medigap or Medicare Advantage plans.

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Does Medicare Part B Cover Allergy Shots?

Yes, Medicare Part B will cover your allergy shots. A lot of the same parameters apply to your benefits covering the costs of your shots, and they are important to remember:

  • Your doctor must deem the allergy shots medically necessary.
  • It’s likely that your allergy shots will need to be as a part of a larger plan to handle your condition.
  • You’re going to need to ensure that your healthcare provider is in the Medicare program.

Once you’ve paid your deductible for the year, 80% of your costs are covered by Medicare Part B, with most, if not all, of the remaining costs covered by Medigap coverage if you are enrolled. Medicare Advantage can also provide you with coverage for allergy shots.

An example of when allergy shots may be covered is when receiving Medicare hay fever coverage. If you are suffering from hay fever and shots become necessary for your healthcare, according to your doctor, your Part B benefits will be there for you.

Does Medicare Pay For Allergy Injections?

An allergy injection is the same as an allergy shot. Therefore, yes, Medicare Part B can help you cover the costs of allergy injections, so long as the guidelines laid out above are met. Because this type of immunotherapy typically takes years, it’s important to discuss other options with your doctor for those seeking immediate relief.

Does Medicare Cover Eczema?

Yes, Medicare eczema coverage is available for those who suffer, which includes doctor visits, appointments with your dermatologist, meeting with other specialists such as nutritionists and allergy immunology doctors, and even other treatment services related to your condition. However, you’ll still need to potentially cover some of the costs left over by Medicare Part B if you do not have a Medigap policy.

You may also face drug costs associated with your eczema treatment. Medicare benefits can also help in this capacity. Medicare covering ear drops for eczema and other medications is available. Many Medicare Advantage plans provide coverage for such medications; Medicare Part D Prescription Drug plans are another option for covering the cost of prescription drugs assisting in your eczema treatment.

It’s also worth noting that while not always the case, many people who suffer from eczema also suffer from asthma. This may lead to the need for asthma inhalers or nebulizer machines.

Fortunately, asthma RX Medicare plans fall under Part D, with nebulizer machines receiving benefits from Part B when medically necessary for your condition. Inhalers may also be covered by Part B benefits when receiving the inhaler in an outpatient setting.

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Is Dupixent Covered by Medicare?

Yes, Dupixent is covered by Medicare through Part D benefits, but coverage will vary from plan to plan. Each Medicare Part D plan will have a formulary listing the specific drugs that each plan offers coverage for. Part D plans vary by location and carrier. Therefore, you’ll want to check your plan’s formulary before enrolling in Part D coverage for your Zip Code.

Depending on how severe your condition is, your doctor may prescribe an injectable. Dupixent is an injection many eczema patients use. While savings may vary, you may also be able to cover some of these costs if you have a Medicare Advantage plan, depending on your policy.

Medicare Part D will cover most Eczema medications, including various prescriptions, such as creams and ointments, oral tablets, and injections. The price you pay depends on the type of medication.

Prescription drugs also come in various tiers, with higher-tier drugs costing more. If you cannot afford the medicine your doctor prescribes, the Extra Help program can help keep your medication co-pays affordable if you qualify. You may also receive free or reduced costs for your healthcare treatments.

Is Phototherapy Covered by Medicare?

Yes, Medicare phototherapy coverage is available through Part B benefits when determined to be medically necessary by your doctor. Also known as light therapy, phototherapy is a popular treatment choice for eczema doctors. Using UV lights on your skin, certain conditions, including eczema, can be treated using this method.

Patients can expect phototherapy to take one to two months of steady treatment to improve eczema symptoms. After which, treatment may be reduced or stopped altogether at the direction of your healthcare provider.

A popular example is PUVA light therapy, which consists of two steps. Medicare can cover this light therapy for eczema, which includes the following form of treatment:

  1. First, you’ll need to take either oral or topical medication.
  2. Secondly, you’ll begin your ultraviolet light therapy.

Medicare covers PUVA light therapy, but this comes after other traditional forms of treatment fail to work. Because PUVA therapy is outpatient therapy, your Medicare Part B benefits will be handling the coverage. Treatment sessions usually only last about 15-20 minutes per session and can often take around 15 sessions before you see a significant change in your skin.

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Does Medicare Cover Optometrist Visits for Eczema?

Yes, Medicare benefits can cover an optometrist when it is medically necessary, according to your doctor and specialist for your healthcare. While Medicare benefits don’t provide vision coverage, you may still need to see an optometrist if you suffer from eczema.

In eczema cases where the severity of your condition is causing complications that are medically necessary to fix, your Medicare benefits can help. What’s important to remember is that you’ll need to make sure that your doctor signs off on the procedure as medically necessary and that the specialist you are seeing is a part of the Medicare program.

How To Find Medicare Allergy Testing Coverage and More

Allergy testing and treatment can range, but being covered for your healthcare is always important. The good news is that there are many different treatments available, as well as a variety of Medicare benefits to help you cover the costs of these healthcare procedures.

Original Medicare will help you cover many different costs associated with allergy testing and treatment, but you may also need a Medicare Part D plan to help cover the cost of your prescription drugs. Similarly, a Medicare Advantage plan may be able to help, but there are other considerations to remember:

  • Medicare Advantage plans vary by carrier and location.
  • You’re going to have to consider your provider network when enrolling in a Medicare Advantage plan.
  • Receiving treatment outside of your network will result in higher costs for those enrolled in Medicare Advantage.

The alternative is a Medicare Supplement plan. When you have a Medigap plan, you receive coverage without the need to stay within your network. Because you can only enroll in either a Medicare Supplement or Advantage plan at once, you’ll need to explore all of your options, including prescription drug coverage. This is why working with a licensed insurance agent is so important.

There are several considerations and routes to weigh, but the team here at MedicareFAQ has the skill and tools to help you identify and enroll in the best coverage options for your healthcare and budget. We help you compare your options and find coverage that meets your present and future needs.

To find Medicare coverage for allergy testing, shots, prescription drugs, and other forms of treatment, give us a call today at the number above. Or, fill out our online rate form to see rates in your area!

Kayla Hopkins

Kayla Hopkins

Content Editor
Kayla Hopkins is an accomplished writer and Medicare educator serving as the Editor of MedicareFAQ.com. Upon completing her Communications degree from Ohio University, Kayla dedicated her time to understanding the ever-evolving landscape of healthcare. With her extensive background as a Licensed Insurance Agent, she brings a wealth of knowledge and expertise to her writing.
Ashlee Zareczny

Ashlee Zareczny

Compliance Manager
Ashlee Zareczny is the Compliance Manager for MedicareFAQ. As a licensed Medicare agent in all 50 states, she is dedicated to educating those eligible for Medicare by providing the necessary resources and tools. Additionally, Ashlee trains new and tenured Medicare agents on CMS compliance guidelines. Ashlee is a Medicare expert who specializes in Medicare Supplement, Medicare Advantage, and Medicare Part D education.

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