Medicare and Allergy Treatments: How Are You Covered?

By Danielle K. Roberts (see bio below)

Do you suffer from allergies? Chances are that you do: In the United States, there are over 50 million allergy sufferers.

Allergies can come in the form of skin allergies, food allergies, asthma, and seasonal airborne allergies. Allergic rhinitis (or hay fever) affects 25 million Americans, making it the most common form of allergies in the United States.

So, does Medicare cover allergy treatments? It sure does. Here is how Medicare pays for allergy treatments.

Medicare Allergy Testing

Our bodies are often the first to tell us we have allergies when symptoms begin flaring up. The trick is finding out what we’re allergic to—and allergy testing is the best way to do it.

Multiple testing options are available depending on what kind of symptoms you have. There are two types of skin tests (patch and intradermal tests) and also a blood test. However, does medicare cover allergy testing?

Medicare would categorize these tests as diagnostic tests and they would be covered by Medicare Part B. Medicare typically covers any medically necessary diagnostic test or procedure. Once you’ve met the yearly Part B deductible ($185 in 2019), Medicare will begin covering 80 percent of your medical services including allergy testing.

Natural Allergy Remedies

Many people would like to treat allergies in a more natural way.

Many natural allergy treatments don’t require medical attention and fall outside of Medicare coverage. Examples of these would be:

• Apple cider vinegar – this natural option can reduce mucus production in your system and clear out your lymphatic system.
• Local honey – bees create honey from the environment around them. The honey will contain trace amounts of pollen to help build up your immune system.
• Saline rinse – flushing out your nasal passages can be a great way to relieve allergy symptoms temporarily
• Exercise – though this option does not always sound like a fun way to eliminate allergies, studies show that your physical activity could have an anti-inflammatory effect on your body.
• Probiotics – Fermented foods have become a hit in the United States. Foods like kimchi and kombucha may help boost your immune system with good bacteria.

Though natural allergy remedies don’t always solve the issue, they can often bring relief without a trip to the doctor.

Immunotherapy

Many would consider immunotherapy treatment a natural remedy for those who suffer with allergies. Immunotherapy is better known as allergy shots and is one of the most effective treatments for allergy symptoms.

Immunotherapy works by taking the allergen that your body is sensitive to and injecting it into your system in small doses. This process helps your body build up an immunity to the allergen. The number of shots and time you will need them varies for everyone.

The good news is that there are medicare allergy shots if prescribed by your doctor. Shots are covered under Part B at 80 percent of allowable charges.

Additional Allergy Treatments

Depending on the severity of your allergies, your doctor may feel that over-the-counter (OTC) medications, sublingual therapy, or Elisa IgG tests will be the best option for treating your symptoms. In this case, no part of Original Medicare will cover your costs.

Unfortunately, Medicare does not consider Elisa IgG tests to be medically reasonable and necessary, so it is not covered.

However, there are some Medicare Advantage plans that do offer a yearly allowance specifically for OTC medications. The costs of OTC medications can add up dramatically so it’s important to consult your doctor about the best long-term solution.

Last, if you deal with life threatening allergies or asthma, you may be prescribed prescription medication such as an EpiPen and/or an inhaler. These medications should be covered under your Medicare Part D plan, but you may have to use a specific brand or type. Your doctor can work with you to prescribe one covered by your plan or help you file a formulary exception.

Danielle Roberts

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Danielle K. Roberts is a Medicare insurance expert who writes regularly for many online publications, including Forbes. A TCU journalism graduate and former magazine editor, she enjoys sharing her knowledge about Medicare, retirement and insurance so that baby boomers can prepare for the costs of healthcare in retirement.