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An Premier Allergist Blog Post: In the USA, Medicare is a national health insurance program for people who are aged 65 or older and also for some people who are younger with disabilities.

May 31, 2019

Here in the USA, Medicare is a national health insurance program for people who are aged 65 or older and also for some people who are younger with disabilities.

Often people who are brand new to Medicare feel concerned about whether Medicare will cover a chronic medical condition like allergies or asthma. The good news is that Medicare provides for most healthcare services that are deemed medically necessary and treatment of allergies and asthma is no exception.

Contact our healthcare professionals at The Premier Allergist today to learn more about allergy and asthma treatments.

Medicare recognized that allergens like mold, dust and pet dander can aggravate other medical problems and exacerbate heart issues or breathing conditions.

Let’s take a look at how these parts of Medicare provide for healthcare services related to allergies.

Medicare Part B: Outpatient Coverage

Original Medicare is made up of two parts. Part A is hospital care and Part B is outpatient care. Both parts of Medicare are very necessary if you have no other coverage.

Dr. Sangeeta Jain of the Premier Allergist of Towson, Maryland says that allergen testing can be complicated by medications, so you’ll want to plan accordingly for the day of your allergy test.

“If I could give one piece of advice for someone who thinks they need allergy testing, it would be to inform the staff of all medications you are taking before the appointment.  Some medications may interfere with the results of our tests, potentially lead to more visits, higher costs, and lead to potentially dangerous situations if you have a reaction.”

Medicare coverage for allergy testing starts after first satisfying the $185 annual deductible in 2019.  Once your deductible is met, Medicare and Part B will pay for 80% of the cost of your Part B diagnostic testing.

In order for Medicare to cover this testing, it must be performed by a physician credentialed in Medicare.  This physician is responsible for documenting the need for the testing and diagnosing your condition so that it may be treated.

If you are diagnosed with allergy-induced asthma, your doctor may prescribe the use of a nebulizer.  In this scenario, Medicare Part B will cover both the nebulizer and the medications used in the nebulizer. Some people with severe allergies or asthma may benefit from the use of a nebulizer.

As mentioned before, Part B will pay 80% of the costs of this equipment after you have satisfied the Part B deductible. For help with covering the other 20% and Medicare’s various deductibles, you can consider enrolling in a Medicare supplement or a Medicare Advantage plan. These are private policies which help to fill in the gaps in Medicare.

Medicare Part D: Drug Coverage

Medicare offers voluntary drug coverage programs to those who want that coverage. Enrolling in a Medicare Part D plan is important for anyone who suffers from allergies because your doctor may prescribe antihistamines or other drugs to help you manage your symptoms.

Each Medicare Part D drug plan will have its own list of covered medications called a formulary.  You should always check the plan documents up front to ensure that all of your important medications are included before you enroll.

Contact our healthcare professionals at The Premier Allergist today to learn more.