Does Medicare cover allergy testing and shots?

Does Medicare cover allergy testing and shots? Medicare Part B and Medicare Advantage may cover them if they are medically necessary. Medicare Part D or a prescription drug plan (PDP) for original Medicare may cover drugs prescribed to treat allergy symptoms. Read more below to learn about your Medicare allergy coverage options.

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D. Gilson is a writer and author of essays, poetry, and scholarship that explore the relationship between popular culture, literature, sexuality, and memoir. His latest book is Jesus Freak, with Will Stockton, part of Bloomsbury’s 33 1/3 Series. His other books include I Will Say This Exactly One Time and Crush. His first chapbook, Catch & Release, won the 2012 Robin Becker Prize from Seve...

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Leslie Kasperowicz holds a BA in Social Sciences from the University of Winnipeg. She spent several years as a Farmers Insurance CSR, gaining a solid understanding of insurance products including home, life, auto, and commercial and working directly with insurance customers to understand their needs. She has since used that knowledge in her more than ten years as a writer, largely in the insuranc...

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Reviewed by Leslie Kasperowicz
Farmers CSR for 4 Years

UPDATED: Dec 26, 2020

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The Highlights

  • Medicare Part B may cover allergy testing and shots if they are medically necessary.
  • Medicare Advantage may cover allergy testing and shots, but you should contact your policyholder to make sure.
  • Medicare Part D or a prescription drug plan (PDP) may cover prescriptions to treat allergies.

If you have the signs or symptoms of an allergy, you may purchase over-the-counter drugs to help them. But you may also need to visit your doctor if these medicines don’t help.

You and your doctor may agree that you need to be tested for allergies and that you need a better plan of treatment to manage your symptoms. But does Medicare cover allergy testing and shots?

Below, we’ll look at what Medicare covers in terms of allergy testing and treatment.

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Does Medicare cover allergy testing and shots?

If allergy testing, allergy shots, or other allergy treatments are considered medically necessary, then Medicare Part B will most likely cover them. Medicare Advantage may cover more or less than what Medicare Part B does, so you will have to contact your plan provider to see what your coverage options are.

Read more below about how Medicare allergy testing coverage works.

Does Medicare cover allergy testing?

If allergy testing meets the following criteria, Medicare Part B will most likely cover it:

  • Your physician prescribes it
  • Your physician deems it medically necessary
  • It is completed in a Medicare-approved lab
  • No previous treatments have been successful at managing symptoms
  • Your physician uses it as only part of a whole treatment plan

Medicare Part B will generally cover skin (or percutaneous) allergy testing, blood testing procedures, and food challenge testing (as long as it is completed as outpatient treatment).

The cost of your allergy testing covered by Medicare will depend on your premiums, health care deductible, and copayments or coinsurance.

What other allergy treatments does Medicare cover?

Medicare Part D may cover drugs prescribed to treat allergies. If you have original Medicare, you may be able to sign up for a prescription drug plan (PDP), or you may have prescriptions covered under Medicare Advantage.

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The Bottom Line

So, does Medicare pay for allergy testing and shots? Medicare Part B may cover allergy testing and shots if it is deemed medically necessary by your physician. Medicare Advantage may cover more or less than what original Medicare does, but you would need to contact your policyholder to make sure.

Medicare Part D, a prescription drug plan (PDP), or Medicare Advantage may cover drugs prescribed to treat allergies.

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References:

    1. https://www.medicare.gov/drug-coverage-part-d/how-to-get-prescription-drug-coverage

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