Does Medicare Cover Allergy Testing?

Does Medicare Cover Allergy Testing?
Medicare Medicare Part D

Allergies seem to affect almost everyone these days. Whether it's due to a seasonal, environmental, food, or random occurrence, you may require allergy tests, shots, or medication at some point to help with your condition.


Is Allergy Testing Covered by Medicare?

Allergy tests are classified as “clinical diagnostic laboratory services” by Medicare. Medicare Part B coverage may be available if you meet the criteria listed below.

If you meet all of the following criteria, Medicare Part B may cover allergy testing:

  • Your doctor must prescribe the allergy test.
  • Your doctor must be a Medicare beneficiary and accept an assignment.
  • The test must be deemed medically necessary, and your doctor must provide documentation to that effect.
  • The tests must be performed in a Medicare-approved laboratory.
  • No previous therapy options have been successful in managing your allergies or allergy symptoms.
  • Your doctor can prove that this testing is the first step in a comprehensive, Medicare-approved treatment plan.

Medicare will not cover or pay for all allergy testing procedures. Always check with your health care provider and Medicare plan provider to see which tests are covered and how. Some tests that Medicare Part B does not cover may be covered by a Medicare Advantage plan, but you must ask your plan provider directly.


Does Medicare Cover Allergy Testing?


What Allergy Tests Are Covered by Medicare?

While Medicare Part B may cover clinical diagnostic laboratory tests such as allergy tests, a Medicare Advantage plan may cover additional or different tests. Again, you should inquire with your plan provider about what other tests or allergy services may be available, as well as how coverage works.

In general, Medicare Part B may cover the following allergy tests:


  • Food challenge testing – this test is only covered when performed as an outpatient to look for allergic reactions to specific foods.

  • Blood testing procedures – these analyze the presence of antibodies in your blood to detect allergens when your body comes into contact with them.

  • Skin (Percutaneous) procedures – these look for allergies to things like pollen or animal dander, food, insects, certain drugs, and more.


Also Read Tips on How To Choose A Primary Care Doctor


If you have any of the following symptoms, you should consult your primary care physician about allergy testing.


  • Skin that is dry, cracked, red, and irritated

  • Hives that are red, itchy, and persistently appear

  • Swelling of the lips, tongue, face, or eyes

  • Itchy, watery, or red eyes

  • Wheezing, coughing, shortness of breath

  • Sneezing with an itchy, runny nose or blocked nasal passages


Allergy Treatments Covered by Medicare

Many people can successfully manage their allergy symptoms while remaining active and healthy. Medication may be beneficial depending on your allergies. Some of your allergy prescriptions may be covered by Medicare Part D (or a Medicare Advantage plan with drug coverage). You should check with your insurance provider to see if your allergy medication is covered.


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Related Articles:

What are Medigap Excess Charges? 

How to Make Medicare Works Better for you

When and How To Sign Up for a Medicare Part D Plan?



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