This is a guest blog submitted by Danielle Roberts regarding allergies and Medicare.
Allergies affect so many people that they’re in the top 10 list of the most chronic illnesses in the county. According to the American College of Allergy, Asthma, and Immunology (ACAAI), a staggering 50 million Americans suffer from some form of allergies.
Allergies may take the form of allergic rhinitis (hay fever), eczema, asthma, and food allergies, and each one of these types of allergies can be expensive to treat. It helps to know how Medicare pays for allergy treatment.
Eczema is a skin allergy said to affect more than 35 million Americans. Eczema starts out as an early childhood condition but can last a lifetime. The trick to managing eczema is avoiding flare-ups.
Many people manage their condition with the use of prescription ointments and pills, home remedies, and phototherapy. When your eczema is too severe for simple at-home remedies such as wet wrappings, your doctor may prescribe corticosteroid ointments or pills. These medications help to alleviate both itch and inflammation.
If you need prescription medications to manage your eczema, Part D may help pay for them. Each drug plan has its own list of covered medications. When you’re prescribed a new drug, be sure to check your plan’s formulary to see if it’s covered. If your new prescription isn’t covered by your plan, talk with your doctor about prescribing an alternative in your plan formulary.
When people are severely affected by airborne allergens such as molds, trees, grasses, dander and pollen, they could suffer from asthma. Asthma affects over 26 million Americans, according to the Centers for Disease Control and Prevention (CDC).
Medicare beneficiaries who suffer from asthma can rest assured that medically necessary tests to help manage their condition are covered by Medicare. A few tests that asthma patients may undergo include skin allergy tests, pulmonary function tests, and bronchial challenge tests. When these tests are medically necessary to help diagnose, treat, or manage your condition, Medicare Part B typically covers them. Allergy immunotherapy or allergy shots falls under this category as well.
Part B will also cover durable medical equipment (DME) such as nebulizers and oxygen tanks if your doctor orders them. If you are prescribed DME by your doctor, be sure to go to a DME supplier who is Medicare-approved and accepts Medicare assignment. Taking these steps will make sure you don’t spend more than you have to out-of-pocket.
Food allergies are common in children and usually fade over time. However, some food allergies are lifelong. The most common food allergens in adults are peanuts, tree nuts, fish and shellfish.
Because food allergies can be life-threatening and cause anaphylactic shock, many people with food allergies carry around rescue medicine like an EpiPen. An EpiPen is an autoinjector pen that injects epinephrine to treat severe allergic reactions.
There are many kinds of epinephrine autoinjectors; EpiPen is a brand name medication. Most Medicare plans don’t cover the brand name EpiPen. However, many will cover a generic version called Adrenaclick.
When obtaining Part D drugs such as these, you pay a copay set by your insurance carrier. Original Medicare generally doesn’t cover prescription medications you use at home.
Help with Costs
Medicare Advantage plans are often a less costly alternative to Original Medicare; your out-of-pocket costs may be lower. If you do prefer Original Medicare, a Medicare Supplement plan, or Medigap, covers some or all of your out-of-pocket costs under Part A and Part B. Plan G offers comprehensive coverage to help you better manage your health care expenses.
Danielle K Roberts is the co-founder of Boomer Benefits where she and her team help baby boomers navigate their Medicare insurance options.