Does Medicare Cover Allergy Shots?

Spring sparks seasonal allergies for many Americans.  In 2021, the Asthma and Allergy Foundation conducted a study that found approximately 81 million Americans are diagnosed with seasonal allergies commonly known as hay fever.¹  Hay fever is an allergic reaction typically  brought on by pollen from growing plants such as trees, grass, and flowers and symptoms can range from nasal congestion, sinus pressure, and sneezing.¹

If you suffer from severe seasonal allergies, a treatment option you may be considering are immunotherapy allergy shots.  Allergy shots are regular injections over a length of time that may help reduce or eliminate allergy symptoms.²  This immunotherapy treatment has helped reduce hay fever symptoms in about 85% of people, making it an effective tool to minimize common allergies.³

Does Medicare Cover Allergy Shots?

 If you are on Medicare and struggle with seasonal allergies, you may be interested in this treatment, but what is the cost?  The cost of allergy shots can depend on your long-term plan and what your allergist recommends.  Typically, treatment can be anywhere between 3-5 years with an average of two shots per week.⁴  Without insurance, allergy shots can range from $1000-$4000 each year and the amount of out-of-pocket costs may vary with certain Medicare plans.⁴

Medicare Parts A and B

If you have Original Medicare, allergy shots will only be covered if your doctor deems it medically necessary for your health.  With that approval, Original Medicare will pay for 80% of your costs, leaving you responsible for the other 20%.

Medicare Parts C

With Medicare Part C, commonly called Medicare Advantage, coverage for allergy shots could vary by plan.  It may depend on if your doctor deems the treatment as medically necessary and it could cost the same as Original Medicare. 

Medicare Supplement

A Medicare Supplement plan may make it easier to see an allergy specialist or an ENT doctor since these plans do not require referrals.  They may also cover more coinsurance and copays than Original Medicare.  But Medicare Supplement coverage for allergy shots can vary case by case.

Allergies can be challenging to overcome, especially during seasons full of natural growth and pollen.  If immunotherapy may be right for you and your doctor affirms it is medically necessary, many Medicare options would help cover up to 80% of the cost.  Shop Medicare plans online and explore coverage options for your needs!

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