How Seniors Can Stay Social and Engaged This Spring

As beautiful as spring and summer can be, they can also bring an unwelcome guest for many seniors—seasonal allergies. Sneezing, itchy eyes, sinus pressure, and other allergy symptoms can interfere with daily life and overall well-being. Fortunately, there are various treatments and medications available to manage allergies, but the big question for many Medicare beneficiaries is: does Medicare cover allergy treatments? At BroadZero, your Medicare experts in Philadelphia, we’re here to help you understand your options and how to make the most of your benefits.

What Allergy Treatments Are Available?

Allergy treatments typically include a mix of over-the-counter and prescription medications, immunotherapy (allergy shots), and testing to determine triggers. Common treatment options include:

• Antihistamines – Help reduce symptoms like sneezing and runny nose.
• Decongestants – Relieve sinus pressure and nasal congestion.
• Nasal Sprays – Treat inflammation and congestion directly.
• Allergy Testing – Identifies allergens through skin or blood tests.
• Allergy Shots (Immunotherapy) – Gradually reduce sensitivity to allergens through regular injections.

Does Medicare Cover Allergy Testing and Treatment?

Medicare coverage for allergy treatments depends on the type of treatment and the medical necessity as determined by your healthcare provider.

1. Allergy Testing

Medicare Part B may cover allergy testing when it is considered medically necessary. This usually includes skin prick or blood tests ordered by a doctor to diagnose allergic conditions. The test must be performed by a Medicare-approved provider.

You’ll typically pay 20% of the Medicare-approved amount after meeting the Part B deductible.

Be sure the test is deemed medically necessary by your provider to qualify for coverage.

2. Allergy Shots (Immunotherapy)

Allergy shots may also be covered under Medicare Part B if your doctor prescribes them and considers them medically necessary.

These treatments are usually given on a regular schedule over months or years, and Medicare may cover a portion of the cost.

Like with testing, you may be responsible for 20% of the approved cost after the Part B deductible is met.

3. Prescription Medications

If your allergy treatment includes prescription medications such as antihistamines or corticosteroids, these would typically fall under Medicare Part D (the prescription drug plan).

Coverage will depend on your specific Part D plan’s formulary.

Generic medications are usually more affordable and widely covered.

BroadZero can help you compare Part D plans that cover the allergy medications you need.

4. Over-the-Counter (OTC) Medications

Unfortunately, Medicare does not cover OTC allergy medications like Benadryl, Claritin, or Zyrtec. However, some Medicare Advantage (Part C) plans offer OTC allowances or wellness cards that can be used to purchase eligible non-prescription medications.

How BroadZero Can Help

At BroadZero, we specialize in helping seniors in Philadelphia understand and navigate their Medicare options. If you suffer from allergies and are unsure whether your treatments are covered, we’ll help you review your current plan or explore new options with better coverage for the care you need.

Conclusion

While Original Medicare offers limited coverage for allergy treatments, many necessary services like testing and immunotherapy are covered if prescribed by a doctor. To get the most out of your benefits, it’s important to know what’s included in your plan—and BroadZero is here to help. Contact us today to schedule a Medicare review and ensure your allergy treatment is covered this season and beyond.