Immunotherapy and Insurance: Coverage Options with Amerigroup

Learn about allergy immunotherapy coverage options with Amerigroup. Explore insurance benefits and understand how to maximize your healthcare plan.
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Does Amerigroup Cover Allergy Immunotherapy?

Amerigroup covers allergy immunotherapy for members when deemed medically necessary, following established treatment guidelines and pre-authorization requirements.

Amerigroup coverage for allergy immunotherapy typically requires a confirmed allergy diagnosis through approved testing methods. Prior authorization is often needed, with documentation from a healthcare provider detailing the necessity and planned regimen of the treatment. Coverage may include both subcutaneous injections and sublingual tablets, if FDA-approved for the specific allergen. Restrictions can include the type of allergen, frequency of treatment, and location of administration (typically in a medical setting to monitor adverse reactions). Periodic review of the treatment’s effectiveness may be mandated to continue coverage. Members should consult their individual plans for specific details.

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Covered

Amerigroup covers a variety of treatments and situations with respect to allergy immunotherapy, recognizing it as a beneficial approach to managing allergies. Coverage typically includes allergy testing to pinpoint specific allergens, and once the diagnosis is established, it extends to both subcutaneous immunotherapy (SCIT), commonly known as allergy shots, and sublingual immunotherapy (SLIT) in the form of tablets. These treatments are intended to gradually desensitize the body's immune system to allergens, potentially reducing the severity of allergic reactions over time. Additionally, Amerigroup may cover medically necessary allergy medications and office visits associated with allergy treatment management, ensuring a comprehensive approach to allergy care for their members. Eligibility for coverage of specific treatments depends on individual plan details and possibly the state's mandates on health insurance coverage.

Uncovered

Amerigroup may exclude coverage for cosmetic surgery, experimental or investigational treatments, and non-emergency services received from out-of-network providers without prior authorization. Fertility treatments, weight loss surgery, and certain dental services unless medically necessary might not be covered. Additionally, personal comfort or convenience items, such as a private hospital room, and over-the-counter medications are typically not covered. It's also standard for elective procedures that do not improve health or function, such as elective abortion, to be excluded. Always verify individual policy details, as exclusions can vary.o

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Our team is here to help!

Dr. Neeta Ogden, MD

Curex is poised to revolutionize the way allergies are treated in America, expanding access to clinical care and treatments that can meaningfully improve patients quality of life.

Dr. Ravi Patel, VP Telemedicine

At Curex, our mission is to help people improve their health and quality of life by understanding their allergies and treating them at their source.We provide more than individualized prescription treatments; we provide individualized care.

Jill Hamburg, PA - C

Immunotherapy made simple.  We enable patients to receive personalized allergy care on their own time. No more waiting rooms.

Dr. Chet Tharpe, Medical Director

Curex has set the standard for the virtual allergy experience. From the comfort of their home, patients nationwide are able to receive a personalized treatment plan from an experienced clinician, aimed at treating the source of their allergies, not just the symptoms.

Kayla Mardaga, NP

Curex offers convenient at-home allergy testing options. Our goal is to determine if a patient would benefit from immunotherapy and then customize a treatment plan that can reduce both the symptoms and the reliance on allergy medications.

Step-by-Step Guide to Starting Allergy Immunotherapy with Amerigroup

1. Verify Coverage: Contact Amerigroup member services using the number on your insurance card to confirm allergy immunotherapy coverage.
2. Primary Care Physician (PCP) Referral: Discuss symptoms and treatment options with your PCP. If immunotherapy is suggested, request a referral.
3. Allergist Appointment: Schedule an appointment with an Amerigroup-approved allergist for evaluation and testing.
4. Treatment Plan: If the allergist recommends immunotherapy, a detailed treatment plan will be created.
5. Preauthorization: Ensure the allergist's office submits the treatment plan to Amerigroup for preauthorization.
6. Follow-up: Stay in touch with the allergist's office to confirm authorization and schedule treatment start.

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Benefits of Curex

At-home treatment

Apply treatments in minutes from the comfort of your own home with under-the-tongue applications instead of shots or pills

5-30x higher cumulative dose vs allergy shots

Sublingual immunotherapy delivers a higher dose of allergens over the course of treatment.

Potential for results in as few as 6 months

Individual results vary but some users have reported a noticeable difference in as few as 6-12 months since starting treatments

Excellent safety profile

Studies that have been reviewed by certified physicians show that sublingual immunotherapy is a safe treatment option
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Treatment prescribed
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Clinicaly made allergen extracts are customized for your allergies

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Your immune system gets desensitized to allergens, giving you long-term relief.

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