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Covered
Blue Cross Blue Shield of Illinois offers coverage for a variety of treatments and situations related to allergy immunotherapy, which may include diagnostic testing to identify allergens, medical evaluations by a specialist to assess allergy severity, and standard immunotherapy injections—commonly referred to as allergy shots. Coverage typically extends to both subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) provided that such treatments are deemed medically necessary and prescribed by a healthcare professional. The extent of coverage for allergy immunotherapy would be detailed in a member’s specific health plan, including any applicable co-pays, co-insurance, and deductibles. Pre-authorization may be required for certain services, ensuring that the prescribed treatment aligns with the insurer's medical guidelines for effectiveness and necessity.
Uncovered
Blue Cross Blue Shield of Illinois typically does not cover treatments and situations deemed not medically necessary, experimental or investigational in nature. This may include certain off-label medication usage, holistic or alternative therapies, and elective procedures. It also excludes coverage for comfort or convenience items and services, educational interventions, and work-related conditions which are covered under workers' compensation. Furthermore, cosmetic procedures not related to accidental injury or congenital anomalies are generally not covered. Specific limitations and exclusions vary by plan, and a treatment's coverage status may change as new medical evidence emerges and standards of care evolve.
