Immunotherapy and Insurance: Coverage Options with Blue Shield of California

Discover how Blue Shield of California covers allergy immunotherapy. Explore your insurance options and make informed decisions about managing allergies.
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Does Blue Shield of California Cover Allergy Immunotherapy?

Blue Shield of California generally covers allergy immunotherapy if deemed medically necessary. Coverage specifics may vary, so check your plan for details on deductibles and copayments.

To have allergy immunotherapy covered by Blue Shield of California, patients must first have a confirmed diagnosis of allergic rhinitis or asthma through proper testing. A referral or prescription by an in-network specialist for immunotherapy is often required. Documentation should demonstrate that conservative treatments have been tried and were unsuccessful or not tolerated.

Coverage is typically granted for standard allergenic extracts, while experimental or non-standard treatments may be excluded. Pre-authorization is usually necessary, and treatments should be aligned with established medical guidelines. Benefits may be subject to plan specifics, including co-pays, deductibles, and annual limits.

Patients should ensure that their immunotherapy provider is part of the Blue Shield network to maximize coverage and reduce out-of-pocket costs. Each plan may have unique restrictions, so it's essential for patients to review their policy details or contact Blue Shield of California directly for clarification.

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Covered

Blue Shield of California provides coverage for various allergy treatments and situations, ensuring that members can access appropriate care. Policyholders benefit from services like allergy testing, which determines specific allergens causing symptoms. Once identified, Blue Shield of California often covers allergy immunotherapy, an effective treatment aiming to desensitize the immune system. This can include both subcutaneous injections and sublingual pills or drops. In cases of severe allergic reactions, emergency treatments may also be covered, ranging from immediate interventions to hospital stays and specialty medications, if medically necessary. Coverage details, including the degree of support for prescription medications to manage allergies, are outlined in individual plans and subject to the terms and conditions of the member's policy.

Uncovered

Blue Shield of California may not cover treatments deemed experimental or investigational, non-medically necessary cosmetic surgery, weight control services, and treatments related to obesity, except for medically necessary bariatric surgery. Coverage for alternative medicine such as acupuncture might have limitations. Custodial care, personal comfort items, dental services not related to accidental injury, and routine foot care are also typically excluded. Additionally, over-the-counter medications and prescriptions not approved by the FDA may not be covered. Keep in mind that specific exclusions may vary by plan and patients should review their individual plan documents for detailed information.

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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 Blue Shield of California

1. Contact Blue Shield of California: Call the customer service number on your insurance card to connect with a representative.
2. Gather Information: Have your insurance ID number ready and specific details about your allergy condition.
3. Request Coverage Details: Ask about coverage for allergy immunotherapy under your plan.
4. Obtain a List of In-Network Providers: Request a list of allergists who are in-network to minimize out-of-pocket expenses.
5. Referral Requirement: Inquire if a referral from a primary care physician is needed to see an allergist.
6. Pre-Authorization: Ask if pre-authorization is required for the immunotherapy procedures.
7. Documentation: Confirm what documentation or medical records are needed to support the necessity of immunotherapy.
8. Follow-Up: Secure a reference number for your call and inquire about the next steps in the process.

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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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