Immunotherapy and Insurance: Coverage Options with Christiana Care Health System

To get allergy immunotherapy covered by Christiana Care Health System insurance, follow these rules:

1. Consultation: Begin with a consultation with a Christiana Care network allergist, who can confirm the necessity for immunotherapy through appropriate testing.
2. Referral & Documentation: Obtain a referral from your primary care provider if required. Keep detailed documentation of your allergy history and treatment attempts.
3. Pre-authorization: Ensure the allergist secures pre-authorization from the insurance for the specific immunotherapy treatment, demonstrating medical necessity.
4. Treatment Plan: Submit a detailed treatment plan outlining the type of immunotherapy (e.g., subcutaneous injections or sublingual tablets), frequency, and duration.
5. Coverage Period: Be aware of coverage duration; some plans limit the number of years covered.
6. Costs: Be prepared for possible co-pays, deductibles or co-insurance fees.

Note any exclusions or restrictions such as non-covered allergens or experimental treatments. Follow-up sessions and periodic re-evaluations are generally required to maintain coverage.