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Covered
EmblemHealth provides coverage for a variety of treatments and situations for those dealing with allergies. This includes diagnostic testing such as skin tests and blood tests to determine specific allergens. Once allergies are diagnosed, EmblemHealth may cover allergy shots (subcutaneous immunotherapy) that are tailored to desensitize the immune system to specific allergens. Moreover, the plan typically covers pharmacotherapy, involving medications such as antihistamines, nasal corticosteroids, or inhalers for asthma, which is commonly associated with allergies. In the case of anaphylaxis, a life-threatening allergic reaction, EmblemHealth insurance may cover the cost of emergency treatments, including epinephrine auto-injectors. Preauthorization might be required for some treatments to ensure coverage. Always check with EmblemHealth for the specifics of your plan.
Uncovered
EmblemHealth may not cover treatments such as cosmetic surgery, except when medically necessary, and experimental or investigational procedures that lack significant medical documentation supporting their efficacy. Coverage for services provided by non-network providers without prior approval may also be excluded. Additionally, over-the-counter medications and certain types of alternative therapies that are not deemed medically necessary might not be covered. Personal comfort items, custodial care, and educational services for conditions like ADD/ADHD can also fall outside of coverage. It's crucial for policyholders to consult their specific plan documents for a detailed list of exclusions.
