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Covered
Fallon Community Health Plan (FCHP) typically covers a variety of treatments and situations related to allergy immunotherapy, which is designed to desensitize the immune system to specific allergens. This may include diagnostic testing to identify allergens, office visits to an allergist or immunologist, and standard forms of immunotherapy such as subcutaneous injections (allergy shots). Additionally, FCHP may cover the costs associated with the preparation of allergen extracts and the administration of the treatment, including the incremental dosing stages and maintenance phases essential for the efficacy of the therapy. It is important for policyholders to consult with their individual plan for specifics, as coverage may vary by policy and require pre-authorization, and to ensure that the healthcare provider and treatment facility are within FCHP's network.
Uncovered
As of the current knowledge cutoff, specific exclusions in the Fallon Community Health Plan (FCHP) might include but are not limited to experimental treatments, cosmetic surgery procedures not deemed medically necessary, and some over-the-counter medications. Coverage for off-label prescription use and alternative therapies like acupuncture could be limited or excluded except under certain medical circumstances. Non-emergency services received from out-of-network providers without proper authorization may also be excluded. It’s essential for members to review their specific plan details as exclusions can vary by plan type and individual circumstances.
