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For Fallon Community Health Plan (FCHP) coverage of allergy immunotherapy, your treating allergist must provide a detailed health assessment, including a positive allergy test and history of symptoms. Pre-authorization is typically required. The plan may cover a set number of visits and limit the type of immunotherapy (subcutaneous injections vs. sublingual tablets). Documentation of ongoing benefit is necessary for continued treatment. Out-of-network services may not be covered or could be subject to higher out-of-pocket costs. Speak with your allergist to initiate the coverage review process. All treatments must be medically necessary, and experimental or investigational therapies may be excluded.
Want to try immunotherapy?
Start with CurexReview your allergy test results with a Curex allergist.
1. Contact Member Services: Start with reaching out to Fallon Community Health Plan's Member Services. Use the number on your insurance card to ensure direct access.
2. Inquire about Coverage: Ask about your specific coverage for allergy immunotherapy. Confirm if pre-authorization is required for this treatment.
3. Find an In-network Provider: Request a list of in-network allergists who can administer immunotherapy to ensure maximum coverage and lower out-of-pocket costs.
4. Referral Requirement: Check if you need a referral from your primary care physician to see an allergist under FCHP.
5. Understand Your Benefits: Clarify your co-pays, deductibles, and any other out-of-pocket expenses related to allergy immunotherapy.
6. Documentation for Claims: Inquire about the necessary paperwork or electronic submission processes to file claims for allergy immunotherapy.
By following these steps, you can effectively initiate your allergy immunotherapy treatment process with Fallon Community Health Plan.
Treatment prescribed
by clinician
Clinicaly made allergen extracts are customized for your allergies
Your immune system gets desensitized to allergens, giving you long-term relief.