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For Gateway Health Plan coverage of allergy immunotherapy:
1. Get a referral or prescription from an in-network physician.
2. Prior authorization might be required; submit your provider's assessment.
3. Determine if coverage includes both subcutaneous (SCIT) and sublingual (SLIT) therapies.
4. Review the plan's formulary; certain allergen extracts may not be covered.
5. Treatment must be deemed medically necessary.
6. Understand any plan-specific visitation limits or duration restrictions for therapy.
7. Keep detailed records of treatment dates and progress.
8. Be cognizant of potential copays or deductible amounts for procedures.
9. For ongoing treatment coverage, periodic reassessment documentation may be required.
Check your specific policy for further details on restrictions or additional steps.
Want to try immunotherapy?
Start with CurexReview your allergy test results with a Curex allergist.
To begin allergy immunotherapy with Gateway Health Plan, follow these steps:
1. Obtain Referral: If required, get a referral from your primary care provider (PCP) to see an allergist.
2. Consult an Allergist: Schedule an appointment with an in-network allergist for an evaluation.
3. Coverage Confirmation: During the consultation, ask the allergist to verify coverage for immunotherapy under your plan.
4. Pre-Authorization: Request that the allergist’s office obtain pre-authorization from Gateway Health, if necessary.
5. Documentation: Ensure all medical necessity documents are prepared by the allergist to support the therapy.
6. Contact Gateway Health: Reach out to Gateway Health customer service at the number on your member ID card for specific plan details and approval process.
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.