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For MDwise coverage of allergy immunotherapy, patients typically need a diagnosis from an allergist confirming the allergy. Prior authorization is often required, ensuring the treatment is medically necessary. The provider must submit detailed documentation, including results from allergy tests and a customized treatment plan. Immunotherapy is generally covered when less invasive treatments have been ineffective. Coverage may include both subcutaneous (injections) and sublingual (under the tongue) therapies. There may be limitations on the duration of coverage and frequency of treatments. For specific plan restrictions, members should consult their individual policy or contact MDwise customer service.
Want to try immunotherapy?
Start with CurexReview your allergy test results with a Curex allergist.
1. Contact MDwise Customer Service: Call the number on the back of your insurance card or visit MDwise.org for contact information.
2. Verify Coverage: Ask about allergy immunotherapy coverage specifics, including pre-authorization requirements.
3. Specialist Referral: Inquire if a referral from a primary care physician is needed to see an allergist.
4. Documentation: Request details on necessary documentation for claims and pre-authorization forms.
5. Out-of-Pocket Costs: Get information on copayments, deductibles, and coinsurance for both diagnostic testing and the treatment.
6. Provider Network: Ensure the chosen allergist is within the MDwise network to maximize coverage.
7. Follow-Up: Request a reference number for the call and note the representative's name for future correspondence.
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.