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For Molina Healthcare, coverage for allergy immunotherapy typically requires a confirmed diagnosis of allergic rhinitis or asthma from an in-network provider. Precise documentation highlighting the medical necessity, such as a detailed history, allergy testing results, and previous treatment attempts, is crucial.
The prescribing allergist must submit a treatment plan outlining the dosage and duration of the therapy. Any limitations will be based on Molina's policy provisions, which may include the number of treatments per year or lifetime caps on sessions.
Prior authorization may be necessary, and ongoing treatment often requires periodic reviews. Coverage for maintenance therapy may have specific qualifiers, and out-of-network services might incur higher out-of-pocket costs or not be covered at all. Ensure adherence to Molina's policy updates, as immunotherapy coverage can evolve.
Want to try immunotherapy?
Start with CurexReview your allergy test results with a Curex allergist.
1. Contact Molina Healthcare: Begin by calling Molina Healthcare's customer service at the number found on your insurance card.
2. Member Services Inquiry: Request information on allergy immunotherapy coverage.
3. Policy Details: Ask about your specific policy benefits, coverage limitations, copays, and deductibles.
4. Preferred Providers: Inquire about in-network providers to ensure maximum coverage for the immunotherapy.
5. Referral & Pre-authorization: Ask if you need a referral from a primary care physician or pre-authorization for the treatment.
6. Documentation: Find out which documentation is necessary (e.g., allergy test results) to support the need for immunotherapy.
7. Claims Process: Understand the claims submission process if you'll need to file claims for reimbursement.
8. Follow-Up: Request an email or written confirmation of the conversation with details about the 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.