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Covered
Priority Health typically covers medically necessary allergy tests such as skin tests and blood tests to identify potential allergens. Following diagnosis, coverage may extend to include allergy immunotherapy, which encompasses both subcutaneous injections (allergy shots) and sublingual tablets, if deemed appropriate for the patient's condition and in accordance with accepted medical practice. These treatments are intended to gradually reduce sensitivity to allergens, resulting in long-term relief of allergic symptoms. It's important to note that coverage may vary based on the specific policy and plan, as well as the individual patient's medical necessity and the physician's recommended treatment plan. Always consult with Priority Health directly to verify coverage for specific treatments or situations related to allergy immunotherapy.
Uncovered
Priority Health may not cover treatments and situations such as cosmetic surgery procedures that are not medically necessary, experimental or investigational treatments, weight loss surgeries or programs not meeting specific medical criteria, non-prescription medications and over-the-counter drugs, fertility treatments beyond certain stipulated limits, treatments for sexual performance issues, and certain alternative therapies like acupuncture or homeopathy unless specifically stated in the plan. Care received outside of the covered network without prior authorization, and services related to work injuries or conditions covered under other insurance like workers' compensation may also be excluded.
