Immunotherapy and Insurance: Coverage Options with Sharp Health Plan

Discover allergy immunotherapy coverage options with Sharp Health Plan. Learn how your insurance provider can support your treatment needs.
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Does Sharp Health Plan Cover Allergy Immunotherapy?

Sharp Health Plan typically covers allergy immunotherapy if deemed medically necessary. Coverage details may vary, so check your specific plan for benefit specifics.

Under Sharp Health Plan, patients seeking coverage for allergy immunotherapy must have documented evidence of allergies from an in-network provider. The provider should perform and submit results of skin or blood tests confirming the specific allergens. Prior authorization from Sharp Health Plan is required to ensure eligibility for coverage. A detailed treatment plan, including duration and dosage of allergen extracts, must be outlined by an allergist. Treatment with FDA-approved extracts is generally covered, but experimental or unproven therapies may not be eligible for reimbursement. There may be limits on the number of treatments covered per year, and co-pays or deductibles can apply depending on the patient's specific plan.

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Covered

Sharp Health Plan, catering to the diverse healthcare needs of its members, includes comprehensive coverage for a variety of treatments and situations, ensuring peace of mind when it comes to medical care. Allergy sufferers can breathe easier knowing that Sharp Health Plan typically provides coverage for allergy testing and immunotherapy, including both subcutaneous injections and sublingual treatments, as a means to diagnose and manage allergies effectively. Additionally, emergency services, hospitalization, prescription drugs, and preventive care are part of the essential health benefits. Members also have access to specialist visits, which could be crucial for those requiring more in-depth investigation of their allergic reactions or for routine management of chronic allergies. Mental health services, chronic disease management, and rehabilitative services are included to support overall health and wellness. It is key to remember that benefits are subject to plan-specific guidelines, pre-authorization requirements, and member eligibility at the time of service.

Uncovered

Sharp Health Plan may exclude coverage for services considered not medically necessary, cosmetic surgery not related to an accidental injury or to improve function, weight loss surgery, unless certain criteria are met, and treatment for fertility issues not related to a diagnosed medical condition. It might also not cover experimental treatments, over-the-counter medications, and elective procedures that do not directly affect health outcomes. Additionally, care received outside of the network without proper authorization, or specific types of alternative therapies such as acupuncture or chiropractic services, may have limitations or are not covered depending on the plan details. As policies can vary, it’s essential to check your specific plan for a detailed list of exclusions.

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Dr. Neeta Ogden, MD

Curex is poised to revolutionize the way allergies are treated in America, expanding access to clinical care and treatments that can meaningfully improve patients quality of life.

Dr. Ravi Patel, VP Telemedicine

At Curex, our mission is to help people improve their health and quality of life by understanding their allergies and treating them at their source.We provide more than individualized prescription treatments; we provide individualized care.

Jill Hamburg, PA - C

Immunotherapy made simple.  We enable patients to receive personalized allergy care on their own time. No more waiting rooms.

Dr. Chet Tharpe, Medical Director

Curex has set the standard for the virtual allergy experience. From the comfort of their home, patients nationwide are able to receive a personalized treatment plan from an experienced clinician, aimed at treating the source of their allergies, not just the symptoms.

Kayla Mardaga, NP

Curex offers convenient at-home allergy testing options. Our goal is to determine if a patient would benefit from immunotherapy and then customize a treatment plan that can reduce both the symptoms and the reliance on allergy medications.

Step-by-Step Guide to Starting Allergy Immunotherapy with Sharp Health Plan

Starting the process with Sharp Health Plan for allergy immunotherapy:

1. Contact Customer Care:
- Phone: Find the number on the back of your insurance card.
- Online: Log in to your Member Center on the Sharp Health Plan website.
2. Ask the representative:
- Confirm coverage specifics for allergy immunotherapy.
- Inquire about required referrals or pre-authorizations.
- Request a list of in-network allergists.
3. Schedule an Appointment:
- Choose an in-network allergist from the provided list.
- Ensure the doctor's office is aware that Sharp is your provider.
4. Follow-Up:
- Obtain necessary referral from your primary care physician if required.
- Confirm that your allergist's office has submitted pre-authorization if needed.

Remember to have your Member ID and personal details ready for all communications.

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Benefits of Curex

At-home treatment

Apply treatments in minutes from the comfort of your own home with under-the-tongue applications instead of shots or pills

5-30x higher cumulative dose vs allergy shots

Sublingual immunotherapy delivers a higher dose of allergens over the course of treatment.

Potential for results in as few as 6 months

Individual results vary but some users have reported a noticeable difference in as few as 6-12 months since starting treatments

Excellent safety profile

Studies that have been reviewed by certified physicians show that sublingual immunotherapy is a safe treatment option
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Treatment prescribed
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Clinicaly made allergen extracts are customized for your allergies

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Your immune system gets desensitized to allergens, giving you long-term relief.

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