Immunotherapy and Insurance: Coverage Options with WellCare

Explore allergy immunotherapy coverage options with WellCare. Learn how your insurance can support treatments and improve your health. Discover your benefits today.
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Does WellCare Cover Allergy Immunotherapy?

WellCare generally provides coverage for allergy immunotherapy if medically necessary, as indicated in their health plan benefits. Coverage specifics can vary, so refer to your individual plan for details.

To secure coverage for allergy immunotherapy under WellCare, patients must typically have a diagnosis of allergic rhinitis or asthma with an allergy component, confirmed through diagnostic testing. Prior authorization is often required, ensuring that the treatment is deemed medically necessary. The prescribing physician must submit a detailed treatment plan, including the type and duration of immunotherapy, such as subcutaneous injections or sublingual tablets.

Coverage restrictions may include limitations on the number of visits, doses, or a specified list of allergen extracts that are covered. Maintenance treatments may only be covered after the initial escalation phase is completed. Exclusions may apply for experimental or non-standard procedures. Always check with WellCare for the most current policy specifics and potential updates to coverage rules.

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Covered

WellCare insurance typically provides coverage for a variety of healthcare treatments and situations to ensure the well-being of its members. When it comes to allergy immunotherapy, a patient with WellCare may find their insurance covers tests to determine allergen sensitivities, as well as the administration of allergy shots (subcutaneous immunotherapy) designed to reduce sensitivity to allergens. Coverage often includes both standard and rush immunotherapy, where applicable, to accommodate the urgency of symptom relief. In addition to in-office procedures, WellCare may also cover prescription medications aimed at managing and treating allergy symptoms, ranging from antihistamines to corticosteroids. Importantly, the specifics of what WellCare covers can vary by plan and individual member agreements, so checking with WellCare directly or reviewing your policy is crucial for accurate information on coverage details.

Uncovered

WellCare generally does not cover treatments or situations that fall under cosmetic procedures, experimental or investigational treatments, and non-medically necessary services. Additionally, over-the-counter medications, most dental services unless part of a covered medical procedure, and elective procedures such as weight loss surgery not deemed medically necessary, may not be covered. Personal comfort items, hearing aids for adults, and routine foot care often fall outside of their coverage scope. It's also common for fertility treatments, like in-vitro fertilization, to be excluded, along with long-term custodial care. Keep in mind, specifics can vary by plan and state, and coverage determinations are made on a case-by-case basis following WellCare's policies.

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Our team is here to help!

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 WellCare

1. Locate WellCare member card or documents for contact information.
2. Call WellCare’s customer service number provided on the card.
3. Request to speak with a representative knowledgeable about allergy immunotherapy coverage.
4. Gather personal identification information, policy details, and medical records regarding allergy history.
5. Inquire about:
- The process for pre-authorization for allergy immunotherapy.
- Required paperwork or forms to be completed by you or your allergist.
- Coverage specifics, including copayments, deductibles, and covered medications or procedures.
6. Ask for a case number or reference for follow-up calls.
7. Contact your allergist with the insurance information to initiate the treatment pre-authorization process.

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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
by clinician

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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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