Does Medicare Cover Food Allergy Testing? 

Allergic reactions are one of the body’s responses to perceived threats. You can technically be allergic to anything, but for the most part, allergies consist of stimuli involving histamines. These are chemicals that your body produces when white blood cells activate an immune response. Common allergens that result in histamine production include mold and pollen, but some people are also allergic to specific foods. Peanut butter and tree nuts are common food allergens, but shellfish and certain food dyes can also trigger an allergic reaction.

What are the symptoms of a food allergy?

If you’re allergic to a food item and you ingest it or come into contact with an item containing ingredients that cause allergies, symptoms can vary. Some people break out in hives when exposed to a food allergen, but others may experience life-threatening swelling in the airways. You may also experience an upset stomach or nausea along with vomiting or diarrhea. In severe cases, a person who is exposed to a food allergen can faint or even stop breathing.

How are food allergies detected?

In order to determine whether you have a food allergy, you will need to be tested. Food allergy testing, sometimes referred to as a food challenge, takes place in a healthcare setting under a doctor’s supervision. You may see an allergist to have a food challenge performed.

During testing for food allergies, you will be given specific food items to eat. Your doctor will then monitor your condition to see if you develop any allergic symptoms. You may also undergo a skin exposure test during which tiny bits of suspected allergens will be injected under your skin to see if an allergic reaction occurs.

Your allergist will also draw blood to test its chemical composition and see if certain antibodies are present. This can help to determine what foods need to be used during a food challenge or pinprick test. Lastly, your doctor may suggest eliminating certain foods from your diet one at a time over the course of days or weeks. You will need to keep a journal during this process to make note of any changes you experience as foods are removed from your diet.

Does Medicare cover food allergy testing?

Although food allergies tend to be a bigger concern for children, seniors can also live with and even develop food allergies late in life. Medicare recipients will be happy to know that Medicare insurance provides coverage for food allergy testing through both the inpatient and outpatient portions of the program.

In most cases, food allergy testing takes place in a doctor’s office or clinical laboratory setting. As such, the outpatient benefits of Medicare Part B apply toward coverage. Medicare benefits under Part B pay for 80% of all outpatient care, including diagnostic testing and lab work. You will need to pay a monthly premium to carry Part B, and each plan requires that Medicare recipients meet a deductible in order to use Medicare coverage for outpatient care services.

If food allergy testing is carried out while you are admitted as an inpatient to a Medicare-participating hospital or skilled nursing facility, Medicare Part A supplies benefits for your inpatient care. This coverage includes all healthcare services rendered while you are admitted. Medicare benefits cover 100% of the cost of inpatient services for 60 days in a hospital setting. In a skilled nursing facility, Medicare covers 20 days of care. Medicare recipients may be eligible to extend care for an additional 30 days in a hospital or 80 days in a skilled nursing facility by paying a per-day rate.

Prescription drugs for allergy relief

After your food allergy testing, you may be prescribed medications to combat your allergies. Medicare Part D, the prescription drug benefit, covers prescription medications as long as your medications are a part of your plan’s formulary, or list of covered medications. Medicare Part D plans sometimes require a copay per prescription at the time of purchase, and you will also face a monthly premium and annual deductible to utilize Medicare benefits for prescription medications.