Allergen Immunotherapy - Insurance Issues

Insurance Issues

Immunotherapy is one of the least-covered areas under most insurance plans. In the USA, sublingual immunotherapy is considered an "off-use" practice and is not approved by the FDA and therefore not covered by almost all insurers. Most insurers only cover immunotherapy if it is considered "medically necessary." The criteria for necessity generally require a history of allergic asthma, stinging insect allergy, and or severe reactivity. In the UK, injection immunotherapy is only covered for severe allergies and never for multiple allergies. For many government programs, including Healthy San Francisco, immunotherapy is not covered under any circumstances, including severe chronic asthma. Quality-of-life allergic rhinitis such as seasonal allergies, pet dander allergies often remain uncovered and undiagnosed.