Does Medicare Cover Allergy Testing?

Allergies. Anyone can suffer from them, no matter their age. They can be seasonal, they can be food-related, they can be triggered by pets…but no matter the cause, they’re always annoying, and sometimes dangerous. Over 50 million people in the United States live with allergies, making them the sixth leading cause of chronic illness. Allergies can develop at any stage in your life, so what happens when you suspect that you’ve developed an allergy to something when you’re 65 or older? Will Medicare cover the necessary testing? 


back of a woman with her hair in a ponytail in a lab testing something
The laboratory where the allergy testing is done must be Medicare approved.

Medicare coverage eligibility is always determined by how necessary and reasonable the treatment is considered to be. Allergy tests are considered “clinical diagnostic laboratory services,” which means they will be covered under Part B as long as you meet certain criteria:

  • Your doctor must prescribe an allergy test
  • The doctor prescribing the allergy testing must be enrolled in Medicare and accept Medicare assignment.
  • The allergy testing must be done in laboratories that are Medicare-approved.
  • No previous kinds of therapy have been able to help manage your allergies 
  • Your doctor can prove that the testing is the first step in a complete, Medicare-approved  treatment program. 

Not all allergy testing procedures are covered by Medicare, so it’s important to know which tests are covered. In order to find out which ones are, you need to contact your physician before testing to make sure that Medicare will pay for your specific procedure. 

The Different Allergy Tests Covered By Medicare

purple glove holding a tube full of blood
Allergy testing can be done by testing the blood for allergens.

Medicare will begin covering any allergy testing after you meet your annual Part B deductible. Medicare will then pay for 80% of the cost of your diagnostic testing. The following types of allergy tests are usually covered:

  • Skin Procedures–  this type of test looks for allergies related to substances such as food, pollen, certain drugs, and more. The skin is pricked or scratched, the suspected allergens are applied to the area, and then the reaction is recorded.
  • Blood Testing- this type of test looks for allergies by analyzing the antibodies in your blood after your body comes in contact with allergens.
  • Food Challenge-  in this test, which is used to confirm or rule out allergic reactions to foods, you are required to eat increasing amounts of the suspected food allergen until you have a reaction, or until your doctor can rule it out as the cause of your symptoms.

Before undergoing any testing, make sure you notify your doctor of all the current medications you are taking, as some medications can interfere with the results of your tests. 

When To Get Help

Some symptoms of an allergic reaction will happen immediately after being exposed to the allergen. Symptoms of the more serious reactions include swelling of the throat, which can lead to death if not dealt with immediately. If you experience any of the following symptoms, you should make an appointment with your doctor as soon as possible:

caucasian woman's chest with pink hives all over it
One of the many signs of allergies are breaking out in hives that are red and itchy.
  • Sneezing and itchy, runny nose
  • Blocked nasal passages
  • Itchy eyes that are red and watery
  • Hives that are red and itchy
  • Swollen lips, tongue, face, or eyes
  • Coughing
  • Skin that is dry, cracked, and irritated
  • Wheezing and shortness of breath
  • Swelling of the mouth or throat 

Millions of Americans experience allergies – if you’re one of them, know that it is possible to manage your symptoms, as long as you are aware of the allergy, and take the necessary medications. If you experience any of the symptoms listed above, talk to your doctor about getting an allergy test. Make sure that the doctor is Medicare-approved and that any tests being performed are approved by Medicare, as well. Some allergies can be life-threatening, so if you suspect you have an allergy, get tested, because it might just save your life.

About The Author:
Cassandra Love

With over a decade of helpful content experience Cassandra has dedicated her career to making sure people have access to relevant, easy to understand, and valuable information. After realizing a huge knowledge gap Cassandra spent years researching and working with health insurance companies to create accessible guides and articles to walk anyone through every aspect of the insurance process.

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