Does Medicare Cover Allergy Testing?

Key Takeaways

• Medicare Part B covers allergy testing when it’s medically necessary and part of a treatment plan from a Medicare-enrolled provider.
• Medicare Advantage (Part C) replaces Original Medicare and offers at least the same testing coverage as Part B. Many plans may also provide extra benefits, such as wellness programs or lower copays.
• Part D doesn’t cover testing but may help with allergy medications like antihistamines or nasal sprays.
• Allergy shots may be covered under Part B, but only if they meet specific guidelines and show continued improvement.

Allergies can affect everything from your breathing and digestion to your quality of sleep. For many people, identifying the root cause is the first step to feeling better, and that often starts with allergy testing.

If you’re on Medicare or approaching eligibility, you might wonder: Does Medicare cover allergy testing?

The answer is yes—but there are certain conditions and guidelines that apply.

In this article, we’ll explore the different types of allergy tests, how Medicare covers them and what to expect in terms of cost and coverage through Parts B, C and D.

8 a.m.-8 p.m., 7 days a week.

Understanding Allergy Testing

Allergy testing helps identify specific substances, called allergens, that may trigger allergic reactions. Getting tested can be a key part of managing symptoms and improving your overall health.

There are a few common types of allergen tests your doctor may recommend:

• Skin Tests — These involve applying or injecting a small amount of an allergen onto or under the skin to see if a reaction occurs. These tests are often used to detect pollen, mold, pet dander or dust mite allergies.
• Blood Tests — These measure the presence of allergen-specific antibodies in your blood. Blood tests are sometimes used when skin tests are not appropriate.
• Food Challenge Testing — This involves consuming small amounts of a suspected allergen under medical supervision to monitor for a reaction. This is typically used when food allergies are suspected.

Each type of test plays a role in diagnosing allergies accurately and creating a plan for long-term relief.

Medicare Coverage of Allergy Testing

Medicare provides coverage for allergy testing, but how much is covered and under what conditions depends on which part of Medicare you have. Original Medicare (Parts A and B) offers specific benefits, while Medicare Advantage (Part C) replaces Original Medicare and may offer additional services. Medicare Prescription Drug Plan (Part D) covers prescriptions only.

Let’s break it down by each part.

Medicare Part B Coverage

Allergy testing is generally covered under Medicare Part B as a clinical laboratory test, but the test must meet certain criteria to qualify for coverage.

In short, Medicare will help pay for allergy testing when it’s medically necessary and part of a treatment plan recommended by your doctor.

To be covered, the following conditions must be met:

• The test is prescribed by a provider who is enrolled in Medicare and agrees to accept Medicare’s approved amount as full payment.
• Your provider reviews your medical history and performs a physical exam.
• The test is deemed medically necessary to diagnose or manage a condition.
• The test is part of a complete treatment program designed to improve your symptoms.

Once these conditions are met, Medicare Part B typically pays 80% of the approved cost, and you’re responsible for the remaining 20% after meeting your annual deductible, which is $257 in 2025.

Medicare Part C Coverage

Medicare Advantage is not an add-on, it’s a separate plan that replaces your Original Medicare (Parts A and B). These plans are offered by private insurers and are required to cover the same allergy testing services as Medicare Part B. 

Some Medicare Advantage plans offer extra perks not covered by Original Medicare, such as:

• Coverage for additional or more specialized allergy tests not typically covered by Original Medicare
• Access to wellness programs that support allergy management
• Lower copays or reduced cost-sharing for allergy-related visits and services

Because Medicare Advantage plans are managed privately, your costs, network and coverage options may vary. Some plans may also include more comprehensive allergy care or access to a broader network of specialists.

To know exactly what your plan covers, it’s a good idea to contact your Medicare Advantage provider directly and ask about benefits related to allergy testing and treatment.

Medicare Part D Coverage

Medicare Part D is an optional plan you can add to Original Medicare to help cover prescription drug costs. While it doesn’t cover the cost of allergy tests themselves, it can help pay for medications used to treat allergy symptoms, such as antihistamines, nasal sprays or other prescriptions you take home.

It’s important to note that allergy shots (immunotherapy) are typically administered in a medical office and are not covered by Part D. However, some Medicare Advantage Prescription Drug (MAPD) plans bundle medical and drug coverage together, offering a more integrated option for managing allergy care.

Managing allergies isn’t just about comfort, it can help prevent more serious health issues down the road. Understanding your Medicare options helps you get the care you need.

FAQs

How Often Will Medicare Cover Allergy Testing?

Medicare doesn’t set a specific limit on how often you can receive allergy testing. Instead, the coverage is based on medical necessity. As long as your doctor documents a valid reason for repeat or follow-up testing—and the test is part of an active treatment plan—Medicare may cover it again.

How Much Does Allergy Testing Cost?

If you have Original Medicare:

• The monthly premium for Part B is $185 in 2025. This is often deducted automatically from Social Security benefits but can also be paid directly to Medicare.
• The annual deductible is $257. You’ll pay this amount gradually over the year as you receive covered services.

Once you’ve paid the deductible, Medicare typically covers 80% of the approved cost for testing. You would pay the remaining 20%, unless you have a Medigap (Medicare Supplement Insurance) policy, which may help cover some or all of that out-of-pocket portion.

Does Medicare Cover Allergy Shots and Injections?

Yes, if your doctor can show that they are medically necessary. Allergy shots, also called immunotherapy, are often covered under Medicare Part B if they are given in a clinical setting and if they meet coverage guidelines.

These shots are considered effective for individuals with:

• Allergic rhinitis (hay fever)
• Allergic conjunctivitis (eye allergies)
• Allergic Asthma
• Stinging insect hypersensitivity

However, coverage isn’t indefinite. After two years, if your provider cannot show that the treatment is helping, Medicare may stop covering the allergy shots.

What does Medicare Advantage Cover that Original Medicare Does not?

Medicare Advantage (Part C) plans cover everything Original Medicare does, and many plans may include extra benefits. For allergy care, this could mean lower copays, access to wellness programs or coverage for additional types of allergy tests.

Note: Benefits vary by plan and location. Always check your plan details to understand what’s covered.

8 a.m.-8 p.m., 7 days a week.

Sources

• Medicare: 2025 Medicare costs
• CMS.gov: Allergy Testing
• CMS.gov: Allergy Immunotherapy
• Medicare.gov: Clinical laboratory tests

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