Does TRICARE cover allergy testing and shots?

TRICARE provides comprehensive coverage for allergy diagnosis, testing, and treatment including immunotherapy (allergy shots).

Covered Allergy Testing

• Skin prick testing (most common)
• Intradermal skin testing
• Blood tests (specific IgE, RAST testing)
• Patch testing for contact allergies
• Food allergy testing when medically indicated
• Environmental allergen panels

Allergy Shots (Immunotherapy)

• Covered when prescribed by an allergist
• Build-up phase (weekly injections for 3-6 months)
• Maintenance phase (monthly injections for 3-5 years)
• Sublingual immunotherapy (under-the-tongue tablets) may be covered
• Must be administered in a medical setting with monitoring

Allergy Medications

• Prescription antihistamines covered through TRICARE pharmacy
• Nasal corticosteroid sprays
• Epinephrine auto-injectors (EpiPens) for severe allergies
• Eye drops for allergic conjunctivitis
• Some over-the-counter allergy medications may require a prescription for coverage

Referral and Access

• TRICARE Prime: PCM referral needed to see an allergist
• TRICARE Select: Direct access to network allergists without referral
• MTFs may have allergy clinics available
• Pre-authorization generally not required for standard testing

Costs

• Active duty: No cost
• Active duty families (Prime): Low or no copay for network care
• Retirees (Prime): Standard specialist copay
• Retirees (Select): Cost-share based on network/non-network
• Allergy shots: Copay per visit during build-up and maintenance

What May Not Be Covered

• Unproven or experimental allergy treatments
• Alternative allergy therapies not supported by evidence
• Over-the-counter medications without a prescription
• Environmental modifications to your home

Tips for Managing Allergies

• Keep a symptom diary before your allergist appointment
• Bring a list of all current medications to your visit
• Ask about generic alternatives for allergy medications
• Discuss whether immunotherapy is right for your type of allergies