Insurance and Allergy Drops: What You Need to Know About Coverage and Costs

Allergies are no fun. They can cause all sorts of irritating symptoms, such as runny noses, itchy eyes, or hives, that hang like a stormcloud over every activity. These symptoms can be uncomfortable and inconvenient, throwing a wrench into your plans. Thankfully, there’s a promising solution that can offer long-term results: allergy immunotherapy. 

While there are multiple types of allergy immunotherapy, allergy drops are a popular choice for their convenience and lack of needles. Unfortunately, they can be pricey, but there are a few options that can help offset the cost, including specialized telemedicine provider programs and insurance. 

What Are Allergy Drops?

Allergy drops are a type of allergy immunotherapy called sublingual immunotherapy. The treatments are administered under the tongue to desensitize the person to a particular allergen, such as dust mites, bee venom, or pollen. 

Allergy drops are one of two types of sublingual immunotherapy. Tablets, the second option, are also administered under the tongue. Both work the same way. 

They deliver a small, incrementally increasing dose of the allergen to the body. The dose exposes your body to the allergen, giving your immune system the opportunity to adjust to the allergen. The process is somewhat complicated, but in simple terms, it reduces the production of the “blocking” antibodies that trigger your allergic reaction when exposed to the allergen. 

Over time, your immune system builds a tolerance, potentially allowing you to be around that allergen without experiencing significant symptoms. For example, suppose you’re allergic to northern pasture grasses, like timothy. After time and consistent treatment, you might find that you can walk through a grassy pasture without the shadow of irritating and noticeable allergic symptoms. 

Of course, progress can look different for everyone—it’s not a linear process. Some folks might notice a subtle improvement, while others may be able to be around the allergen without significant issues. It all depends on you and how your body reacts to treatment. 

Can Allergy Drops Actually Help With Allergies?

Allergy drops have been proven to be highly effective across multiple studies. While studies on this type of immunotherapy aren’t as widespread due to the inherent variabilities of each patient’s dosage, there are multiple studies documenting its efficacy. 

For example, one study examined allergy immunotherapy’s long-term impact on allergic rhinitis. It found that both types of allergy immunotherapy, sublingual (allergy drops) and subcutaneous (allergy shots) are highly effective in achieving an allergen-specific tolerance. Both offered clinical benefits and immunological changes that align with such a tolerance. 

So, yes, allergy drops can greatly help improve allergies! Of course, it’s important to remember that they’re not a quick fix. It takes time to see results. Most people need two to three years of consistent treatments before they notice significant improvements, although they might notice the initial changes in the first year. 

How Much Do Allergy Drops Cost?

The cost of allergy drops varies from one patient to the next, as the exact dose and schedule depend on factors specific to you. In general, allergy drops tend to be more expensive than allergy shots, which can cost several thousand dollars out of pocket. 

This higher cost stems from multiple factors, including the need for precise dosing, costs associated with FDA-approved allergenic extracts, and the higher dosage of extract in allergy drops compared to allergy shots. In some cases, allergy drops can contain up to 30 times more allergenic extract than shots, driving the overall cost higher. 

So, if you were to pay out of pocket for your allergy drops, you might end up paying several thousand dollars or more for your treatment. 

Does Insurance Cover Allergy Drops?

In most cases, health insurance doesn’t cover allergy drops. The FDA hasn’t yet approved SLIT allergy drops, so most insurers exclude it from coverage. However, there are a few providers that offer partial coverage to help offset the cost of allergy drops, and some employers even offer coverage as a benefit. 

As more FDA-approved allergenic extracts become available, this could change. More insurance providers may cover allergy drops, deeming it a medically necessary and FDA-approved option. However, until then, it’s important to double-check with your insurance provider. Not all providers cover this treatment, but since some offer partial, it doesn’t hurt to check.

How to Afford Allergy Drops

Paying thousands of dollars out of pocket isn’t feasible for many Americans, especially for families with multiple family members who need treatment. It adds up quickly and can put a strain on your budget. Thankfully, there are alternative solutions that can help you afford your allergy drops. 

First and foremost, check with your insurance provider. If they cover the treatment, even just part of it, your costs might be substantially lower. While coverage varies, it doesn’t hurt to check. 

If your health insurance provider doesn’t cover treatment, consider looking for a more affordable allergy immunotherapy provider. Multiple high-efficiency compounding pharmacies have partnered with specialist telemedicine providers, laying the groundwork for more affordable allergy drops. 

For example, allergy drop costs might be as low as $49 per month with one of these telemedicine providers. For many Americans, that amount is far more doable than the lofty, several-thousand-dollar out-of-pocket price tag of other allergy drop programs. 

Wrapping Up

While allergy drops can be beneficial treatments for allergies, their cost and insurance coverage remain significant considerations for many Americans. Current insurance coverage for allergy drops is limited, but there is hope for expanded coverage as research and FDA approvals continue to evolve.

In the meantime, alternative allergy providers can be a cost-effective option, making allergy drop treatment more accessible for those who need it. Of course, if you’re considering allergy drops for your allergy immunotherapy needs, remember to chat with your doctor first. They can help you decide which treatment is best suited to your needs, budget, and medical history.