Checklist to Help People with Allergies and Asthma Choose the Best Health Insurance Plans

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Health Insurance checklist for allergy and asthma benefits by ACAAI advices consumers about the features of a managed care or health insurance program.

A "Consumer Checklist for Allergy and Asthma Benefits" was released on Oct. 20 to help the more than 50 million Americans who suffer from allergies or asthma choose a health insurance plan.

The checklist, developed by the American College of Allergy, Asthma and Immunology (ACAAI), advises consumers about the features to look for when they enroll in a managed care or health insurance program.

"The National Institutes of Health and professional organizations have developed consensus guidelines for the best treatment of allergies and asthma, yet some health insurance plans do not provide adequate reimbursement for all the recommended diagnostic and treatment options," Myron Zitt, M.D., ACAAI president, said. In an ACAAI survey of its members, 90 percent of allergists said they had some patients with health insurans plans that negatively affected the quality of their care.

The ACAAI checklist advises consumers of features to look for and questions to ask before enrolling in a health insurance plan. It also can be a guide for employers and other purchasers of group health care in choosing health insurance that will lower overall health care costs and reduce time lost from work because of allergies and asthma.

Consumers should enroll in a health insurance benefits plan that:

* Allows patients to see a specialist for allergic diseases such as asthma, allergic rhinitis (hay fever), eczema and other skin allergies, allergies to food, drugs and insect stings, and recurring infections caused by immune system deficiencies

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* Provides the option of diagnosis and ongoing disease management by a specialist

* Does not limit the number or frequency of visits to professionals for allergy/asthma care

* Provides reimbursement for special diagnostic tests, such as antigen testing and "challenge" tests to determine the cause of allergies, pulmonary function tests to evaluate the lungs of individuals with asthma, rhinoscopy to examine the nasal passages, and nitric oxide monitoring to measure inflammation in the lungs

Provides affordable specialty treatments such as immunotherapy (allergy shots) and anti-IgE therapy, a new treatment option that blocks the antibodies that cause allergic reactions

* Does not require excessive co-payments or other out-of-pocket costs for specialty diagnoses and treatments for allergies and asthma.

"Today there are more treatment options available than ever before to help people with asthma and allergies manage their condition and lead healthy, active lives," said Bradley Chipps, M.D., whose committee directed the checklist development. "The key is making sure that the allergy and asthma patient has access to these options and that the treatment is affordable. We encourage all patients with asthma and allergies to use this checklist when choosing or renewing their enrollment in a health insurance plan so that they have access to the best possible care."

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The ACAAI "Consumer Checklist for Allergy and Asthma Benefits" is part of Connections to Allergy and Asthma Care, a program of the ACAAI to help consumers make informed choices about health care benefits. The checklist is available online at www.acaai.org or by calling the ACAAI toll free number at (800) 842-7777.

This page is updated on May 11, 2013.

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