Plan improves allergy benefit

The state’s Empire Plan has a new remedy for a frustrating and expensive problem that’s been plaguing some members receiving allergy injections under the plan.

Routinely, the plan provides a paid-in-full benefit for the administration of an allergy injection, including the cost of the serum, when billed by a participating provider.

But, when the serum was dispensed by a participating physician and then administered by a different participating physician or, in some cases, by the patient or the patient’s family, benefits for the “take-away” serum were provided under the basic medical portion of the plan and were subject to the annual deductible. Even when the deductible was met, the plan paid just 80 percent up to what it deemed a “reasonable and customary charge.”

Now, the Empire Plan has announced that effective January 1, 2002, the “take-away” serum will be paid in full under the participating provider program.

For more information, call United HealthCare at 1-800-942-4640.
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