Spring Allergies and Health Insurance: Managing Seasonal Health Challenges

If your allergies start to act up as pollen counts rise during the spring, you can take various steps to manage your symptoms such as avoiding your allergy triggers, keeping your house clean and, of course, taking medicine. Your health insurance may not cover nonprescription remedies but is likely to cover more invasive treatments like immunotherapy shots.

Read below to find out more about managing spring allergies including what the most common symptoms are and how your health insurance plan may be able to help.

Key Takeaways Steps you can take to minimize your spring allergy symptoms include avoiding the things you are allergic to as much as possible, spending less time outside, taking medicine, limiting the amount of pollen that gets into your home and discussing a treatment plan with your doctor. About one-fourth of American adults experienced seasonal allergy symptoms in 2021. Health insurance generally covers allergy testing, immunotherapy injections and prescription remedies such as inhalers and corticosteroid pills. Your health plan likely won’t cover over-the-counter (OTC) remedies if you don’t have a prescription, although these options may still be cheaper depending on your prescription drug plan’s copay or coinsurance requirements.

Are Spring Allergies Common?

Spring allergies are quite common, with about a quarter of all adults in the United States experiencing a seasonal allergy in 2021.^[1] An increase in the amount of pollen produced by trees and grass during the springtime results in an allergic reaction known as hay fever or allergic rhinitis for many people.

Common hay fever symptoms include the following:^[2]

• Runny nose
• Watering and itchy eyes
• Nasal congestion and sinus pressure
• Sneezing
• Coughing caused by postnasal drip
• Fatigue due to poor sleep
• Itching in the roof of the mouth or the throat
• Bruises under the eyes known as allergic shiners

How Do I Manage My Spring Allergies?

Taking the following steps can help you manage your spring allergy symptoms and hopefully lower your health care costs by alleviating your allergic rhinitis before it becomes a major health concern.

1. Know Your Triggers

Pay attention to what triggers your allergies so you can know when and how to prepare for them. For example, even though many people associate allergic reactions to pollen with the spring, you should instead anticipate experiencing symptoms in the fall if you are allergic to ragweed pollen.^[3]

In addition, you should note what activities and situations tend to make you feel sick so you can either avoid them or take action in advance to mitigate their impact on your health. For example, rain can cause pollen counts to increase, so you may want to pass on outdoor activities that you could otherwise handle if there has recently been a heavy rainstorm in your area.^[3]

2. Limit Time Outdoors

Perhaps the most straightforward way to lessen your allergy symptoms is to spend less time outside at the height of your allergy season. While hay fever can be caused by indoor triggers like dust mites and pet dander, it is often caused by outdoor triggers like pollen and spores from fungi and mold.^[2]

Of course, it likely won’t be feasible or enjoyable to avoid going outside altogether during the spring, so it may be helpful to instead be strategic about when you participate in outdoor activities. For example, pollen levels tend to be highest in the morning, so you may be better off if you push your typical morning jog to the evening.^[3] Alternatively, you could simply look up the pollen count in your area to gauge whether it’s a good time for your outdoor exercise routine.

3. Take an Allergy Medicine

There are several allergy relief medicines that you can purchase without a prescription in order to treat your hay fever. Keep in mind that the right medicine for you will depend on your specific set of symptoms. See the below table for an overview of common over-the-counter (OTC) allergy drugs.^[4]

Category	Medications
Antihistamine oral medications	Xyzal, Claritin, Alavert, Allegra, Zyrtec, Chlor-Trimeton and Benadryl
Antihistamine eye drops	Zaditor, Alaway, Pataday and Lastacaft
Antihistamine nasal sprays	Astepro
Decongestant oral medications	Sudafed (only available behind the counter but may not require a prescription)
Decongestant nasal sprays	Afrin, Dristan and Neo-Synephrine

It can be beneficial to start taking allergy medicines before you start experiencing symptoms. For example, if you consistently experience allergic rhinitis symptoms near the middle of March, you could begin to counter those symptoms ahead of time by taking medicine as early as the first week of March. At the very least, you should not wait for your symptoms to become severe before you start treating them.

4. Keep Your Doors and Windows Closed

If your allergy symptoms are primarily triggered by pollen, it’s important to keep your doors and windows closed whenever possible so you can prevent an excessive amount of pollen from getting into your home. You can also take care of pollen that has already gotten into your house by regularly cleaning windows and other hard surfaces and sweeping and vacuuming your floors.

5. Remove Your Shoes Before Entering Your Home

Another simple lifestyle change that may help your allergies is taking off your shoes before you come inside your home so you can avoid tracking pollen throughout your house. Similarly, you may want to shower and change clothes as soon as possible after you get home so you can minimize the amount of pollen that sticks with you.

6. Talk to Your Doctor

Although allergy symptoms are often manageable on your own, you may want to see a doctor if you are unable to get relief from your symptoms, are experiencing negative side effects from OTC medicines or have a condition such as asthma that exacerbates your hay fever symptoms.^[2]

Does Insurance Cover Medications for Spring Allergies?

Coverage for allergy medications and other treatments varies among Affordable Care Act (ACA) health plans.

In general, coverage will depend on the type of treatment you are receiving and whether it has been approved or prescribed by your primary care physician.

Inhalers

Many health plans cover inhalers for policyholders with asthma and similar conditions, although your insurance company may set a limit on the number of refills you can get within a given time frame. For example, TRICARE covers up to six inhaler refills per 90 days for military personnel and their families.^[5]

Nasal Sprays and Eye Drops

Your health insurance likely won’t cover nonprescription nasal sprays or eye drops but OTC products may be covered if you can get a prescription for them. However, it’s worth noting that OTC allergy remedies may be your cheapest option in some cases even if you don’t have a prescription according to Griff Harris, president and CEO of Griffith E. Harris Insurance Services.

“Despite the allure of coverage, it’s not uncommon for the copays on certain covered prescription allergy meds to exceed the cost of OTC alternatives,” Harris said in an email to SmartFinancial. “The caveat to remember is that each plan is unique and individuals should compare their insurance coverage against OTC prices, potentially making use of Health Savings Accounts (HSAs) or Flexible Spending Accounts (FSAs) where eligible, to determine the most cost-efficient approach to managing their spring allergies.”

Skin Creams

While it isn’t a common symptom, hay fever can cause rashes for some people, so it’s possible that your health insurance carrier will cover skin creams intended to treat allergy-induced rashes as long as your primary care physician deems them medically necessary. However, nonprescription OTC ointments likely won’t be covered.

Antihistamines and Corticosteroid Pills

Your health insurance likely won’t cover nonprescription antihistamines and may not cover antihistamines at all unless you can meet strict eligibility requirements, while coverage for corticosteroid pills largely depends on the type of drug you need.

For example, Cigna only deems certain antihistamines to be medically necessary if you have unsuccessfully tried to treat your symptoms with at least three other antihistamines and will only reauthorize coverage after a year if the drug has demonstrably improved your condition.^[6]

Meanwhile, most Medicare and health insurance plans cover corticosteroids like prednisone, methylprednisolone and fluticasone propionate but don’t cover triamcinolone, prednisolone acetate or loteprednol.^[7]

EpiPen Emergency Epinephrine Shots

Insurance coverage for brand-name EpiPens can vary but generic epinephrine auto-injectors are covered by most health plans.^[8] However, you should note that Medicare Part D plans may place restrictions on the amount of epinephrine you can have filled at one time.^[9]

Allergen Immunotherapy Injections

Most health plans cover immunotherapy that involves receiving allergy shots over an extended period of time in order to build up a resistance to the substance you are allergic to. The process generally requires one or two allergen injections per week during a build-up phase that lasts three to six months, followed by one shot every two to four weeks during a maintenance phase that lasts three to five years.^[10]

Does Health Insurance Cover Allergy Testing?

The majority of health plans also provide coverage for allergy testing. The primary way to test if you have any allergies is to undergo a skin test, during which your skin will be exposed to small doses of potential allergens. Afterward, your doctor should be able to easily determine what substances you are allergic to by noting which substances prompted an allergic reaction, usually in the form of itchy or swollen skin.^[11]

How To Get Health Insurance To Prepare for Spring

As you get ready for your spring allergies to flare up, you should compare quotes from about three to five health insurance companies in order to find a plan that will provide coverage for the treatments you need at an affordable rate. That said, separately contacting multiple carriers to give them your information can be a tedious undertaking.

Instead, you should use an insurance marketplace like SmartFinancial to expedite the process. After you fill out a brief questionnaire, we’ll connect you with insurance agents near you who can match you up with health plans that meet your coverage needs at an appropriate cost. Click here to start your questionnaire and get a free health insurance quote today.