Coverage for Spring Allergies and Asthma

May 01, 2025

With longer days, springtime brings warmer weather and pollen. If you have spring seasonal allergies or asthma, these can make your symptoms flare. The Asthma and Allergy Foundation of America (AAFA) report that nearly 28 million Americans have asthma and about 81 million have seasonal allergies—also known as hay fever.

Asthma is a long-term lung disease that causes swelling in the airways and makes it hard to breathe. Though there is currently no cure, asthma can be managed.

Seasonal allergic rhinitis is the scientific name for hay fever. This is a condition where your nose becomes itchy and sore due to exposure to allergens, such as pollen from trees and grass. Pollen can also make your eyes water and itch, and make you sneeze, cough, wheeze and have shortness of breath. As temperatures rise in the spring, plants begin to flower and release their pollen into the air.

There’s a link between asthma and seasonal allergies. If you have allergic asthma (the most common type), then pollen and other allergens in the air can make your asthma worse. Once you’re diagnosed with asthma, your doctor can run tests to see if your asthma is triggered by allergens. Treatments for allergic asthma can focus on asthma, allergy or both conditions at once. Health insurance coverage for asthma and allergy care varies, though most plans will cover at least some tests and treatments.

Coverage for Asthma Care
If you have health insurance, you’ll likely have coverage for asthma care. However, there still may be out-of-pocket costs. These costs can include asthma medication. They can also include copays and coinsurance for visits to see a primary care doctor or asthma specialist.

Ask your plan what medicines are covered for asthma. Find out if there’s a limit on the kinds of treatment or medical devices you can get. Many health plans cover an asthma management program or asthma action plan—ask about it if you don’t already have one. This can help you understand how and when to use your medicine and devices, such as nebulizers and spacers.

Asthma medicines almost always require a prescription. However, some asthma inhalers have a price cap on them to make them more affordable. Find out more from the AAFA here.

Coverage for Allergy Care
Getting allergy tested is one way to be sure of what’s causing your seasonal allergy symptoms and/or triggering your allergic asthma. Once you know, you can plan to avoid the allergen as much as possible. But not all insurances cover allergy tests. Check with your health plan to find out what kinds of allergy tests they cover. Also check whether you need a referral from your primary care doctor. And check what your out-of-pocket costs will be.

A lot of plans cover allergy shots. These are injections that can reduce your symptoms. You may still have out-of-pocket costs though, even if the shots are covered by your health plan.

You can get nose sprays, eye drops, decongestants and antihistamines over the counter at your local pharmacy. These medicines might help your seasonal allergy symptoms but probably won’t be covered by your health insurance. Check with your doctor about whether you’d benefit from prescription allergy medicines, which are usually stronger and might be covered by your plan. You can check your plan’s drug list, known as a formulary, to see what’s covered.

If your seasonal allergies are severe, seeing an allergy specialist (allergist) could help. They can help you make a personalized plan to avoid triggers. Find out if your health plan has limits on how many times you can see an allergist.

Medicaid and Medicare Coverage for Asthma and Allergies
If you have Medicaid, find out what your state’s program covers for asthma care. The American Lung Association has a state chart here. Contact your state’s Medicaid agency to find out what’s covered for seasonal allergies. If you have Medicare, it will cover some testing, medications and other treatments for asthma and allergies. Read our article to find out What You Need to Know About Medicare.

Coverage for Alternative and Complementary Treatments
Acupuncture may improve asthma and allergy symptoms. Check your plan to see if it covers alternative treatments such as acupuncture. Some plans will cover a specific number of sessions per year. And see our article on Getting Covered for Alternative Medicine for more information.

Preventive Care
AAFA recommends staying up to date on vaccines for respiratory illnesses if you have asthma. These include the flu, COVID-19, whooping cough and pneumonia. Under the Affordable Care Act, most health plans must cover preventive care. That means these vaccines should be covered by your health plan or may be available free of charge.

An air purifier or humidifier can lessen both asthma and allergy symptoms. But health insurance companies typically won’t cover them. However, some may cover part of the costs, especially if they’re used with other durable medical equipment (DME). Check with your plan to see what kinds of DME it covers. Also, you may be able to use your health savings account or flexible spending account to pay for such equipment if you can provide a letter from your doctor that says it’s medically necessary. Find out more about these kinds of accounts in our article on Flexible Spending Plans.