We are very blessed for a great team here at Narberth Allergy and Asthma. We are aiming to create a welcoming atmosphere in our office. Every patient will receive friendly, personalized and respectful treatment starting with the first phone call to our office. Together with her team of medical assistants and nurses, Dr. Corinna Bowser is able to achieve this goal providing excellent and compassionate care. Dr. Bowser takes the time to listen to her patients’ concerns before determining the ideal treatment plan. She has been named TopDoc repeatedly by Philadelphia Magazine and Main Line Today.
Today we welcome our new medical assistant Bonnie to the team! Unfortunately Karen will leave after over 15 years of great service to the practice. We wish her the best for her future in Northern PA ( -any doctor looking for an excellent nurse in the Bethlehem area?)
Do you suffer from allergies? The American College of Allergy, Asthma, and Immunology lists allergies as the 6th leading cause of chronic illness in the United States. Each year over 50 million people in the U.S. alone suffer from allergies.
Considering the vast number of people who suffer from allergies, it is important to discuss how Medicare covers various treatment options.
What is Medicare?
Medicare is a federal insurance program in the United States for people 65 and older and/or with disabilities or end-stage renal disease. The Medicare program is divided into different parts of coverage. As a Medicare beneficiary it is important to know the different parts of Medicare.
Medicare Part A will cover your inpatient stay at the hospital, skilled nursing facility, or hospice center. It is best to think of this part of Medicare as your hospital insurance.
Medicare Part B will cover your outpatient doctor services as well as other medical care. Medical supplies, durable medical equipment (DME) and preventative services would fall under Part B.
Medicare Part C is often referred to as Medicare’s “all in one” plan called Medicare Advantage. These plans are regulated by Medicare but offered by private insurance companies.
Medicare Part D plans are also offered through private insurance companies and provide coverage for prescription drugs.
Medicare Supplement plans, also referred to as Medigap, are private plans. These plans cover some of your out-of-pocket costs under Part A and Part B.
Medicare Coverage for Allergy Testing and Immunotherapy
Allergies can range in severity, but for many people, immunotherapy treatment is needed to help the body build up an immunity to a specific allergen.
In order to determine whether you have an allergic reaction to a particular substance, an allergy test is needed. Medicare will generally cover two types of allergy tests:
- Percutaneous Testing – also referred to as a scratch test. When using this method of testing, different allergens are put as trace amounts in a solution. The medical professional administering the test will use a lancet to prick your skin allowing the trace amount to make contact. If you are allergic, a small red bump will appear.
- Intradermal Testing – this type of testing is slightly more invasive than percutaneous testing. A small thin needle is injected just below the surface of the skin and the diluted allergen is injected.
Typically, your allergist will opt for the less invasive percutaneous test before deciding to do an intradermal test.
The outpatient coverage from Medicare Part B would cover this type of medically necessary allergy testing. After meeting your annual Part B deductible ($185 in 2019), you would be responsible for 20% of the remaining costs. Alternatively, if you have a Medigap plan such as a Plan G or Plan F, you may not pay any out-of-pocket costs for your allergy testing.
Immunotherapy is another word for allergy shots. This type of treatment is one of the most effective ways to treat allergies.
When it comes to coverage, if your doctor has prescribed this type of allergy treatment, Medicare will cover 80% of the allowable charges for necessary immunotherapy to treat your symptoms.
Medicare Coverage for Asthma
Asthma is a condition often associated with chronic allergies. Asthma makes breathing difficult as it causes the airways to swell, sometimes severely. Asthma attacks can be caused by certain allergens. Often, doctors will work out an asthma plan for patients at risk for asthma attacks that include an inhaler. Quick-acting rescue inhalers can help immediately expand airways.
Typically, inhalers or other fast-acting medications for asthma will be covered under a Medicare Part D plan. It is important to look over the plan’s formulary and coordinate with your doctor to prescribe a medication listed on your formulary.
Furthermore, Medicare Part B will cover durable medical equipment (DME) such as nebulizers and oxygen equipment. It is important to make sure your doctor and DME supplier accept Medicare.
In all, the treatment of your allergy and asthma symptoms will generally be covered by Medicare if the treatments are medically necessary and prescribed by your doctor.
– by Danielle Kunkle
Philadelphia magazine just came out with its TopDoc edition 2019. Dr. Corinna Bowser of Narberth Allergy and Asthma was listed again as on of the top allergists in the Philadelphia region. Since starting her own practice in 2013, she has won awards as Top doctor in Philadelphia and Main Line Today magazine every year. Dr. Bowser feels honored by this award. She strives to continue providing the best patient care in Allergy and Immunology to her adult and pediatric patients.
…by her peers as published in Main Line Today. This is a big honor particularly in this first year of existence of Narberth Allergy and Asthma. Dr. Bowser always strives to respect patient preferences while providing the best up-to-date care for allergies and related problems. She is very well liked by her patients and also received the “patient choice award” (vitals.com).
Eczema is an annoying and ongoing condition. Doctors will usually prescribe topical steroid creams like hydrocortisone for treatment. But are there alternatives? These medicated creams and ointments obviously have side effects when used long term. How else can this annoying itchy skin condition be treated?
What causes eczema?
To further explore this we first have to understand what the underlying problem is in eczema. Atopic dermatitis – as eczema is called in medical terms – is a combination of an allergic reaction and a skin barrier dysfunction.
First I want to focus on the skin barrier dysfunction. The skin of patients with atopic dermatitis loses water, and therefore becomes dry and itchy. So any effort keeping the skin hydrated helps. Of course, frequent moisturizing is the first step. However, wet wrap treatments are a more intense and more successful approach, pioneered by the allergy department at National Jewish Medical Center in Colorado (further info and video here).
What are wet wrap treatments?
This is definitely time intensive, but well worth it. The regimen should be followed for at least 2 weeks daily for successful treatment. It starts with a long bath in warm, but not hot, water. All areas affected by eczema need to be well soaked (until the skin gets wrinkly). After the bath, the skin should be patted dry (not rubbed!) and moisturizer should be applied immediately (ie, within 4 minutes).
During bad eczema flares, moisturizer can be temporarily replaced by topical steroid ointment or cream. Then, a wet layer of clothing should be used to cover all areas of the body affected by eczema. This could be a wet pajama set, long johns, or simply socks or bandages covering arms or legs. Supplies can also be ordered online.
“Wet” does not mean dripping or soaking wet, but the kind of wet you get when taking clothes out of the laundry after the spin cycle. A dry layer of clothing can be worn on top for comfort during the night. The wet wrap should be kept on at least 2 hours, but is best worn overnight. The next morning, the wet clothing gets removed and moisturizer (or steroid cream) applied immediately.
Yes, it is a lot of work, but if done consistently for 14 days, it leads to major improvement of eczema and may reduce the need for steroid creams. The coolness of the wet clothing may actually soothe the itch associated with eczema flares.
Allergies and Eczema
As mentioned above, eczema is also worsened by allergies. These can be directed against foods or allergens in our environment like dust mite. This makes allergy testing an important step in treating the disease. Once the causative allergen is identified symptoms can be controlled by avoidance. Putting on dust mite covers and washing sheets in hot water may help eczema sufferers who are allergic to dust mite. Avoiding egg or peanut in their diet is often a “cure” for children suffering from food-induced eczema.
Beyond the Basics: Creams and Injections
Mild to moderate eczema can usually be controlled by treating the two pillars of disease (skin barrier dysfunction and allergies) with the strategies mentioned above. There are newer treatments on the market now for treating eczema including creams without steroids and injections to reduce inflammation. Review of these medications goes beyond the scope of this post, and should be discussed with your allergist or dermatologist.