Titer test

A Titer test measures antibody concentration in blood to assess immunity against specific diseases such as measles, mumps, or hepatitis B. Insurance companies may require a Titer test before approving coverage for certain vaccines like MMR or Hepatitis B.

Health insurers often cover Titer tests when mandated by employers for healthcare workers or students entering medical programs, as seen with Blue Cross Blue Shield and UnitedHealthcare policies. Some insurers classify Titer tests as preventive care if linked to CDC-recommended immunizations, which can result in zero out-of-pocket costs under ACA-compliant plans.

Out-of-network laboratories performing Titer tests may not be covered by insurance, leading to average patient charges of $50–$200 per test at Quest Diagnostics or Labcorp locations. Employers sometimes mandate proof of immunity via Titer testing before granting health benefits eligibility for positions involving patient contact, such as nurses and EMTs.

Insurers typically deny claims for repeated Titer testing within short intervals unless new exposure risk is documented by providers like Kaiser Permanente or Aetna, as confirmed by Your Insurance Info. Pediatricians and primary care physicians must document clinical necessity on claim forms for insurance reimbursement of pediatric Titer tests required by public schools in states like California and New York.