Allergy-related medical care can be expensive. Between diagnostic tests, office visits and ongoing treatments, costs can add up quickly—especially if you don't know what your insurance plan covers.

The good news? Marketplace insurance plans are required to cover pre-existing conditions, including allergies.

That means if your doctor recommends allergy testing, there’s a good chance your insurance will help cover it—especially if it’s considered medically necessary and performed by an in-network provider.

In this article, we’ll walk through the most common types of allergy tests, what kind of costs and coverage you can expect and how to check your health plan’s benefits with confidence.

Common Allergy Tests

Allergy testing helps healthcare providers identify the substances—or allergens—that may be triggering your symptoms. Once your triggers are identified, your provider can recommend the best course of treatment or lifestyle adjustments.

Here are some of the most common tests, each suited to different allergy concerns:

• Skin prick or scratch test: Small amounts of suspected allergens are introduced into the skin’s surface to observe reactions like redness or swelling.
• Intradermal test: A small amount of an allergen is injected just under the skin. This is typically used if the skin prick test is inconclusive.
• Patch test: Patches containing allergens are placed on the skin for 48 hours to detect delayed reactions, often for skin-related allergies.
• Blood test (IgE): measures the immune system's response to specific allergens by analyzing antibodies in a blood sample. This may be recommended if skin testing isn’t an option.
• Food challenge: A closely supervised test in which a patient consumes small amounts of a potential food allergen in a medical setting to monitor for reactions.

The test your provider recommends will depend on your symptoms, medical history and clinical needs.

What You Can Expect for Costs and Coverage

In most cases, if allergy testing is recommended by your provider for a medical reason, and performed by an in-network specialist, it will be covered as a diagnostic service under your Marketplace plan.

However, it’s important to understand that coverage does not always mean “no cost.” You may still be responsible for certain out-of-pocket expenses depending on your plan:

• Deductible: The amount you must pay before your insurance begins to cover certain services
• Copay: The set amount that you may have to pay when you visit an in-network care provider or fill a prescription.
• Coinsurance: A set fee or percentage you pay for services after your deductible is met
• Out-of-pocket maximum: The most you’ll pay in a given year before your plan covers 100% of covered costs

Also, keep in mind that allergists are considered specialists. This means your copay or coinsurance may be higher than it would be for a visit to a primary care provider.

If you need allergy medications or follow-up treatments (such as immunotherapy), these may fall under your plan’s pharmacy or outpatient treatment benefits, which have separate cost structures.

How to Check Plan Coverage

Whether you’re shopping for a new health plan or want to better understand your current coverage, it’s important to review your plan documents closely–especially when it comes to specialist visits and diagnostic tests like allergy testing.

The best place to start is with your Summary of Benefits and Coverage (SBC). This standardized document outlines what’s included in your health plan, what services are covered and what you’ll likely pay out of pocket.

Here’s what to look for:

• If you’re comparing plans on the Marketplace: Use the “Plan Details” or “Compare Plans” features to access each plan’s SBC before enrolling. These tools help you understand coverage differences across multiple options.
• If you already have a health plan: You can find your SBC by logging into your member portal, checking your welcome packet or contacting your insurance company directly. Most insurers will also email or mail the SBC to you upon request.

Within the SBC, focus on the “Common Medical Events” section. This area breaks down typical situations—like doctor visits or lab tests—and what your insurance will cover.

Key rows to review:

• “Visit a health care provider’s office”
• “If you have a test”

Then, check the columns labeled “What You Will Pay” to find:

• Specialist visit copays or coinsurance (since allergists are specialists)
• Coverage amounts for diagnostic testing, including lab work or in-office allergy tests

If something isn’t clear or if your SBC doesn’t mention allergy testing specifically, don’t hesitate to call your plan’s member services line. They can walk you through the benefits and confirm which services are covered—and how much you might pay.

Understanding your SBC not only helps you plan for potential costs—it gives you the confidence to schedule the care you need without unexpected surprises.

Questions About Insurance Coverage for Allergy Testing