Getting a sickle cell test is straightforward: you need a standard blood draw, which you can order through your doctor, a hematologist, or directly from a lab. The test checks for abnormal forms of hemoglobin, the protein in red blood cells that carries oxygen. Most adults get results within a few days.
Who Should Get Tested
Every state in the U.S. screens newborns for sickle cell disease at birth, so most people born in the country have already been tested. But if you were born outside the U.S., if your newborn screening records were lost, or if you simply want confirmation of your carrier status before having children, getting tested as an adult makes sense.
Sickle cell trait (carrying one copy of the gene) affects roughly 1 in 13 Black Americans and is also common among people with ancestry from sub-Saharan Africa, the Mediterranean, the Middle East, and parts of India. Carriers usually have no symptoms but can pass the gene to their children. If both parents carry the trait, each pregnancy has a 25% chance of producing a child with sickle cell disease.
How to Order the Test
The most common route is asking your primary care doctor. A simple request during a routine visit is enough. Your doctor orders the bloodwork, you go to a lab for a draw from a vein in your arm, and results come back to your doctor’s office. If the initial screen detects anything abnormal, your doctor may refer you to a hematologist for follow-up.
If you prefer to skip the doctor visit, direct-to-consumer lab services let you order the test yourself. Quest Health, for example, offers a sickle cell trait screen for $66 (including a physician service fee) that you purchase online, then complete at a local Quest lab. These services do not bill insurance, so the cost is entirely out of pocket.
Community health centers and federally funded sickle cell programs are another option, especially if cost is a barrier. The Health Resources and Services Administration (HRSA) funds clinics and community-based organizations across five U.S. regions that provide testing, counseling, and education related to sickle cell disease. Calling your local health department or searching for HRSA-funded sickle cell programs in your area can connect you to low-cost or free screening.
What the Lab Actually Does
The standard of care uses two separate methods on every blood sample. The first method screens for abnormal hemoglobin, and the second confirms the diagnosis if anything unusual shows up. This two-step approach reduces the chance of a false result.
The most commonly used methods are high-performance liquid chromatography (HPLC), capillary electrophoresis, gel electrophoresis, and isoelectric focusing. All of them work by separating the different types of hemoglobin in your blood so the lab can identify exactly which forms are present and in what proportions. HPLC has become especially popular because it detects more hemoglobin variants than older methods and precisely measures the percentage of each type. That precision matters not just for diagnosis but for monitoring people already receiving treatment.
You don’t need to choose the method yourself. The lab selects which techniques to use, and any accredited lab will follow the two-method protocol.
Understanding Your Results
Your results will typically describe which hemoglobin types were found in your blood and their relative amounts. Here’s what the main outcomes mean:
- Normal (HbAA): Your red blood cells contain only normal adult hemoglobin. You do not carry the sickle cell gene.
- Sickle cell trait (HbAS): You have one normal gene and one sickle cell gene. You are a carrier. This rarely causes health problems on its own, but it’s important information for family planning.
- Sickle cell disease (HbSS): Both copies of your hemoglobin gene are the sickle type. This is the most common and typically most severe form of sickle cell disease.
- Other variants (HbSC, HbS-beta thalassemia): You carry one sickle gene paired with a different abnormal hemoglobin gene. These combinations also cause sickle cell disease, though symptoms can vary in severity.
If your result shows sickle cell trait or disease, a hematologist can walk you through what it means for your health and your family. Genetic counseling is particularly useful for couples where both partners carry a hemoglobin variant.
Testing Before or During Pregnancy
If you’re pregnant or planning a pregnancy and either parent carries sickle cell trait, prenatal testing can determine whether the baby is affected. Testing can be done as early as 8 to 10 weeks into the pregnancy. One method takes a small sample from the placenta, and the other collects a sample of amniotic fluid (the liquid surrounding the developing baby). Both carry a small risk of complications, so the decision is typically made in consultation with a maternal-fetal medicine specialist.
Many OB-GYN offices now routinely offer carrier screening to both parents early in pregnancy or even before conception. If you haven’t been tested and you’re thinking about starting a family, asking for a hemoglobin test at a preconception visit is one of the simplest steps you can take.
Cost and Insurance Coverage
When ordered through a doctor, hemoglobin electrophoresis is a routine lab test that most insurance plans cover, especially when there’s a clinical reason such as family history or pregnancy planning. Your out-of-pocket cost depends on your plan’s lab benefits and whether the facility is in-network.
Without insurance, expect to pay roughly $60 to $100 for a basic sickle cell screen at a commercial lab. The direct-to-consumer option through Quest Health runs $66 and does not accept insurance reimbursement. Community health organizations funded through HRSA may offer screening at reduced cost or free of charge, particularly for populations at higher risk.