This Test Might Help Predict Your Heart Attack Risk—so Why Doesn’t Insurance Cover It?

Before your annual physical, your doctor requires blood testing. Your results showed that your LDL cholesterol tests normal. But your general risk of heart disease appears average. You and your doctor need to decide whether you should take a statin drug. A CT scan will give you and your doctor the information you both need to make an informed decision about this medication and your heart attack risk. 

This Test Might Help Predict Your Heart Attack Risk -- so Why Doesn't Insurance Cover It

According to Mary Norine Walsh, MD, a CT scan helps physicians determine their patients’ risk levels https://www.health.com/condition/heart-disease. Dr. Walsh is the medical director of cardiac transplantation and heart failure at Indianapolis’ St. Vincent Heart Center. The American College of Cardiology plus the American Heart Association also recommend having coronary artery calcium (CAC) https://www.lipid.org/sites/default/files/pteduc.cac1_.pdf test in recent cholesterol management guidelines in November 2018. 

While the CAC test results give physicians an excellent view of what’s going on in your heart, the information from the test doesn’t save you from an attack. Once the physician knows the condition of your heart, he or she prescribes treatments for that condition. Your job remains to follow that prescription and other health care advice given to help prevent heart attacks. 

Everyone in the medical community doesn’t endorse the helpfulness of this test’s diagnostic ability. The U. S. Preventive Services Task Force stated that there isn’t enough evidence at present to recommend adding the CAC test to traditional heart attack risk assessment measures in people without other symptoms. 

What is a Coronary Calcium Scan? 

A computed tomography (CT) scan used to x-ray your coronary arteries is a CAC scan. The test is fast as well as non-invasive. If you have calcified arteries, they hardened plaque appears on the scan results. Calcium, plaque and fat buildup in your arteries increases your chances of a heart attack. You’ll get a calcium score as a result of the test. If you have a score of 0, no plaque exists in your coronary arteries. If you have a score of 100 or more, you have significant plaque buildup in your heart and need to take a statin medication, as well as change your eating and increasing the amount of exercise you perform daily. The scale doesn’t have a top number for measuring plaque. Some people have test results of 1000 and don’t have heart attack symptoms. But 100 remains the score needed to indicate plaque in your arteries. 

Who Needs a Coronary Artery Test? 

Everyone still needs routine testing of their LDL and blood pressure levels. And if you smoke, you remain at a higher risk for heart disease. But if you have high blood pressure, a high LDL test, or smoke, you stay at a higher risk for a heart attack. If you’re on the borderline, a CAC test helps your health care provider determine whether a statin medication and lifestyle changes are needed to lower your heart attack risk. Also, it’s your doctor’s call on whether you need the CAC test if you have diabetes or a family history of heart attacks. 

Right now, insurance doesn’t pay for CAC tests. If they prove a useful diagnostic test, insurance companies may help people pay for their CAC tests in the future.