My point is that this test really doesn't rise to the level of "medically necessary" and that is why insurance and national health plans don't typically cover it. What should someone with a score of zero do differently than someone with a score of 400? Nothing. The test doesn't detect soft plaque, so a score of zero does not mean you're not at risk. Someone with no plaque now could still develop it later. It's not a license to be care free.
You are 100% accurate. I never said anything different.
It’s a diagnostic test. I told my son at 37. I want him to get it. I suggested to my siblings who really have a large family circle. They should have their kids get one.
Here is why, flip around your statement. What should a person do with a CAC score of 10 or even 2 at the age of 37? He just established he has coronary artery disease and at the age of 37 he can take steps to mitigate it instead of finding out 20 years later.
And what about the person with a score of over 400 which prediction models say a 90% chance of a heart attack in less than five years.
So this is key, in this area for $125 which I told my son I will pay for he can get a scan that takes approximately eight minutes and find out if he has to double down and even take a statin at the age of 37, granted that’s on the young side typically you would start around 40 however our family history genetically is a train wreck with heart disease and diabetes.
I mean, you could use modern medicine to your advantage or not that’s a personal choice.
Just because insurance will not pay for it doesn’t mean you can’t be proactive. Medicare doesn’t think going to a dentist is medically necessary either and they do not pay for it unless a tooth gets so infected it needs to be pulled, then it is medically necessary.
To me, it’s the same as going to a dentist for a check up in order to check for cavities which Medicare will not pay for or you can ignore it and wait until you’re in pain or your tooth starts to break up, gets infected, and then they will pay for it.
The gold standard would be to get your doctor to order a CT angiogram which would be the gold standard right below an invasive angiogram. You will need symptoms for that if you want insurance to pay and that might be considered extreme as a diagnostic tool for somebody without any symptoms at all, especially at that age and I seriously doubt insurance will pick up the cost but if you can get away with it, sure that’s great.
For me personally, with established heart, disease, and based on a angiogram five years ago, I got my first calcium scan January 2026 and with the score of 474 I want a CT angiogram to see how I’m doing. The cardiologist which I hope to see you shortly or my primary doctor would have further ammunition to submit for insurance approval using the CAC score.
Ironically, five years ago, when I received my invasive angiogram, which my cardiologist nurse sat with me as they set it up, she said to me in a low voice, no matter what the results are here. Also get a calcium scan, but don’t tell him I told you. It sets a baseline. Because you can be assured, if calcium shows up on a scan, you have soft plaque
