Most insurers have strict criteria* for approving the cardiac calcium score test. Most people do not meet these criteria, even though this is a very useful test that your health care provider has recommended. Even if the test is approved by your insurer, if you have a deductible you will have to pay for it at your insurer’s contracted rate, which is often higher than our discounted self-pay rate. Our discounted self-pay price is $220, which is the lowest in Chittenden County.
*Some of the criteria required by insurance companies for cardiac calcium score tests include (these have to be provided by the referring provider):
-Age 40-75
-10-year heart attack risk (ASCVD score) between 5% and 20% ("intermediate risk”).
-Low-density lipoprotein (LDL) between 70 and 190 mg/dL.
-Personal history of vascular disease? If “yes", you may not qualify.
-Family history of premature vascular disease? If "yes", you may not qualify.
-Personal history of diabetes? If “yes", you may not qualify.
-Currently taking a ‘statin’ medication? (This is a common class of cholesterol-lowering drugs.) If “yes", you may not qualify.
There may be other exclusions as well. For more specific details, please refer to your individual insurance plan as the criteria varies.