WASHINGTON – A simple test can detect early signs of heart disease, but insurance will not cover it.
Dr. Allen Taylor, chief of cardiology at Medstar Georgetown University Hospital, calls it “a mammogram for the heart.”
The test includes a heart scan that looks for calcium deposits in coronary arteries, and Taylor says it is the best test available to check for early signs of heart disease — the leading cause of death among Americans.
“The test is a very simple CT scan of the heart that takes 5 minutes to complete, involving only holding your breath for 10 seconds and using a low dose of radiation — about the same as a mammogram,” he says.
Taylor describes the coronary calcium scan as safe, effective and inexpensive. But it is not on the government’s list of necessary health screenings, like mammograms and colonoscopies, which means insurers are not required to cover costs.
And that has Dr. Warren Levy, the head of the largest cardiology practice in the region, very frustrated. Levy, the chief medical officer of Virginia Heart, says a lot of money is spent to cover cancer screenings, but there is little, if any, support for preventative tests for heart disease.
“We don’t reimburse anyone to screen for cardiovascular disease. It’s a major flaw in our health care system,” he says, adding that “there is a lot of published data out there about how many lives we could save with simple screening procedures that are available today.”
The Centers for Disease Control and Prevention says cardiovascular diseases – such as heart disease and stroke — are responsible for more than one-third of all deaths in the United States. Treatment for the diseases accounts for about $1 of every $6 spent on health care in the country.
“There is a clear disconnect between the cost of the problem, the prevalence of the problem and the amount of money that we will invest in preventing it,” says Medstar Georgetown’s Allen Taylor.
He says that a disease this expensive and common needs support for better screening.
Medicare covers heart scans starting at age 65, and many hospitals provide them for younger adults at or below cost — usually between $100 to $200. While health insurers won’t cover these preventative screenings, some life insurance companies use screening results to help calculate premiums.
Only one state, Texas, requires insurers to cover heart scans for patients who have certain risk factors for cardiovascular illnesses.
Taylor says a member of the state Legislature had heart disease, and that led to an emotional push for action.