LUBBOCK, TX (KCBD) - A new state law now requires health insurance companies to pay for preventative tests for heart disease. Texas is the first to take this step, and now were finding out what this means for you.
There are some restrictions on age, type of screening, and cost, but doctors say this is an important step. "We used to have to beg to get any kind of study like this done," Dr. Ray Smith said.
Times are changing, though, and Smith says prevention is becoming even more important, even for insurance companies. "Now that they're paying for coronary bypass studies and angiograms and stint placements, which are increasingly more expensive, prevention is become more the forefront of therapy," Smith said.
Under the law, which took effect January 1, 2010, a majority of health benefit plans must cover up to $200 for a preventative screening every five years. Women ages 56 to 75 and men 46 to 75 who are diabetic or have an elevated risk of heart disease are eligible.
The law applies to plans renewed on or after January 1st, and it includes a CT Scan to measure Calcium in the Coronary Arteries and a Carotid Ultrasound that determines if there is narrowing or plaque formation in the arteries. "I don't think it's everything you need; I think it's a very important part of what you need," Smith said.
Carla McGee with Well Heart Services at Covenant Medical Center agrees with Smith. "I really think that the law that's passed is a good step toward the direction we need to be going as a society," McGee said.
"I do think that there are other tests and other procedures that are out there that are equally important, if not more so, and simpler, less expensive," McGee added.
Both Smith and McGee says other tests are needed, because those covered could miss a potentially dangerous plaque build up. "90% of every plaque grows down into the wall of the artery," Smith said.
Statistics show that 70% of heart attacks and 86% of strokes occur with blockages less than 50%. "That often is not shown in your traditional cardiovascular testing," McGee said.
McGee recommends a PLAC Test, which is a simple blood test. In a collaborative study with Texas Tech University, Covenant found a PLAC Test can identify more people at risk. "In that project, we found that those individuals who would have been classified as low risk based on traditional risk factor analysis were in fact high to moderate," McGee said.
You can check with your insurance provider for more information and testing options. You may also contact McGee at Covenant's Wells Heart Services by calling (806) 725-4386.
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