Maryland now covers a heart scan that could catch trouble before you ever feel symptoms

A new law covers a key heart test

Maryland now requires state-regulated health insurers and Medicaid to cover a scan that spots early signs of heart disease. House Bill 666 took effect on Jan. 1, 2026, after Gov. Wes Moore signed it last May.

The law applies to all policies issued or renewed in the state on or after that date. Delegate Jamila J. Woods sponsored the bill, with Sen. Augustine cross-filing it in the Senate.

The scan checks for hidden plaque

A coronary artery calcium (CAC) test is a quick CT scan of the heart.

It takes about 10 to 15 minutes, needs no needles or contrast dye, and captures images of the coronary arteries. What doctors look for is calcium deposits, which signal plaque building up in the artery walls.

That plaque buildup is the hallmark of coronary artery disease, the kind that leads to heart attacks. Most people have no idea it’s happening until something goes wrong.

Scores help doctors decide next steps

The scan gives patients a calcium score that estimates how much plaque has built up. A score of zero means no detectable calcium and low heart attack risk.

Higher scores mean more plaque and a bigger chance of a future cardiac event. Doctors use the number to guide decisions about medications like statins.

The test also helps patients who are on the fence about starting preventive treatment, giving them and their doctors a clearer picture to work with.

Cost kept many patients from getting tested

Most private insurers and Medicare nationally do not cover CAC testing as preventive screening. Without insurance, the scan runs anywhere from about $50 to $400 out of pocket.

For many patients, that price tag was enough to skip the test entirely.

The American Heart Association (AHA) has pushed for broader coverage, noting CAC testing is one of the most reliable ways to predict future heart events. Maryland’s law aims to remove that financial barrier.

The law follows national medical guidelines

Coverage under the new law must follow the most current preventive care guidelines from the American College of Cardiology (ACC).

An earlier version of the bill limited coverage to patients with at least three risk factors such as diabetes, high blood pressure, or a family history of early heart disease.

Lawmakers removed those narrow restrictions in the final version, broadening access.

The law covers both the fully insured private market and Maryland Medicaid enrollees, though Medicaid already covered the test before this law passed.

Heart disease still kills more Americans than anything

Heart disease led all causes of death in the United States in 2024, accounting for about 683,000 deaths based on provisional CDC data.

Coronary heart disease, the type that CAC testing screens for, is the most common form. Many people with this condition have no symptoms at all until a heart attack strikes.

That’s what makes early screening so valuable.

Lifestyle changes and preventive treatment can make a real difference when doctors catch plaque buildup before it causes a crisis.

Medical groups back the test for some patients

The 2019 ACC and AHA guideline on preventing cardiovascular disease gave CAC testing a Class IIa recommendation.

In plain terms, that means the test is considered useful for patients at intermediate risk, especially when the decision about statin therapy is unclear. The guideline does not recommend testing for everyone.

It focuses on people whose risk level falls in an uncertain range.

Maryland tied its law to whatever the ACC’s most current guidelines recommend, so coverage could expand over time.

Self-insured employer plans are not included

The mandate covers state-regulated plans, including individual and small group market plans, HMOs, managed care organizations, and nonprofit health service plans.

But it does not cover self-insured employer plans, which follow federal ERISA law and sit outside state insurance rules.

A large share of Marylanders with employer-sponsored coverage may have self-insured plans that this law does not touch. Medicare coverage for CAC screening also remains limited at the federal level.

Lawmakers passed the bill with strong support

House Bill 666 passed the Maryland House of Delegates 108 to 31 and cleared the Senate 42 to 5. The bill drew bipartisan co-sponsors, including both Democratic and Republican delegates.

The Legislative Black Caucus of Maryland listed it as a 2025 priority, pointing to higher rates of heart disease among Black Marylanders. That broad coalition helped push the bill through both chambers with wide margins.

Texas and New Mexico passed similar laws first

Texas became the first state to mandate CAC coverage back in 2009. The Texas law covers men ages 45 to 75 and women ages 55 to 75 who meet certain risk categories.

New Mexico followed in 2020, covering adults ages 45 to 65.

Maryland’s law goes further than both because lawmakers stripped out the specific age-range and risk-factor limits from earlier drafts. That makes it the broadest CAC coverage mandate in the country.

Patients should talk to their doctors first

Marylanders on state-regulated plans can now ask about CAC testing without worrying about out-of-pocket costs. The test helps most for people at intermediate risk of heart disease, typically between ages 40 and 75.

People who already know they have coronary artery disease or who sit at very low risk may not benefit from the scan.

The best step is a conversation with a doctor about whether the test makes sense for your health profile.

Prevention could save lives and cut costs

Heart disease costs the U.S. health care system hundreds of billions of dollars each year.

A CAC test that catches early plaque buildup can lead to preventive treatment that avoids a future heart attack or hospital stay.

Maryland’s Department of Legislative Services estimated the law’s cost impact would be minimal, with savings from avoided cardiac events helping offset new testing costs.

Supporters say the law shifts the focus from treating heart attacks after they happen to preventing them.

This article was created with AI assistance and human editing.

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