Life Insurance With a High Coronary Calcium Score – Does it Matter?

If you have taken the coronary calcium (CAC) test and your numbers were a bit higher than you like, you may be wondering what that means for life insurance. First of all, know this:

Yes, it is possible to still get life insurance even if you have a high coronary artery calcium score.

In this article, we are going to take a hard look at what all goes into the decision process regarding life insurance with a high coronary calcium score.

Here is a handy guide to this article, feel free to head directly to the section you need.


Overall, a higher amount of calcium in your coronary arteries can be a significant indicator of your potential for developing heart disease. As such, most underwriters will consider patients with an above average score to be more of a risk for artery plaque all over your body.

Furthermore, there are no false positives on a CAC test.  If calcium is present, it is easy to find. There is also very little room for a measurement error.


Why is CAC Important?

Using properly calibrated instruments and standard software, if I test my own coronary artery calcium on machine 1, machine 2, and machine 3, I should get the same answer from all three tests.

If we were going to line up all the currently available risk markers … the winner is still CAC.

Dr. Philip Greenland, MD and Professor of Cardiology

How Were You Tested?

Usually, your doctor will perform a CT scan of your heart to see what your calcium levels are like. However, in some cases, you may get what’s known as an “ultra-fast” CT scan, which is not as accurate.

To ensure that you are getting the most accurate measurements, you should review your test with your cardiologist. He or she will be able to better determine your actual calcification levels and then set up a plan of action.

What is Considered a “Normal” Coronary Calcium Score?

Although insurance companies may differ regarding how they assess this condition, the most common ranking system is based on your age and sex. As we get older, we have more of a risk of developing calcium in our hearts, and men seem to be affected by it more than women.

So, a man less than 40 years old or a woman less than 50 years old shouldn’t be tested at all.  There would not be any calcium to score.

For everyone else, there is a score from 1 to 1000 units measured on the Agatston scale.  This is named after the cardiologist and “South Beach Diet” creator Dr. Arthur Agatston who was a big proponent of its use.

Normal CAC will be Based on Others of the Same Sex and Age

Older participants will have higher scores than younger participants and will be measured against others of the same age range.  Men will be measured against other men, and women will be measured against other women to determine risk.

Generally speaking, this is what an underwriter will project based on your calcium score:

Coronary Calcium ScoreExtent of coronary artery disease (CAD)
0No identifiable plaque, very low risk of CAD
1-10Mild identifiable plaque, however risk of CAD is still low.
11-100Definite plaque, at least mild. Mild coronary artery stenosis is likely
101-400Definite moderate plaque. Mild CAD is very likely. Significant stenosis possible.
Greater than 400High risk, extensive plaque. High likelihood of at least one significant coronary narrowing.

What Other Factors Do Insurers Consider?

We’ve already mentioned age and sex, however there are plenty of other things that go into determining your life insurance rates.

  • Family History of cardiovascular disease
  • Smoking
  • Obesity
  • Current Medication
  • Diet and Exercise Regimen
  • High Cholesterol
  • Diabetes

What we see very often is a more serious heart condition, like congestive heart failure, a heart attack, or atrial fibrillation.

In these instances, we will underwrite based on that risk itself.  The coronary calcification score could help – or hurt – the approval chances which we will discuss below.


Yes, there is quite a bit that you can do to make it easier for insurers to consider you to be less of a risk. While genetic factors such as family history and sex cannot be altered by your actions, you can still make great strides to help lower your calcium score and improve your chances of getting better coverage.

Improved Diet and Exercise

Overall, you want to improve the health of your heart, which you can do with better eating habits and more physical activity. If you can show that you are making changes in these areas, insurers may consider you to be less of a risk.

More specifically, start eating more leafy greens.  Vitamin K2, found abundantly in foods like kale and spinach, has been associated with lower calcification of the arteries.  It also may reduce vascular damage throughout the body overall.

Losing Weight

Obesity is a prime risk factor for heart disease already, so if you are shedding pounds, then it will put less strain on your heart and help you get into better physical shape.

Doing What your Doctor Reccommends

You should already have spoken to your doctor about a treatment plan based on your calcium score. If you are following that regimen and taking your prescriptions as directed, it will allow you to get better rates.

Credits for Cardiac Stress Testing

Stress scanning, an exercise stress test, or a treadmill test could be more conclusive than a CAC score. Furthermore, these additional tests show you are taking the condition seriously and this would result in credits.

Different life insurance companies call them by different names, but lifestyle credits or table shaving credits or underwriting credits all accomplish the same goal.

These credits would lower your life insurance rates, sometimes by 25% or more!


If your cardiologist ordered these scans to help develop a treatment plan, does that hurt your chances at life insurance?

Probably not.

If you are absent any other symptoms of heart disease, these are the health classes we usually see.

What if your CAC is 0, Zilch, Nada?

Good news!  Depending on your age, this may help your life insurance approval and may save you some money.

Say you developed hyperlipidimia later in life and a life insurance underwriter suspects atherosclerosis. With a CT scan showing a CAC of 0 in your file, that can prove the risk for cardiovascular disease is low, thereby keeping your rates lower.

When You Are Under The Age Of 35

If you are young and there is a CAC test in your profile at all, that will raise eyebrows from underwriters. Why was it ordered?  What other risk factors do you have?

If you have any calcium score at all before age 35, please call us to prepare a quote.

Between The Ages Of 35-44

If your score is between 1 – 100, then expect mild substandard rates. If it is between 101 and 400, then you are looking at moderate substandard rates.

Over 400 CAC could be declined or postponed for additional stress testing.

If You Are Between 45-64 Years Old

A score range from 100 – 400 would result in mild substandard rates. Scoring 400 – 1000 your rates would be moderately substandard.

Scores over 1000 could be declined or postponed pending further testing.

When You’re Over The Age Of 65

A score of less than 1000 and less than 90% of other people in the same age and gender group would warrant mild substandard rates.  Anything over 1000 will go moderately substandard.


In reality the CAC score will neither deny nor approve a life insurance file on its own.  It is part of a holistic picture of health.  It’s just another variable that the insurance company is trying to nail down.

The truth is you do not get a CT scan of your heart for fun.  There is either a heart condition present, or a suspicion of a major heart condition. Therefore, the life insurance policy will be underwritten based on that underlying heart condition nine out of ten times.

Even if your score is much higher than average, you should find out what your options are from an expert.  Why not choose an expert in underwriting life insurance with heart conditions, like everyone here at Heart Life Insurance?

Why not put our team to work for you?

We stand ready to get the protection your family needs, today.