CAC Scan Australia: 5 Things to Do Before You Book Your Test — Including the One Your GP Won't Mention
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Written by Christopher Hall, AdvDipFP | Authorised Representative, AFSL 526688 | June 2026 A coronary artery calcium (CAC) scan requires almost no physical preparation — no fasting, no injections, and no recovery period. The scan takes less than 15 minutes and most patients drive themselves home immediately afterwards (Heart Foundation Australia, 2019; Hamilton-Craig et al., 2017). But there is one step that most Australian GPs do not mention when recommending this test: reviewing life insurance cover before booking — not after. For Australian men over 45 who have recently been recommended a CAC scan by their GP, this is the most time-sensitive item on the list.
1. Sort Out Your Life Insurance Before You Book the Test
This is the step a GP will not mention — not because it is unimportant, but because it falls outside their clinical scope.
The CAC scan is a cardiovascular risk prediction tool recommended by the Cardiac Society of Australia and New Zealand (CSANZ) for asymptomatic Australians aged 45–75 at intermediate cardiovascular risk (Hamilton-Craig et al., 2017). It is designed to find coronary artery disease before symptoms appear. That is exactly what it does. From a life insurance underwriting perspective, however, the moment a GP refers a patient for this investigation, a disclosure clock starts.
The Pending Investigation Rule
Under Australian life insurance underwriting practice, an open investigation — a specialist referral ordered, a scan booked, or results pending — will almost always place a new insurance application on hold until the investigation concludes. This applies regardless of how routine the original referral was.
Christopher Hall, AdvDipFP, Authorised Representative, AFSL 526688, has observed this pattern across more than 500 life insurance policy reviews. In Christopher Hall's experience, as soon as a pending investigation is recorded — including a GP referral for a CAC scan — underwriters place new applications on hold. The insurer requires the full outcome: the result, the specialist report, and its clinical interpretation before assessment can proceed.
Once the scan produces a result, the underwriting implications depend entirely on what that result shows.
What the Results Mean for Insurance Access
The CSANZ classifies CAC scan results using the Agatston score — a standardised measure of calcified plaque volume in the coronary arteries (Hamilton-Craig et al., 2017):
Score of zero: No detectable calcium. Very low cardiovascular event risk. No pharmacotherapy recommended. From an underwriting perspective, a zero score is a clean result that typically does not affect new insurance applications.
Score of 1–99: Low risk. Lifestyle management recommended. Minimal underwriting impact in most cases.
Score of 100–399: Moderate risk. Aspirin and statin therapy considered reasonable (Hamilton-Craig et al., 2017). Both medications are now on the medical record — disclosable on every future insurance application.
Score of 400 or above, or above the 75th percentile for age and sex: High risk. High-efficacy statin and aspirin recommended. Referral for further cardiac investigation may follow.
A score of 100 or above does not only change a patient's treatment plan. It creates active medication records and, frequently, further specialist referrals. Each becomes a disclosure item on future applications for income protection, TPD, trauma, and life cover. Each disclosure reduces the likelihood of obtaining cover on standard terms.
What Happens After a Significant Result
The CSANZ notes that the test is designed specifically for asymptomatic individuals — those without known coronary artery disease (Hamilton-Craig et al., 2017). Once a significant result is found, the individual is no longer asymptomatic. From that point, new insurance applications across all four cover types — life, TPD, income protection, and trauma — face underwriting assessment that accounts for the cardiac findings. Each cover type is affected differently. Life cover may remain available with loadings. TPD and income protection carry a higher likelihood of cardiac exclusions. Trauma insurance may exclude heart attack and cardiac-related events — precisely the scenarios a person with a high CAC score would most want covered.
In Christopher Hall's experience, men who approach Arrow Equities for a life insurance review after a CAC scan has revealed significant findings — calcium scores requiring specialist investigation, surgical intervention, or ongoing cardiac management — frequently find themselves unable to obtain new cover while treatment or outcomes remain unresolved. For some, the window closes permanently.
Australia's healthcare system is a double-edged sword in this context: excellent at identifying risk markers early; capable of creating insurance barriers through precisely that early detection. This is consistent with why life insurance applications are getting harder — Christopher Hall's 500+ policy reviews find accumulated health markers, not major diagnoses, to be the primary driver of harder underwriting outcomes.
The Superannuation Option
For men who assume cost is the barrier, life insurance and TPD premiums can be funded through superannuation contributions taxed at 15% inside the fund — lower than most policyholders' marginal tax rate. This reduces the net out-of-pocket cost without changing the coverage amount. Income protection premiums paid personally may, depending on individual circumstances, also allow premiums to be claimed as a personal tax deduction. An annual insurance premium review can confirm which insurance payment structure reduces effective cost for a given set of circumstances. The question of affordability is often resolved once payment structure is reviewed.
Acting Before the Scan
In Christopher Hall's experience, the most time-sensitive action for men recently recommended a CAC scan is a review of current cover — specifically whether gaps exist across life, TPD, income protection, and trauma insurance — before the scan is booked. Understanding pre-existing conditions and life insurance and what to disclose when applying for life insurance clarifies what options remain open. The insurable window — the period during which cover can be obtained on standard terms — narrows with every clinical step that follows.
For eligible clients, an Arrow Equities insurance review is complimentary. Find out if you're eligible →
2. Avoid Caffeine and Don't Smoke Before the Test
Beyond the insurance question, physical preparation for a CAC scan is straightforward.
The Heart Foundation recommends avoiding caffeine and smoking for a few hours before the scan (Heart Foundation Australia, 2019). Mayo Clinic's guidance is consistent (Mayo Clinic, 2024). Both substances can elevate heart rate, affecting the quality of the CT images captured during the scan sequence.
No fasting is required. Unlike blood tests or a CT coronary angiogram, the CAC scan does not require an empty stomach. The Heart Foundation confirms: "Otherwise, there's nothing you need to do to prepare" (Heart Foundation Australia, 2019). Patients eat and drink normally on the day of the test.
3. Leave Jewellery at Home and Dress Comfortably
ECG leads are placed on the chest to monitor heart rhythm during the scan (Mayo Clinic, 2024). Metal jewellery near the chest and neck should not be worn on the day of the test. Light, comfortable clothing makes the ECG setup faster and more straightforward. Patients may be asked to change into a hospital gown on arrival, so uncomplicated clothing is practical.
4. The Scan Takes 15 Minutes — Plan to Drive Home Immediately After
The CAC scan is fast, painless, and requires no recovery period.
The CSANZ notes that CT image acquisition takes less than 10 seconds with a single breath-hold; total appointment time, including ECG lead placement and patient positioning, typically runs 5–15 minutes (Hamilton-Craig et al., 2017). No injections are administered. No contrast dye is used.
Most patients drive themselves home immediately after the appointment (Mayo Clinic, 2024). In some cases, medication to slow heart rate is administered to improve image clarity — patients receiving this are typically observed briefly before leaving.
The CAC scan is not covered by Medicare in Australia (Heart Foundation Australia, 2019). The Heart Health Check that may precede the GP referral can be bulk-billed at practices that bulk bill, but the scan itself requires out-of-pocket payment. Australian radiology providers typically charge $150–$195 (PRP Imaging, 2024; GXU Imaging, 2024).
5. Know What to Do With the Results
CAC scan results are reported as an Agatston score — a standardised measure of calcified plaque volume and density in the coronary arteries (Hamilton-Craig et al., 2017; Mayo Clinic, 2024).
A score of zero — described in the cardiology literature as carrying the "power of zero" — indicates no detectable calcium in the coronary arteries. Among 44,052 patients in published data, cardiovascular mortality at 10 years among those with a zero score was below 1% (Hamilton-Craig et al., 2017). The CSANZ notes that asymptomatic patients with a zero score do not require pharmacotherapy, and the result typically remains meaningful for approximately five years.
A score of 1–99 places a patient in the low-risk category. Healthy diet and lifestyle adjustments are recommended.
A score of 100–399 indicates moderate risk, associated with a 10-year coronary risk of approximately 10–20% and an annual cardiac event rate of 1.3% (Hamilton-Craig et al., 2017). Aspirin and statin therapy are considered reasonable by the CSANZ in this range.
A score of 400 or above, or a score above the 75th percentile for age and sex, is classified as high risk. High-efficacy statin and aspirin are recommended, with consideration of further functional cardiac assessment.
The CSANZ notes that a score can also be expressed as a percentile relative to age and sex, using benchmarks from the Multi-Ethnic Study of Atherosclerosis (MESA). A patient with a moderate absolute score may sit at the 99th percentile for their age cohort — reclassifying their risk as high regardless of absolute number (Hamilton-Craig et al., 2017). Results are discussed with the referring GP, who determines appropriate next steps.
For men who receive a result of 100 or above — particularly those in the high-risk classification — reviewing insurance cover before initiating further cardiac investigations is worth prioritising (Hamilton-Craig et al., 2017). Understanding trauma insurance timing and the coverage window is particularly relevant for men over 45 where cardiac event cover is the most direct concern. Each subsequent investigation creates additional disclosure obligations and further narrows what cover is available on standard terms.
Frequently Asked Questions
Can life insurance still be obtained after a CAC scan?
It depends on what the scan finds. A score of zero does not affect a new insurance application. A score of 1–99 creates minimal underwriting concern in most cases. A score of 100 or above — particularly where statin and aspirin therapy has been prescribed — creates disclosure obligations that affect the outcome of new applications. The extent of impact depends on the specific score, the insurer, and the applicant's broader health history. A score of 400 or above, or one requiring further cardiac investigation, significantly restricts access to cover and in some cases prevents it. Men in this situation may wish to seek guidance from a qualified life insurance adviser before lodging any new application.
Does booking a CAC scan affect existing life insurance policies already in force?
No. Existing policies — those already in force before the scan is booked or conducted — are not affected by new medical investigations or findings. The policy terms and definitions that applied when cover was issued remain unchanged. This is one of the core reasons reviewing existing cover before the scan matters: in-force policies are protected. New applications are not.
How much does a CAC scan cost in Australia?
The CAC scan is not covered by Medicare in Australia (Heart Foundation Australia, 2019). Out-of-pocket costs at Australian radiology providers typically range from $150 to $195 (PRP Imaging, 2024; GXU Imaging, 2024). The GP Heart Health Check that may precede the referral can be bulk-billed at practices that bulk bill, but the scan itself is an out-of-pocket expense. Fees vary by provider and location — confirming the cost with the radiology centre before booking is recommended.
Does the CAC scan require fasting?
No. The CAC scan does not require fasting (Heart Foundation Australia, 2019; Mayo Clinic, 2024). The preparation requirements are avoiding caffeine and smoking for a few hours before the test. Unlike a fasting blood test or CT coronary angiogram, patients eat and drink normally before this scan.
What is a normal CAC score for someone aged 45–55?
The CSANZ notes that no single score is universally "normal" — the Agatston score is best interpreted relative to age and sex, using percentile benchmarks from the Multi-Ethnic Study of Atherosclerosis (MESA) (Hamilton-Craig et al., 2017). For men under 50, any score above zero places them above average relative to their age cohort. A score of zero at any age is associated with a very low cardiac event rate. For men in their 50s, scores in the 1–99 range are not uncommon but are assessed against age-matched percentiles. A score above the 75th percentile for age and sex is classified as high risk regardless of absolute number.
Getting Cover Before the Test
For eligible clients, an Arrow Equities insurance review is complimentary.
Arrow Equities provides professional life insurance advice from Christopher Hall, AdvDipFP (AFSL 526688), covering life insurance, TPD, income protection, and trauma cover — all four types most directly affected by cardiovascular investigation findings. The review is conducted before any formal application is lodged, meaning the underwriting position for each insurer can be assessed informally before a formal decline is placed on record. A formal decline is a disclosable event on every subsequent insurance application.
About the AuthorChristopher Hall, AdvDipFP, is the principal financial adviser at Arrow Equities and an Authorised Representative under AFSL 526688. He has completed more than 500 life insurance policy reviews for Australian families, with a specialisation in life risk insurance.
Bibliography
# | Citation | Type | Date |
1 | Hamilton-Craig, C.R., Chow, C.K., Younger, J.F., Jelinek, V.M., Chan, J. and Liew, G.Y.H. (2017) 'Coronary artery calcium scoring: position statement executive summary', Medical Journal of Australia, 207(8), pp. 357–360. https://doi.org/10.5694/mja16.01134 | Tier 1 — institutional (CSANZ peak body position statement) | October 2017 |
2 | Heart Foundation Australia (2019) Coronary artery calcium score, Heart Foundation Australia. Available at: https://www.heartfoundation.org.au/your-heart/medical-tests-coronary-artery-calcium-score (Accessed: June 2026). | Tier 1 — institutional (national heart health organisation) | 2019; accessed June 2026 |
3 | Mayo Clinic (2024) Coronary calcium scan, Mayo Clinic. Available at: https://www.mayoclinic.org/tests-procedures/heart-scan/about/pac-20384686 (Accessed: June 2026). | Tier 2 — independent research (international medical institution) | 2024; accessed June 2026 |
4 | PRP Imaging (2024) CT calcium score services, PRP Diagnostic Imaging. Available at: https://www.prpimaging.com.au/ct-calcium-score-services/ (Accessed: June 2026). | Tier 2 — editorial (commercial provider pricing data) | 2024; accessed June 2026 |
5 | GXU Imaging (2024) Calcium score test, GXU. Available at: https://gxu.com.au/services/calcium-score-test/ (Accessed: June 2026). | Tier 2 — editorial (commercial provider pricing data) | 2024; accessed June 2026 |
6 | Detrano, R., Guerci, A.D., Carr, J.J., Bild, D.E., Burke, G., Folsom, A.R., Liu, K., Shea, S., Szklo, M., Bluemke, D.A., O'Leary, D.H., Tracy, R., Watson, K., Wong, N.D. and Kronmal, R.A. (2008) 'Coronary calcium as a predictor of coronary events in four racial or ethnic groups', New England Journal of Medicine, 358(13), pp. 1336–1345. https://doi.org/10.1056/NEJMoa072100 | Tier 2 — independent research (peer-reviewed clinical study, NEJM) | March 2008 |
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