The AHA and ACC’s 2026 dyslipidemia guidelines recommends every adult measure Lp(a) at least once. But health insurance medical policies, including Medicare’s, haven’t yet been updated.

Medicare’s coverage policy for cardiovascular biomarkers is based on a 2009 USPSTF report that concluded the evidence was insufficient to recommend newer risk factors for screening asymptomatic adults. That was 17 years ago, before the large genetic and epidemiological studies that established Lp(a) as the strongest inherited risk factor for heart disease.

Even though Medicare doesn’t cover Lp(a) testing, you can still get tested affordably. In this post, we’ll explain what Medicare’s policy says, the evidence, and how to get tested.

What does Medicare’s coverage policy say about Lp(a)?

Medicare’s LCD L36358, “Biomarkers in Cardiovascular Risk Assessment”, governs which cardiovascular tests are covered. The policy is clear:

This policy denies coverage for all CV risk assessment panels, except the basic lipid panel.

It goes further, denying coverage for advanced biomarkers individually as well:

This policy denies coverage for all non-lipid biomarkers when used for CV risk assessment including but not limited to, biochemical, immunologic, and hematologic, and genetic biomarkers for CV risk assessment regardless of whether ordered in a panel or individually.

Medicare covers a basic lipid panel (total cholesterol, HDL, LDL, and triglycerides), but not Lp(a).

When was Medicare’s Lp(a) policy last updated?

Medicare’s LCD was last updated in January 2026, just two months before the AHA/ACC released their new guidelines recommending universal Lp(a) screening. The policy still relies on the 2009 USPSTF evidence review, which predates most of the Lp(a) research we have today.

The 2026 AHA/ACC guidelines cite large studies (including the UK Biobank) showing that elevated Lp(a) increases cardiovascular risk by 40% or more. About 1 in 5 people have elevated Lp(a), and most don’t know it.

Does private insurance cover Lp(a)?

Coverage varies. Most private insurers follow similar logic to Medicare for general cardiovascular screening. Some health insurers cover Lp(a) testing when specific risk factors exist, such as family history of premature cardiovascular disease, diabetes, or high tryglicerides.

How to get Lp(a) tested

Since Lp(a) is genetically determined and doesn’t change much over your lifetime, you only need to test it once. Several options are available. Empirical Health’s comprehensive heart panel includes Lp(a), ApoB, hs-CRP, and the other biomarkers emphasized in the 2026 guidelines, starting at $190.