Maine CDC Breast and Cervical Health Program (MBCHP)


Enrollment - Frequently Asked Questions...


 

1. How do I know if I qualify for MBCHP?

2. I have some health insurance; can I still qualify for the MBCHP?

  • You may still be eligible for MBCHP even if you have insurance, such as, your health insurance does not cover mammograms or Pap tests, or if you have a large deductible. Call the Program to see if you qualify:
    • 1-800-350-5180...or;
    • 207-287-8068...or;
    • TTY Users dial 711 (Maine Relay)

3. Can I still go to my regular doctor to get my MBCHP screenings services?

  • Maybe. MBCHP works with a network of health care provider service locations all over the state. In order to have MBCHP pay for covered services you must be seen at a MBCHP PCP service location. If your regular doctor practices at the MBCHP PCP service location you chose when you enrolled (listed on the back of your MBCHP client ID card) then MBCHP would pay for your screenings. However, if your regular doctor participates in MBCHP at one of our service locations but provides your service at a different location, your service may not be paid for by MBCHP.
    • 1-800-350-5180...or;
    • 207-287-8068...or;
    • TTY Users dial 711 (Maine Relay)

4. My regular doctor (not the MBCHP site I enrolled at) usually does my referral for my mammogram. Will MBCHP still pay for my mammogram.

  • If you get a referral from your "usual" doctor (not a health care provider at the MBCHP site you signed up for when you enrolled with MBCHP) for your mammogram, the results of your mammogram will be sent to your doctor. Unless you have specifically asked for results to be sent to your MBCHP site and/or MBCHP, we will not receive your results. If MBCHP does not receive results of your mammogram, MBCHP may not pay for your mammogram. If MBCHP paid for your mammogram and cannot get a copy of the results, the amount paid for the claim may be taken back by MBCHP. If this happens, you may receive a bill for your mammogram. If you have questions, please contact us.

5. Can I "self-refer" to my mammography site and avoid having to have an office visit at my MBCHP PCP site?

  • Yes. If you do not need to see your MBCHP PCP for an office visit, i.e., you are not due for a Pap test, and just want to have your mammogram done, you can self-refer at many MBCHP mammography sites in Maine. If you self-refer for your mammogram, please:
    1. Make sure you tell them you are enrolled in MBCHP (so they will bill us),
    2. Provide the mammography site with your MBCHP member number (the 9 digit number followed by an "A" on your MBCHP member card),
    3. Ask the mammography site to send MBCHP (and your MBCHP PCP site) a copy of the results of your mammogram. This is very important in case your mammogram is not normal. If you do not have a normal result from your mammogram, your PCP may need to schedule an additional view or make referrals for any diagnostic testing that may be required.

6. I just had a mammogram or Pap test: if I join, will MBCHP pay for those tests?

  • If you qualify and join the program, MBCHP can backdate your enrollment start date up to 90 days to pay for covered services performed at a MBCHP PCP service location or participating mammography site.

7. After joining the Program, I received a bill: what should I do with it?

  • You should not receive a bill for any MBCHP covered service.
  • If you do receive a bill, please call the provider and give them the ID # on your MBCHP enrollment card.
  • If you receive a second bill, please call the Program immediately and we will try to help straighten it out.

8. Do I have to reapply every year to be a part of MBCHP?

  • Yes, MBCHP offer services to you every year as long as you are still eligible.
  • Once a year, MBCHP will send a form for you to update your enrollment information.
  • The re-enrollment form must be completed and returned to MBCHP to stay on the program.
  • If you do not return the re-enrollment forms to MBCHP, your coverage will automatically end and any services you have after your enrollment ends, may not be paid for by MBCHP.
Updated August 22, 2013