Maine CDC Breast and Cervical Health Program (MBCHP)

Important Information about Follow-up Testing...

Based on the results of your cancer screening tests, your MBCHP network service location provider may recommend that you receive follow-up tests. Call the MBCHP Case Manager at 1-800-350-5180 if your provider recommends any follow-up tests.

When ordered by your MBCHP network service location provider, the program will pay for these follow-up tests:

  • Diagnostic mammogram
  • Breast ultrasound after a mammogram
  • Surgical consults for possible breast or cervical cancer
  • Fine needle aspiration of a breast cyst
  • Breast biopsy (hospital charges are not covered)*
  • Colposcopy (magnified view of the cervix) with or without biopsy
  • Cervical diagnostic excisional procedures (requires Case Manager authorization)
  • Pathology charges for breast and cervical biopsies

*About breast biopsies:
If your MBCHP provider recommends a breast biopsy, talk to the MBCHP Case Manager regarding coverage of hospital charges not covered by MBCHP.

Covered Services - Frequently Asked Questions...

1. Does MBCHP cover breast Magnetic Resonance Imaging (MRI)?

  • MBCHP does not cover a breast MRI.

2. Does MBCHP cover an endometrial biopsy?

  • MBCHP can only cover an endometrial biopsy (EMB) if the client's screening Pap test reported:
    • Abnormal Glandular Cells (AGC), or;
    • Adenocarcinoma In-Situ (AIS), or;
    • Negative Pap result, with endometrial cells present AND the client is post-menopausal.
  • Before MBCHP can approve coverage for an EMB, documentation supporting the clinical reason why an EMB was/will be performed must be completed and faxed to MBCHP at 207-287-2279.

3. Does MBCHP pay for the MBCHP provider to remove a cervical polyp?

  • If a MBCHP provider determines the need and provides documentation of the polyp type, the Program will cover:
    • Removal of an endocervical polyp and pathology, and/or;
    • Biopsy of an endocervical polyp and pathology.

4. After I had an abnormal screening result, I was referred to a MBCHP diagnostic service location. Can I continue going to the MBCHP diagnostic provider to have my Pap tests?

  • No, you must see the MBCHP network service location listed on your MBCHP member ID card for Pap tests.

5. If I am diagnosed with breast or cervical cancer, does MBCHP pay for my cancer treatment services?

6. Will the MBCHP pay for a human papillomavirus (HPV) test?

  • The human papillomavirus (HPV) test is covered as part of a regular screening exam if done in conjunction with your Pap test (called co-testing). Make sure you talk to your health care professional about your Pap test. Whether you have a Pap test alone, or a Pap test with an HPV test (co-testing), will determine how long you should go between visits and when your next cervical cancer screening is recommended.

7. Does the MBCHP cover a pelvic or a transvaginal ultrasound?

  • MBCHP does not cover a pelvic ultrasound or a transvaginal ultrasound. If you need to have either of these procedures, please contact the MBCHP case manager.

8. I will need to have a LEEP. Will MBCHP cover this procedure?

  • If you should need this procedure, please contact the MBCHP case manager BEFORE your provider schedules this procedure. Any cervical diagnostic excisional procedure requires Case Manager authorization.

9. Does MBCHP cover a hysterectomy?

  • No.

10. Does MBCHP pay for a urine test?

  • No.

11. My MBCHP network service location is recommending that I have a colposcopy (magnified view of the cervix). Will MBCHP cover this procedure?

  • Yes, the MBCHP covers a colposcopy with or without a biopsy. If you should need to have this procedure, please contact the MBCHP case manager.

12. I received a bill for something that I think should be covered by MBCHP. Who should I contact?

  • If you received a bill for a service that you thought should have been covered by MBCHP, please contact the MBCHP Medical Care Coordinator at 287-6285 to have the bill reviewed.

Updated April 26, 2016