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?
- No, but if you are diagnosed with breast or cervical cancer, MBCHP will determine if you qualify for the MaineCare Treatment Act or other resources for treatment support services.
- MaineCare Treatment Act informational brochure
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?
10. Does MBCHP pay for a urine test?
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