Ladies First Services - For Providers

Ladies First pays for the following services

Breast Screening

(Ladies First members ages 21 and up)

  • Clinical breast exam
  • Breast self-exam instruction
  • Screening Mammogram
  • Diagnostic Mammogram
  • Ultrasound
  • Consultation
  • Second opinion
  • Breast biopsy

Ladies First members can be referred for full health coverage during treatment. Contact the Clinical Navigator at 802-863-7332.

View the Ladies First fee schedule

Cervical Screening

(Ladies First members ages 21 and up)

  • Pelvic exam
  • Pap smear every 3 years
  • Pap smear & HPV every 5 years
  • Colposcopy
  • Diagnostic tests

Ladies First members can be referred for full health coverage during treatment. Contact the Clinical Navigator at 802-863-7332.

View the Ladies First fee schedule

Cardiovascular Disease Screening **NEW** Changes Starting July 1st

One of the Ladies First program’s grants is ending in June. The CDC’s WISEWOMAN grant has allowed Ladies First to cover the cost of heart disease screenings and Lifestyle Programs for its members. Unless funding is renewed, Ladies First will not be able to cover the cost of heart health screenings and Lifestyle Programs. We will continue to cover the cost for breast and cervical cancer screenings, including Pap tests and mammograms, and needed diagnostic tests, and clinical navigation support.

Ladies First will not longer cover the cost of (starting July 1st):

  • Annual heart screenings
  • Blood pressure screening
  • Total cholesterol testing
  • Blood sugar testing
  • Weight Watchers
  • Tops (Take Off Pounds Sensibly)
  • Curves Complete
  • Self-Monitored Blood Pressure Program
  • Other Local weight management and fitness programs

A new, competitive grant application is expected to be released at the end of April. Ladies First is well-positioned for a new round of funding, thanks to the hard work and dedication of our community partners. We will keep in touch with our partners as we learn more and to close out sub-awards.

View the Ladies First fee schedule

Breast and Cervical Cancer Treatment Program

The Breast and Cervical Cancer Treatment Program provides Medicaid coverage for cancer treatment and services for Vermont Ladies First members.

Who is eligible?

A woman may receive full Medicaid coverage if all of the following requirements are met:
  • Screened and found to be in need of treatment for breast or cervical cancer or precancerous conditions
  • Over age 21 and younger than age 65
  • U.S. citizen, U.S. national or qualified immigration status
  • Vermont resident
  • Meets income guidelines
  • No other credible health insurance or Medicare

How does A Patient apply?

A patient can apply by contacting the Ladies First Clinical Navigator at (802) 863-7332 to complete an application for the Breast and Cervical Cancer Treatment Program and an application for Medicaid. 

The patient recieved treatment before applying. Will these costs be covered?

If the patient has medical or dental expenses from the last three months, the Breast and Cervical Cancer Treatment Program may be able to help pay for those expenses.  The Medical provider must be an enrolled Vermont Medicaid provider in order for services to be covered.
 

What benefits are available?

Once enrolled in the program, the patient can access all Medicaid services, including:
  • Treatment
  • Mental health counseling 
  • Primary care
  • Specialist services 
  • Transportation 
  • Physical therapy 
  • Limited dental
  • Eye exams

When does the patient get their ID card?

The Medicaid member ID card should come three to six weeks after being accepted into the program. 

What does the patient have to pay for medical care?

Patients who get Medicaid coverage through the Breast and Cervical Cancer Treatment Program do not have to pay any Medicaid copays. 
 
 

Send all abnormal breast and cervical cancer screening results to Ladies First. The Clinical Navigator will guide Ladies First members who have been diagnosed with cancer through the process of applying for the BCCT Program. This program provides full Medicaid benefits during treatment.

For more information about Ladies First clinical navigation services, please call the Ladies First clinical navigator at 1-800-510-2282. 

Non-covered Services
  • Pelvic and trans-vaginal ultrasound
  • Endometrial biopsy (unless patient has Atypical Glandular cells of Undetermined Significance (AGUS) Pap test results).
  • Cervical conization (can be covered by the Vermont Breast and Cervical Medicaid Treatment Program if eligible)
  • Computer-aided diagnostic test (CAD)
  • Gonorrhea, chlamydia STD tests
  • Electrocardiogram
  • Thyroid stimulating hormones test (TSH)
  • Bone density test
  • Screening MRIs (only high-risk MRIs are allowed)

View the Ladies First fee schedule