You First members are eligible for different benefits depending on their age.
|Age 21-29||Age 30-64||AGE 65+|
Help understanding screening needs, results and next steps, and how to use You First benefits.
Payment of breast and cervical cancer screenings and some follow-up tests.
Help scheduling and arranging transportation to You First health care appointments.
Payment of heart health screenings.
Support from a local health coach via phone or email.
Healthy lifestyle perks like free weight-loss and gym memberships, farmers' market coupons, state park passes.
We can help you get free screenings for the health problems listed below.
1 in 8 women in the U.S. will get breast cancer in their lifetime. While there is no known cause of breast cancer, regular breast cancer risk assessments and screenings can reduce your risk.
We pay for these breast cancer screenings and tests for members:
- General office visit: During this visit your provider will perform a breast cancer risk assessment, including a discussion on when to get screened and a referral for a mammogram if needed.
- Clinical breast exam: In this exam, your health care provider will use their hands to feel for lumps or other changes in your breasts.
- Mammogram: This test is an X-ray picture that health care providers use to find signs of breast cancer.
If a screening shows signs of possible cancer, we pay for follow-up tests to help your health care team learn more:
- Diagnostic mammogram: This type of mammogram takes more X-ray pictures to show areas of concern more fully.
- Ultrasound: This test uses sound waves to create a computer image of the insides of your breasts.
- Breast biopsy: This test removes a small amount of tissue from your breast. A medical expert then examines the tissue to check for cancer cells.
- Magnetic resonance imaging (MRI): This is a test that uses radio waves and strong magnets to create detailed pictures of the insides of your breasts. We pay for high-risk MRIs when your health care team agrees there’s a valid medical reason for this test.
We also pay for these services when needed:
- Second opinion: You can get a second health care provider to review your test results and provide their opinion.
Note: You First does not cover cancer treatment. If you need treatment for breast cancer, we will help you enroll in the Vermont Breast and Cervical Cancer Treatment Program. Contact our You First team for more information.
Cervical cancer used to be the leading cause of cancer deaths in women in the U.S. But simple screening tests and the HPV vaccine have greatly reduced the number of cervical cancer cases and deaths. So, getting screened has never been more important.
You First pays for these cervical cancer screenings for members:
- General office visit: During this visit your provider will perform a cervical cancer risk assessment, including a discussion on when to get screened and a cervical exam if needed.
- Cervical exam: In this exam, your health care provider will check your cervix.
- Pap test: This test removes a small number of cells from your cervix. A medical expert then checks those cells for signs of abnormal growth. This test helps your provider find abnormal cells before they turn into cancer.
- Human papillomavirus (HPV) screening: This test removes a small number of cells from your cervix. A medical expert then examines the cells to check for signs of HPV, a common virus that can cause cervical cancer over time. Screening for HPV can help show if you’re at greater risk for cervical cancer.
- If screenings show signs of possible cancer, You First pays for follow-up tests to help your health care team learn more. This may include a colposcopy, a test that uses a special instrument to examine your cervix, vagina, and vulva more closely.
Note: You First can’t cover cancer treatment. If you need treatment for cervical cancer, we will help you enroll in the Vermont Breast and Cervical Cancer Treatment program. Contact our You First team for more information.
Heart Disease (for members 30-64)
About 655,000 Americans die from heart disease each year—that’s 1 in every 4 deaths. Factors like obesity, high blood pressure, and smoking raise your risk of heart disease. Screenings help you understand your risk so you can work with your health care team to lower it.
You First pays for these heart health screenings for members who are 30-64 years old:
- Heart health visit: Visit to your provider to assess your heart health by measuring your height, weight, blood pressure, cholesterol, and blood sugar or A1C. This visit is the first step in participating in our heart health program. Remember to answer your heart health questionnaire on the day of this visit.
- Blood pressure readings: This test measures the pressure in your arteries as your heart pumps blood through your body. It uses an inflatable cuff around your arm. If you have high blood pressure, you have a higher risk of heart disease.
- Cholesterol testing: This blood test measures the amount of each type of cholesterol and certain fats (called triglycerides) in your blood. If you have high cholesterol, you have a higher risk of heart disease.
- Fasting blood sugar testing: Fasting blood sugar tests measure your glucose (blood sugar) concentrations at the moment of your test, while hemoglobin A1C tests measure your average blood sugar levels over the past three months. Both tests are used to show if you have diabetes or prediabetes. Prediabetes means your blood sugar levels are higher than normal, but you don’t have full diabetes yet. If you have diabetes, you have a higher risk of heart disease.
SERVICES NOT COVERED BY YOU FIRST
- Problem-focused office visits not related to breast cancer, cervical cancer or heart health screenings
- Pelvic and transvaginal ultrasounds
- Ovarian and uterine cancer screenings and diagnostic tests
- HPV vaccine
- Blood tests other than cholesterol and blood glucose or A1c
- Bone density scans
Lifestyle programs to help you get—and stay—healthy
If you’re 30-64 years old we offer additional perks. We can help you get the tools you need to lower your risk and improve your overall health. Plus, we pay for the programs and resources listed below.
Note: Members are eligible for these benefits after an initial heart health screening with their provider.
Healthy eating and weight loss programs and resources:
- Weight Watchers (WW)
- Eat Smart Move More Weigh Less
- TOPS (Take Off Pounds Sensibly)
- Farmers' market coupons or vegetable CSA shares
Fitness programs and resources:
- 90-Day Commit to Get Fit (Offered by The EDGE Fitness Center to You First members remotely or in person to members in Chittenden County)
- Other local fitness programs
- Online fitness programs
- Fitness equipment (like exercise bands, gym socks, step counters)
- Passes to state parks for hiking or swimming
Other health programs and resources:
- Self-monitored blood pressure program
- MyHealthyVT.org, MyHealthyVT Workshops: Free, online healthy living workshops created by the CDC and run by experienced, local health coaches. High blood pressure, quit smoking, diabetes prevention and management workshops are available at no cost to Vermonters.
- 802Quits, resources to help you stop smoking or using tobacco
How do I apply for You First?
To get started, give us your name, phone number and email address below. We’ll contact you to help you apply.
Or you can download the application now. If you need help filling out the application, give us a call.
For general questions or inquiries, contact us Monday to Friday, 7:45AM to 4:30PM:
Call: 800-508-2222 | TTY/TDD: Dial 711 first