You First Services

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:

• Consultation
• 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.  

Go to the CDC website to learn more about breast cancer screenings

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.  

Go to the CDC website to learn more about cervical cancer screening

You First pays for these heart health screenings for members who are 35-64 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.

Go to the CDC website to learn more about heart disease risk factors