Common questions and answers about the Sage Screening Program

Who is eligible

Q: If a woman has insurance but it doesn’t cover screening, or if she has an unmet deductible, can she be on Sage?
A: Yes, if she meets the age and income guidelines. Her insurance will be billed first, and Sage will cover if the charges are rejected or only partially paid (note to clinics: Sage payment after insurance is only up to the medicare reimbursement rate for the service- charges over that amount must be written off).

Q: If a woman has Medical Assistance (MA) or MinnesotaCare can she be on Sage?
A: It isn't necessary. Both Minnesota MA and MinnesotaCare already cover these screening services. If a woman has an unmet sped-down under Minnesota MA she may enroll in Sage.

Q: What about women on Medicare?
A: Women on Medicare can be enrolled in Sage. Medicare covers screening mammograms every year in women age 65 and above. Medicare covers screening Pap smears every 2 years. If there are any charges from the visit that Medicare doesn't cover, or if there are any co-payments, Sage could cover those costs.

Q: Will Sage pay for mammograms for women under age 40?
A: Possibly. Sage endorses the American Cancer Society's guidelines for breast cancer screening starting at age 40. However, if a woman is under 40 and her clinician determines that a screening mammogram (or breast ultrasound) is indicated due to an elevated risk (family history of breast cancer in a parent, sibling, or child),or due to breast symptoms, Sage will reimburse for both the visit and the mammogram.

Q: Will Sage pay for a Pap smear if the woman has had a hysterectomy?
A: Yes, but only if the hysterectomy was done because of cervical cancer or if a portion of the cervix remains. Her clinician can determine the need by examining her.

Q: Does a woman need to provide proof of her income when she enrolls?
A: No. Self report of income is all that is required. She may use her current monthly income, average income over the last year, or income reported on last year’s tax return.

Q: If a woman is self employed (e.g. farmer) how is her income determined?
A: Use net household taxable income after deducting business expenses.

Q: Are non-Minnesota residents eligible?
A: No. Note: Surrounding states have active screening programs also.

Q: Are men eligible for Sage breast screening?
A: No. Although men do develop breast cancer (approximately 300 deaths per year in the USA), the vast majority of breast cancers occur in women (46,000 deaths per year). Men with abnormal breast symptoms are encouraged to see a health care professional for evaluation.

Services provided

Q: Can a woman have a Sage mammogram only, without a breast exam?
A: No. She must enroll in the program and be examined at a participating Sage screening site. The site will order her mammogram after her exam. The report will be sent to the health care professional who examined her for the appropriate follow-up.

Q: Is a woman required to have both the Pap smear and the breast screening in order to be in the program?
A: No. She may request only cervical or only breast screening. However, for most women the best approach is to have both types regularly. (See also above question)

Q: What if a woman had her last Pap smear/mammogram less than a year ago?
A: For women without problems, it is best to wait approximately a year between breast cancer screenings and 3 years between Pap smears.

Q: What about return visits?
A: Sage will pay for covered services as often as needed. Eligibility for services is reassessed at each visit. Examples of services that Sage does not cover are: cervical treatments such as LEEPS or laser or cryotherapy, and cancer treatment. However, every attempt is made to help women with abnormal test results find resources to obtain the care they need.

Other concerns

Q: What should I tell a women who is concerned about her personal data and test results being released to the Sage Screening Program?
A: Sage maintains all personal and medical information in a confidential manner. No information that could identify an individual woman is reported to the Centers for Disease Control and Prevention, or to any other agency or individual without the woman’s written consent.

Q: Is a woman required to return every year for the remainder of the program?
A: No. She may withdraw from Sage at any time, simply by not returning for future visits.

 

Updated Monday, 14-Apr-2014 15:25:35 CDT