Sage Cancer Screenings Covered Services and Eligibility

Breast and cervical cancer screening

Updated Sage Provider Manual eligibility criteria: Eligibility (PDF)

For a detailed explanation of eligibility, see the Sage decision Trees (broken down by age): Sage Decision Tree (PDF)

Eligibility

• Breast – Women 40 and older^1,2
• Cervical – Women ages 21 to 64¹

  Understanding Eligibility

   

  • Do not have insurance
  • Have insurance that does not cover screening or has a deductible or co-pay
  • Have income within program guidelines

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Screening services

• Office visit for breast and/or cervical exam, and/or breast health education
• Screening mammogram – office visit required including breast health education and/or clinical breast exam
• Pap smear every 3 years, (or every 5 years if Pap accompanied by HPV co-testing)

Diagnostic services

• Office visit to review abnormal screening results
• Breast surgical consult
• Diagnostic mammogram
• Fine needle aspiration of breast lump, including pathology reading
• Colposcopy, including biopsy
• Endometrial Biopsy (when done as a follow-up for a Pap with abnormal result of Endometrial cells or Adenocarcinoma)
• High Risk HPV Panels (when done as a follow-up for a Sage-covered Pap with ASCUS or LSIL results)
• Breast ultrasound
• Breast biopsy

Note: Treatment for non-insured, Sage patients may be covered by the Medical Assistance for Breast or Cervical Cancer (MA-BC). 

Income Eligibility ³

Self-employed or farmers: use household net income (after business expenses)

Maximum allowable gross income (Effective January 1, 2023: Guidelines change yearly**)

Schedule a screening

If you are interested in receiving breast, cervical or colorectal cancer screening, or have questions call Sage at 1-888-643-2584 to see if you are eligible.

¹ Sage age eligibility guidelines for breast and cervical cancer screening will be reviewed June 2023.

² Age exceptions for breast services: If a woman under 40 has breast symptoms or a family history of breast cancer (self, parent, sibling, child) Sage may cover her office visit and any other breast screening testing. If further follow-up is needed, the woman could also have a diagnostic mammogram, breast ultrasound, breast surgical consult or outpatient breast biopsy.

³ Program income guidelines are based on the Federal Poverty Level. This is updated annually at the end of January. Sage's prior year guidelines remain in effect until then.