You First Provider FAQs

Our secure fax number is 802-657-4208.

Yes, You First will cover a preventive visit. However, it is important to keep in mind that You First only covers breast cancer screenings, cervical cancer screenings, and heart health screenings. You First does not cover immunizations, birth control, thyroid testing, or other blood testing that is not listed on our fee schedule.

Yes, You First pays for second opinions and consultations for breast and cervical cancer screening and diagnostics.

No, You First does not pay for BRCA testing, genetic counseling, or genetic testing.

No, You First cannot pay for cancer treatment. If your patient is diagnosed with breast or cervical cancer, the patient navigator can help transition eligible members to the Breast and Cervical Cancer Treatment Program (BCCTP).

No, You First does not pay for colonoscopies.

Yes, You First coverage is retroactive 90 days from the application signature date.

The majority of You First members learn about the program from their health care provider. Here are some steps to refer your patients:

• Tell any patients you think might be eligible that You First covers the cost of certain screening and diagnostic services.
• Refer them to YouFirstVT.org to learn more about our services and benefits.
• Give patients a printed application.  You can download them here.
• Prompt them to reach out to our team with questions and assistance applying.
     800-508-2222 | TTY/TDD: Dial 711 first
     [email protected]

Or they can complete this secure form and we'll get in touch.

Individuals are eligible for You First if they:

• Have (or have had) breasts or a cervix or need preventative breast or cervical cancer screenings.
• Live in Vermont
• Are at least 21 years old
• Are 35-64 years old to receive heart health screenings and lifestyle benefits
• Earn up to 250% of the federal poverty level.
• May be uninsured, have Medicaid, have private insurance, or have Medicare.

Learn more about You First eligibility

Should a member need it, our partner program, the Breast and Cervical Cancer Treatment Program, provides full Medicaid coverage to eligible members throughout their cancer treatment. Members can get full Medicaid coverage if they:

• Are screened and found to be in need of treatment for breast or cervical cancer or precancerous conditions
• Are over age 21 and younger than age 65
• Are a U.S. citizen, U.S. national or have qualified immigration status
• Are a Vermont resident
• Meet income guidelines
• Have no other health insurance

Once enrolled in the program, members can access all Medicaid services, including:

• Cancer treatment
• Mental health counseling
• Primary care
• Specialist services
• Transportation
• Physical therapy
• Limited dental services
• Eye exams

To ensure your patients have timely access to this program, please send all abnormal breast and cervical cancer screening results to You First.

Our team can help members apply to this program. Contact us to get started