Cancer Control Program

Information for RI Women
Frequently Asked Questions

1. How do I get enrolled?
All women are enrolled at the physician office visits. Each participant must be enrolled at a participating provider office prior to being given a referral for a mammogram.

2. I am over 50 years old and I have already had a breast exam by my doctor, but he is not a provider of service with the Program, can I have a free mammogram?
In order to have a mammogram paid for by the Program, a woman must have a breast exam by a participating doctor’s office, a participating Health Center, or a participating clinic. It is not required that she have a Pap and Pelvic Exam if these exams were conducted during the last 12 months. The WCSP encourages clients to have a complete Women’s Health exam including a Pap Smear, pelvic exam and a breast exam if the client has not received these services through her provider.

3. I’m under 40, don’t have insurance, and I’m within the income guidelines for the program, and I want a mammogram. Will the Program cover a mammogram for me?
Unless the woman has a palpable lump or a clinical finding of something suspicious for cancer, a personal history of breast cancer, or a relative with pre-menopausal breast cancer, the Program is unable to cover a mammogram for woman under age 40. Although she can not receive a mammogram through this program, there are radiology sites who offer reduced mammograms for women who are uninsured.

4. I have a sister who is 38 years old with no health insurance and she earns less than the income guidelines, but she has a lump. What should she do?
Uninsured women meeting the income guidelines, with a palpable breast lump are eligible to receive program services. Please call the statewide toll-free information line at 222-4324 for additional information.

5. I’ve been screened under the Program and my doctor tells me I need an additional mammogram. Will the Program pay for the mammogram?
Yes, the Program will pay for additional radiological services needed as a result of the abnormal screening result. Please call the statewide toll-free information line at 222-4324 for additional information.

6. My doctor told me that I need a breast biopsy as a result of my being screened under the Program. What do I do?
All women who are U.S. citizens or Permanent Resident Aliens should apply for Medical Assistance if recommended to have a biopsy. Treatment will be provided through a special Treatment Component of the Program administered by the Department of Human Services (DHS). Please call the statewide toll-free information line at 222-4324 for additional information.

7. I participated in the program last year and I would like to return for my annual exams. What should I do?
Women can receive screening services annually through the Program. Please call the statewide toll-free information line at 222-4324 for additional information.

8. I have health insurance but I do not know if it will cover the cost of an office visit, to include a Pap smear and a mammogram.
Women should call their insurance and ask about services covered by their health insurance. If her insurance does not cover the cost of an annual Pap, pelvic exam, and/or mammogram, and she meets income and age eligibility criteria, the Program will cover her services.

9. If I have Medicare, can I get a mammogram through the Women’s Cancer Screening Program?

• If a woman has Medicare Part B, she is not eligible for the program because Medicare will cover the cost of an annual mammogram.
• If a woman does not have Medicare Part B, (only Part A) she is eligible for all program services.
• Women 65+ who are undocumented are eligible for all program services.

10. Do I have to have a Pap and a pelvic exam, or can I just get a mammogram?
The Rhode Island Department of Health encourages a Women’s Health Exam, but if you do not want a Pap or pelvic exam, you can refuse those services. You must have a clinical breast exam by a participating providing in order to receive a mammogram.

11. I live in Massachusetts but my doctor is in Rhode Island, can I participate in the Rhode Island program?
Only Rhode Island women may participate in the Rhode Island program. Massachusetts and Connecticut are funded for the same program though the Centers for Disease Control & Prevention (CDC) and also have funding for breast and cervical cancer. CDC mandates that women must receive services from the state in which they reside.

12. Am I going to have a mammogram at the time of my office visit?
No, the first visit is with a participating provider for a women’s health exam, which includes a Pap smear, pelvic exam, and a Clinical Breast Exam (CBE) and the doctor will give you a referral for a mammogram.

13. I have been screened under the program and I have a referral for a mammogram. What is my next step?
All Rhode Island radiology facilities participate in the Program. When calling a radiology facility to schedule an appointment for a mammogram, please be sure to mention that you are a participant of the Women’s Cancer Screening Program.

14. I already called my health insurance and they do cover for yearly screening but I have to pay a co-payment. Do I still qualify for the program and get the co-payment covered?
No, you do not qualify for the Program at this time. WCSP does not cover co-payments.

15. I am an undocumented woman and I just had an abnormal mammogram. I have been told I need further follow-up. What does the program cover for me?
WCSP pays for some follow-up costs, including a biopsy. Please call the statewide toll-free information line at 222-4324 for additional information.

16. I participated in the program last year and I made my appointment for this year’s visit, do I have to get enrolled again at the doctor’s office?
Yes, an enrollment form should be completed every year to ensure that you continue to qualify for program services and the program has the most up-to-date information in our database.

17. I went to the office visit and I had all my screening tests done. I just got a bill and I had understood that the Women’s Cancer Screening Program was going to cover these services. What do I do now?
You should not receive a bill for these services (Office visit, Pap smear, Pelvic Exam, Clinical Breast Exam, and/or Mammogram), but in case you do, please call the WCSP information line immediately at 222-4324 so we can resolve the problem. Please do not throw away any bill until you have contacted us and we are aware of the billing error.