r/HealthInsurance • u/Feelthegrass-7 • Jul 10 '25
Medicare/Medicaid Pap Smear with Medicaid?
Hi all! I recently turned 21, and I know it is recommended to get a pap smear. Any advice is helpful I dont have another woman or someone who knows anything about women's health that I can ask. I have medicaid and am very confused because my PCP that I used when I was younger passed away, so I don't currently have one. Mainly would just use my insurance for when I would need medicine or had to go to Urgent Care. Do I have to get a new PCP then they have to refer me to someone else to get a pap smear and cervical cancer screening? I called a OBGYN clinic close to me and they said they don't accept medicaid, so I asked how much money would the pap smear be, and they told me they cannot accept a payment from me if I have medicaid??? Just feeling overwhelmed with the process so anything helps, thank you!!!
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u/Living-Hyena184 Jul 10 '25
You just need to find a primary doctor that does well woman care. These offices essentially “do it all”. You should be able to get a list of offices/doctors from your Medicaid provider
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u/Keddie7 Jul 10 '25
It’s of great value to get established with an OBGYN. Check your provider directory and be persistent to call and confirm they are in network and accepting new patients. Medicaid can be a lot of work because the provider directories can be very wrong, but your health is worth being proactive about and an OBGYN will offer more in depth care and education than a PCP.
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u/Future-Ad4599 Jul 10 '25
I would find a PCP that accepts your plan. They will do the pap for you. It is true that if you have Medicaid, it's not legal for clinics to collect payment from you.
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u/paperairplane77 Jul 10 '25
Is there a Planned Parenthood near you? They're solid for basic GYN care, and they accept Medicaid.
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u/church-basement-lady Jul 11 '25
Everyone should have a primary care provider. Pick one, make an appointment to establish care. Whether the first visit or a follow up visit, they can do a PAP smear for you. See this person once a year for a basic checkup, because this way you stay on top of health screenings and also have someone to call when you have a concern.
There is no reason to see a specialist (OB-GYN) at this time. Just set up primary care.
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u/Coffee4Joey Jul 10 '25
OP please look up "FQHC" in your area. That would be a "federally qualified health center" who invariably will accept Medicaid. Other options would be your local planned parenthood and "women's clinic" in your area.
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u/Upstairs_Smile9846 Jul 11 '25
Second finding an FQHC. They are community health centers and are focused on care for underserved populations, especially those on Medicaid. They will help you with all your health needs including behavioral/mental health and dental. They will be your primary care medical home.
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u/grapefruit781 Jul 13 '25
Planned parenthood doesn’t accept medicaid anymore per trumps new bill. She can’t go there even for preventative stuff
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u/pathto250s Jul 10 '25
Do you only have medicaid or do you also have a separate plan sponsored by medicaid? (horizon, aetna etc varies state to state). Very few providers take straight medicaid. They are correct that it is illegal for them to accept payment from you. Get a PCP and then get a gyn referral. Your insurance website should have a list of providers
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u/Kwaliakwa Jul 10 '25
In most states, if you have Medicaid, they will assign you a PCP. You could get a pap through them. Medicaid will also cover women’s health screenings like Pap smears through a reproductive health care provider. Look through your insurance plans website, there’s usually a list on there.
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u/Obse55ive Jul 11 '25
I was on Medicaid for 14 years. Find a new PCP that's in network and they will order a pap smear with your annual physical exam. I just finally started making enough to not be on Medicaid anymore but the same thing holds true. If they find something off, they will let you know, I have a friend with history of HPV and she had to go get one every year. I just got mine done and I have always had normal results pretty much and get mine done every 3 years.
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u/BeingSad9300 Jul 11 '25
Medicaid usually assigns you a PCP if you don't pick one within X days of enrollment & I don't know if it's everywhere, but they allow you to change your PCP twice a year, I think.
I've never been the type to be comfortable shopping around, & the pcps I've had were all not at all a good fit. But I've had only 3 obgyns in 25yrs, all of whom I really liked, & I skipped straight to them. So yes, you can go without a referral. A PCP is good to have though, if you can find one you like.
I always thought the Medicaid rule was that if they accepted Medicaid, and a patient has Medicaid, then they cannot accept self-pay. But if they don't accept Medicaid, it's okay to self-pay.
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u/sloatn Jul 11 '25
You can get a pap done at your PCPs office once you find a new one, but not all PCPs will do paps so it’s important to ask and find out if they’ll do one in the office. You can also find an OB/GYN and have them do your pap instead.
If you call or go online you should be able to find a list of providers/clinics that accept Medicaid in your area and can use that as a starting point for finding a new PCP and OB/GYN
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u/Opportunity_Massive Jul 11 '25
I think it’s best to call a Ob/Gyn and get set up as a patient. It might take a couple of months to get your appointment, but it’s worth it. Just call around to different Gyn doctors to find one that takes your insurance and is accepting new patients. An Ob/Gyn doctor serves as a primary care doctor for a lot of the things that women need. You can also get set up with a primary care doctor whenever you have time. Do the same thing, find a doctor that takes your insurance and who is accepting new patients, and make an appointment to “establish care”. That way, if you ever get sick or develop a non-emergency health issue, you can call your doctor for an appointment instead of having to go to the urgent care.
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u/Gynetrix Jul 12 '25
Just as an FYI the American Cancer Society updated their guidelines and now recommends routine cervical cancer screening (pap and HPV testing) not begin until age 25
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u/Sinkinglifeboat Jul 13 '25
Find a GYN clinic that takes Medicaid or go to Planned Parenthood. No referral is required for GYN over 21.
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