5500 BREAST AND CERVICAL CANCER MEDICAID
The Center for Disease Control ( CDC ) and Prevention conducts the National Breast and Cervical Cancer Early Detection Program, which provides funding for breast and cervical cancer screening in all 50 states. To encourage women to seek treatment, Congress passed the Breast and Cervical Cancer Prevention and Treatment Act of 2000. This act authorizes states to provide Medicaid coverage to women who are diagnosed with cancer through participation in a CDC screening program. Alaska began using this optional Medicaid eligibility category on July 1, 2001.
5500 A. BCHC SCREENING
The Division of Public Health ( DPH ) operates and determines eligibility for the Breast and Cervical Health Check ( BCHC ) program to screen individuals in accordance with the national CDC criteria. This program uses 25 different health care providers in 15 communities throughout the state. There are also three tribal grantees that provide screening services:
Southcentral Foundation;
Southeast Alaska Regional Health Corporation; and
Arctic Slope Regional Health Corporation.
To be eligible for the BCHC program, a woman must:
Be age 18-64;
Be uninsured or have insurance that does not cover preventative screening services; and
Have income below 250% of the Federal Poverty Guideline for Alaska. DPH determines income eligibility for this program.
After a woman has been screened by the BCHC , she may apply for Medicaid by using the Gen 50B application form. Screened recipients may get the Gen 50B application from a public health center, the BCHC Program screener, a public assistance office, or fee agent. Medicaid applications for this eligibility category must be sent to:
Division of Public Assistance
Coastal Regional Office
Attention: Breast and Cervical Cancer Coordinator
3601 C Street, Suite 410
Anchorage, AK 99524-0249
To be eligible for this Medicaid category, an applicant must:
have been screened under the Alaska
BCHC
, or
CDC
National Breast and Cervical Cancer Early Detection program from another state, and determined to need treatment for breast or cervical cancer;
meet general Medicaid eligibility requirements of residency and assignment of rights;
be a U.S. citizen or qualified alien; and
not be eligible for any other Medicaid category.
The Breast and Cervical Cancer Medicaid category does not have a separate financial eligibility test beyond what was already required for eligibility under the BCHC screening program.
Although men may also get breast cancer, they are not included in the CDC screening program and, therefore, are not eligible for this Medicaid category.
A woman may remain eligible for this Medicaid category as long as she is undergoing treatment for breast, cervical, or a directly related cancer. The woman's treating health care provider and QUALIS Health work together to determine when her course of treatment is considered to have ended. When her treatment ends, her Medicaid eligibility under this category also ends.
Comprehensive Medicaid coverage is available to a woman eligible under the Breast and Cervical Cancer category. Services are not restricted to cancer-related services.
Coverage may include home and community based services if the recipient meets the requirements of the Adults with Physical Disabilities waiver. See Aged, Disabled and Long Term Care Medicaid Manual Section 560. For recipients who appear financially eligible for APA-related or Long Term Care Medicaid, the caseworker should recommend, but cannot require that she pursue a disability determination so that when treatment ends and eligibility has ended under the BCC category, the woman can be transitioned to those Medicaid eligibility categories.
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