Low-income, uninsured women diagnosed with breast or cervical cancer who are in need of treatment may qualify for medical assistance through Medicaid for Breast and Cervical Cancer (MBCC). The Texas Department of State Health Services (DSHS) Breast and Cervical Cancer Services (BCCS) program determines eligibility criteria for MBCC.
Texas Breast and Cervical Cancer MBCC Facts
On October 24, 2000, the Breast and Cervical Cancer Prevention and Treatment Act of 2000 was signed into law. This Act gives states the option to provide Medicaid medical assistance to women who were screened through the Centers for Disease Control and Prevention's (CDC) Breast and Cervical Cancer Early Detection Program (NBCCEDP) and found to have breast or cervical cancer.
In January 2007, Congress reauthorized NBCCEDP to provide women with low-cost screening and diagnostic services for breast and cervical cancer.
In 2002, Texas began providing Medicaid to women who are diagnosed with breast or cervical cancer by a DSHS BCCS program contractor. Most recently, the 80th Texas Legislature passed Senate Bill 10 that allows any health care provider to refer eligible women in need of treatment for breast or cervical cancer to Medicaid.
Beginning September 1, 2007, any woman diagnosed with breast or cervical cancer who meets all eligibility requirements, as determined by DSHS BCCS policy for Medicaid for Breast and Cervical Cancer, may receive services.
To be eligible for MBCC, a woman must be:
- Diagnosed and in need of treatment for one of the following biopsy-confirmed definitive breast or cervical diagnoses: CIN III, severe cervical dysplasia, cervical carcinoma in-situ, invasive cervical cancer, ductal carcinoma in situ or invasive breast cancer, as defined by BCCS policy; and
- Have family gross income at or below 200% of the Federal Poverty Income Guidelines, as defined by BCCS policy; and (see Table at: www.dshs.state.tx.us/bcccs/eligibility.shtm#income.)
- Uninsured, that is, she must not otherwise have creditable coverage (including current enrollment in Medicaid); and
- Under age 65; and
- A Texas resident; and
- A U.S. citizen or qualified alien.
- Contact a BCCS contractor in your area, visit the BCCS Clinic Locator.
- A BCCS contractor will screen for eligibility and if applicable complete the Medicaid Medical Assistance Application (form 1034). The BCCS contractor will review and collect required documentation of eligibility.
- DSHS will verify the patient’s qualifying diagnosis and send Form 1034 to HHSC.
- HHSC Centralized Benefits Services makes the final Medicaid eligibility determination.
- A woman is entitled to full Medicaid coverage beginning on the day after the date of diagnosis (services are not limited to the treatment of breast and cervical cancer).
- Medicaid eligibility continues as long as the Medicaid Treatment provider certifies that the woman requires active treatment for breast or cervical cancer.
- Should a woman have a recurrent breast or cervical cancer, the BCCS contractor must reapply for the woman to be eligible for Medicaid.
- For the location of a BCCS contractor in your area, call 2-1-1 or visit the BCCS Clinic Locator.
- Contact the Health and Human Services Commission by dialing 2-1-1 concerning questions and or information regarding Medicaid eligibility and enrollment.
- Additional information may be obtained through the Centers for Medicare and Medicaid Services (CMS) at: www.cms.gov .