Eligibility Online Manual

M1301 Breast & Cervical


Purpose: This section will provide basic information on the Breast & Cervical Cancer Treatment program.


Current Policy Effective Date: September 1, 2017

Date Last Reviewed: October 30, 2017

Previous Policy: September 1, 2016

POL M1301: BREAST & CERVICAL

1. Breast and Cervical Cancer Early Detection Program

The Department of Health, Prevention and Health Promotion Unit Division, screens applicants for assistance under the Wyoming Breast and Cervical Cancer Early Detection Program (WBCCEDP). This program provides access to breast and cervical cancer screening services.

Refer questions about the WBCCEDP to the Department of Health, Prevention and Health Promotion Unit Division at 1-800-264-1296.

Applicants, who are financially eligible and identified to be in need of treatment by WBCCEDP, are referred to the Medicaid Customer Service Center to determine eligibility for the Breast and Cervical Cancer Treatment program.

2. Applicants Must Meet Basic Eligibility Factors

Refer to Section M600 for a description of all basic eligibility factors.

3. Applicants Must Meet Income Requirements

Countable family income must be less than or equal to 250% of FPL. Refer to Medicaid Table 1. Refer to Table 2A to determine if income is countable.

4. Applicants Must Be Under The Age of 65

5. Applicants Must Not Be Eligible for Medicaid and Must Have No Health Insurance

6. Benefits Begin First Month of Eligibility

7. Applicants May Be Eligible For Retroactive Medicaid

Applicants may receive retroactive Medicaid benefits if they incurred medical bills and would have been eligible during any of the three months prior to the month of application.

Retroactive benefits may not be authorized prior to the month of the biopsy.

8. Clients Must Be Reviewed

Clients must be periodically reviewed every 12 months to determine continued eligibility.

Clients must provide verification of income and need for continued breast or cervical cancer treatment.

9. Clients May Lose Benefits

The case will close on the first day of the next month when any of the following occur:

    • Client does not complete review.

    • Client obtains other insurance.

    • Client enters a public institution, excluding the Geriatric Hall at the State Hospital in Evanston.

    • Client dies.

    • Client is no longer receiving treatment.

    • Client moves out of state.

    • Client turns 65.

    • Client determined no longer eligible.

Reference:

Defining Group: Social Security Act § 1902(a)(10)(A)(ii)(xviii)

Clarifying Information:

Worker Responsibilities:

A referral from the Wyoming Breast and Cervical Cancer Program is required

1. Check to see if a referral has been received by the Wyoming Breast and Cervical Cancer Early Detection Program. This is a requirement before authorizing any applicant for the Breast and Cervical Cancer Treatment Program.