PURPOSE

This is health coverage, available since February 2002, for California residents with a diagnosis of breast or cervical cancer who meet financial eligibility criteria.

HISTORY

Breast and Cervical Cancer Treatment Program (BCCTP) received national authorization through Medicaid in the year 2000. Each state is required to determine how its program will operate and when it will begin to provide coverage. The California program is administered by Medi-Cal and was authorized to begin coverage on January 1, 2002.

MEDICAL ELIGIBILITY

Medical eligibility for this program is based on individual's diagnosis of breast or cervical cancer and his or her being either underinsured or uninsured. Disability due to breast or cervical cancer is not a requirement for Medi-Cal’s BCCTP.

FINANCIAL ELIGIBILITY (as of 2006)

Asset Requirements

This eligibility category of Medi-Cal has set no asset limitation rules. An individual’s liquid assets (accessible money) and other property are not considered in determining eligibility for the program.

Income and Earnings

To qualify for Breast and Cervical Cancer Treatment Program (BCCTP), the sum of the individual’s monthly income can be up to $1,634 for an individual and $2,200 for a couple for 2006.

The figure $1,634 for an individual is calculating 200% of the monthly Federal Poverty Level ($817, as of 2006).

The figure $2,200 for a couple is calculating 200% of the monthly Federal Poverty Level ($1,100, as of 2006).

The individual is not responsible for any cost for this eligibility category of Medi-Cal.

REQUIRMENTS AND BENEFIT OVERVIEW

Two programs form this eligibility category of Medi-Cal: a State-Only Program and a Federal Program. Individuals may be eligible to enroll in one or both programs.

Note: if an individual is disabled, has a monthly coutable income (earned and unearned) of not more than $1,047 ($1,472 for a couple), and meets asset limitation criteria, he or she may be eligible for Medi-Cal coverage at no cost through the Age and Disabled eligibility category.

INTEGRATION

If an individual has other health coverage, Medi-Cal (in all eligibility categories) becomes the secondary payer. In this case the other health coverage must be used before Medi-Cal coverage is available to supplement that coverage.

Individuals who qualify for the State-Only Program and have private health insurance are eligible to have their premiums paid through Medi-Cal’s Health Insurance Premium Payment program (Medi-Cal/HIPP) when:

• health insurance premium, co-payment, and deductible costs total $750.00 or more annually and
• health insurance coverage is necessary to access cancer treatment.

APPLICATION

The processing of an application takes an average of 30 to 60 days from the application date.

Individuals without any other health coverage may apply for accelerated eligibility. Once approved, an Immediate Need Card is issued and medical coverage becomes available.

BCCTP applications are obtained through authorized providers who process the application online.

Authorized providers render screening services under the state’s existing Cancer Detection Section (CDS) programs which include:

• The Breast Cancer Early Detection Program (BCEDP) and
• The Breast and Cervical Cancer Control Program (BCCCP).

To find locations of authorized organizations call (800) 824-0088 (voice).

RETROACTIVE PAYMENTS

If an individual is eligible for the Federal Program, Medi-Cal can pay medical bills incurred up to three months prior to the application date.

ADDITIONAL INFORMATION

There are a limited number of doctors who accept new Medi-Cal patients. Treatment and prescription limitations may exist.

Medi-Cal does have the ability to recover costs from the estate of deceased individuals over age 55.

As an individual’s circumstances change, it is important to review the most cost effective eligibility category of Medi-Cal available. Here are five additional Medi-Cal eligibility categories:

1. SSI-linked Medi-Cal is medical coverage an individual automatically receives if he or she qualifies for a cash benefit from Supplemental Security Income (SSI) in a given month. When an individual receives no SSI cash benefit because of earnings, Medi-Cal coverage may continue under Social Security’s 1619(b) provisions.

2. Aged and Disabled Federal Poverty Level Medi-Cal is medical coverage for which an individual qualifies at no cost if his or her monthly countable unearned income and/or countable earned income is not more than $1,047 for an individual or $1,472 for a couple for 2006.

3. Medically Needy Medi-Cal is medical coverage for which an individual applies if his/her monthly countable unearned income and/or countable earned income is above SSI limits and the Aged and Disabled category of Medi-Cal. This coverage requires the individual to incur a monthly co-payment known as share of cost.

4. In-Home Supportive Services (IHSS) is a Medi-Cal program that provides personal assistance services an individual can use to live at home or maintain employment safely.

5. 250% California Working Disabled (CWD) program allows disabled workers to buy into Medi-Cal health coverage by paying a monthly premium.