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Title 8: Medicaid Page 23 Iowa Department of Health and Human Services Employees’ Manual Chapter F: Coverage Groups Breast and Cervical Cancer Treatment Revised February 28, 2025 Responsibilities of the Client An individual eligible for Medicaid under BCCT is not required to report:  Income changes  Resource changes  Household composition changes  Turning age 65 (It is the responsibility of DHS to track this and act on it.) Annual Review Legal reference: 42 CFR 435.916; 441 IAC 76.7(249A) At the annual review, determine whether the individual continues to:  Be in need of treatment. (Verify through the treating physician.)  Be ineligible for a mandatory coverage group.  Lack creditable health insurance coverage. (See Health Insurance Changes.)  Be under age 65. An individual remains eligible the entire month of the individual’s birthday, unless the birthday is on the first day of the month.

1. Ms. K is diagnosed with breast cancer and applies for Medicaid in June 2009. Ms. K’s 16-year-old son lives with her. The worker determines that, due to family income, Ms. K would only be conditionally eligible for Medically Needy with a spenddown. Medicaid eligibility for Ms. K is established under BCCT effective June 1, 2009. When conducting the annual review in May 2010, the worker requests information about family income and household composition. The worker determines that the household composition is the same and the family income continues to make Ms. K only conditionally eligible for Medically Needy with a spenddown. Since Ms. K is under age 65, does not have creditable health insurance coverage, and continues to receive treatment, her eligibility under BCCT continues.