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This category is identified in IEDSS as MA E.

Individuals may be eligible under this category when family planning services are requested. There is no age requirement. Income standards are based on 141% of the Federal Poverty Level and there are no resource requirements. 1621.00.00 BREAST AND CERVICAL CANCER TREATMENT SERVICES Breast and Cervical Cancer Treatment Program (ISDH): In Indiana, the Breast and Cervical Cancer Treatment program (BCCP) is administered by the State Department of Health. To be eligible, an individual must be screened and found to need treatment for breast or cervical cancer by the BCCP and have income equal to or less than 200% of the Federal Poverty Level (FPL). The Indiana Breast and Cervical Cancer Program provides access to breast and cervical cancer screenings, diagnostic testing, and treatment for underserved and underinsured women who qualify for services and meet all other Medicaid requirements. Eligibility includes:

• Indiana resident • Uninsured or underinsured • Insured with unmet deductible • 30 - 49 years of age (for office visit, clinical breast exam, and Pap smear) • 50 - 64 years of age (for office visit, clinical breast exam, Pap smear, and mammogram) • 65 years of age and older if not enrolled in Medicare Part B • At or below 200% of the FPL

BCCP Option 3 (MA 12): Alternatively, an individual can receive full Medicaid benefits and coverage for treatment under the BCCP Option 3 program, which is identified as the Medicaid category MA 12. To be eligible, an applicant must be diagnosed with breast or cervical cancer and referred to FSSA through ISDH, and meet the following criteria:

• Indiana resident • At least 18 years old but not over 64 years old • Has income at or below 200% of the FPL • Is not eligible for Medicaid under any other category and is not enrolled in Medicare • Is uninsured or underinsured (cancer treatment not covered).

The effective date of coverage is based on dates of application and diagnosis. Example 1: Application received 5/15/2020 with a diagnosis date of 4/15/2020. Effective date of coverage should be 4/1/2020.

Example 2: Application received 5/15/2020 with a diagnosis date of 12/15/2019. The effective date of coverage should be 2/1/2020. (It cannot go beyond 90 days prior to application month.) For information on screening through BCCP and referrals for BCCP Option 3, see the ISDH website at: https://www.in.gov/health/cdpc/cancer/early-detection/