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Louisiana Medicaid Eligibility Manual Eligibility Determinations

Reissued Feburary 13, 2025

Page 1 of H-1400 Replacing November 22, 2022

Revised/added text indicated by underscore

Deleted text indicated by “**”

H-1400 BREAST AND CERVICAL CANCER (BCC) PROGRAM H-1410 GENERAL INFORMATION

The Breast and Cervical Cancer (BCC) Program provides full Medicaid benefits to uninsured women under age 65 who are identified through the Centers for Disease Control and Prevention’s (CDC) National Breast and Cervical Cancer Early Detection Program and are in need of treatment for breast and/or cervical cancer, including pre-cancerous conditions and early stage cancer.

An applicant/beneficiary may be eligible for Medicaid services under the BCC program if she: • Is under the age of 65; • Has been screened for breast and/or cervical cancer under the Louisiana Breast and Cervical Health Program (LBCHP) and found to “need treatment” for breast and/or cervical cancer (including a precancerous condition). A list of LBCHP partner providers can be found here: LBCHP providers.; Note: For purposes of the BCC program, “need treatment” means in the opinion of the applicant’s/beneficiary’s treating physician, the diagnostic test(s) following a breast and/or cervical cancer screen indicates she is in need of cancer treatment services. Cancer treatment services include diagnostic procedures necessary to determine the extent and proper course of treatment, as well as definitive cancer treatment itself. Based on the physician’s plan-of-care, women who require only routine monitoring services for a precancerous breast or cervical condition (e.g., breast examinations and mammograms) are not considered to “need treatment.” • Is not enrolled in Medicaid under any other mandatory eligibility group; and • Does not have creditable health insurance (Refer to I-2200 Creditable Health Insurance). If the applicant/beneficiary has health insurance coverage, she may be considered uninsured if: - The treatment of breast and/or cervical cancer is not covered by the plan,