Page 2

Countable income must be at or below 250% FPL. Income is self-attested. CREDITABLE COVERAGE: Individuals applying for Medicaid under the MBCCTP cannot have health insurance or other coverage that will pay for breast and/or cervical cancer treatment and meets the definition of ‘creditable coverage’. The deductible amount (such as $5,000 or more) does not change the determination; if the policy covers treatment and is considered creditable coverage, the individual is not eligible for the MBCCTP.

*Indian Health Service coverage is not considered creditable coverage for the BCC program. COVERAGE LENGTH: MBCCTP Medicaid coverage continues until the earlier of: 1. Cancer treatment is completed; or NOTE: Follow-up screenings are NOT considered treatment, and BCC Medicaid cannot remain open to cover follow-up. 2. The month prior to the individual’s 65th birthday, whether or not treatment is completed; Other factors that cause BCC Medicaid to close are when the individual: 1. Obtains creditable coverage; or 2. Fails to comply with any MBCCTP requirement, including renewal. RETROACTIVE COVERAGE: Up to three months of retroactive MBCCTP coverage is available to eligible individuals. Retroactive months are based on application date and cannot be opened prior to the month of diagnosis. SEE BUSINESS PROCESS: Montana Breast and Cervical Cancer Effective Date: November 03, 2018 Revised Date: May 2, 2024