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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M03 April 2024 Subchapter Subject Page ending with Page M0330.000 FAMILIES & CHILDREN GROUPS M0330.700 27

• LIFC; • Pregnant Women; • Child Under Age 19; • SSI recipients. • Former Foster Care 2. Creditable Health Insurance Coverage BCCPTA individuals must not have creditable health insurance coverage. Creditable health insurance coverage includes: • a group health plan; • health insurance coverage under any hospital or medical service policy or certificate, hospital or medical service plan contract or health maintenance organization contract offered by a health insurance issuer; • Medicare; • Medicaid; • armed forces insurance a medical care program of the Indian Health Service (IHS) or of a tribal organization; • a state health risk pool. There may be situations where an individual has creditable health insurance coverage as defined above, but the coverage does not include treatment of breast or cervical cancer due to a period of exclusion or exhaustion of lifetime benefits, or the woman may have a high deductible. The individual is not eligible for Medicaid in the BCCPTA covered group because of the creditable health insurance. C. Financial Eligibility There are no Medicaid financial requirements for the BCCPTA covered group. The BCCEDP has income and resource requirements that are used to screen individuals for this program. Individuals requesting Medicaid coverage of LTC services must provide verification of their resources and income and must meet all the LTC eligibility requirements in chapter M14. D. Application Procedures The application procedures for individuals who meet the BCCPTA non- financial requirements have been streamlined to facilitate the prompt enrollment and immediate access to services for individuals who are in need of treatment for breast or cervical cancer. In addition to the nonfinancial information required to evaluate eligibility in the BCCPTA covered group, the following information is needed for enrollment in Medicaid: • name, • address, • sex and race, • date of birth, • country of origin and entry date, if an alien. Individuals who meet the description of individuals in the LIFC, Pregnant Women, Child Under Age 19, or SSI recipients covered groups must complete the appropriate MA application for the covered group and must have an MA eligibility determination completed prior to determining their eligibility in the BCCPTA covered group. If not eligible in a mandatory coverage group,