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West Virginia Income Maintenance Manual Chapter 1

West Virginia Income Maintenance Manual Page 207 Chapter 1 Application/Redetermination Process

1.24 BREAST AND CERVICAL CANCER MEDICAID COVERAGE GROUP (BCC) APPLICATION PROCESS 1.24.1 APPLICATION PROCESS To be eligible for Breast and Cervical Medicaid (BCC), the client must: • Be enrolled in the West Virginia Breast and Cervical Cancer Screening Program (WVBCCSP) through the office of Maternal, Child and Family Health (OMCFH) and the Center for Disease Control (CDC). • Be diagnosed with breast or cervical cancer or certain pre-cancerous conditions and actively receiving cancer treatment. • Be a woman under age 65 who is not receiving Medicare benefits. • Be uninsured or under-insured or otherwise lacking creditable medical coverage. o IMM Chapter 22, Appendix A identifies the different types of insurance benefits that will affect BCC eligibility and the types of insurance that a client can have while still having BCC Medicaid. • Not be eligible for a mandatory Medicaid coverage group.

The application process must be completed in the following order: • Before a client can be approved for BCC Medicaid, they must be an active participant in the WVBCCSP. To enroll in WVBCCSP, the client must: o Contact a WVBCCSP Screening Provider who will determine eligibility for WVBCCSP, assist the client with the completion of the DFA-BCC-1, and provide a blank CDC Certificate of Diagnosis for the client’s treating physician to fill out and sign. o The Screening Provider will fax the completed DFA-BCC-1 to WVBCCSP who will verify current enrollment in their program. The client’s treating physician will fax the completed CDC Certificate of Diagnosis to WVBCCSP. o WVBCCSP will then forward the DFA-BCC-1, CDC Certificate of Diagnosis and a Letter of Eligibility stating that the client is enrolled in WVBCCSP to the client’s local DOHS Office.

• Once the Worker receives the DFA-BCC-1, CDC Certificate of Diagnosis, and the Letter of Eligibility from WVBCCSP, the Worker must enroll the client into the Presumptive