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4.7 Medicaid for Breast and Cervical Cancer (MBCC)
Through MBCC, the state of Texas provides Medicaid benefits to eligible women who were screened through the Centers for Disease Control and Prevention's (CDC) National Breast and Cervical Cancer Early Detection Program and found to need treatment for breast or cervical cancer, including precancerous conditions.
DSHS receives the CDC funds and awards these funds to providers across the state to perform breast and cervical cancer screenings and diagnostic services under the Breast and Cervical Cancer Services (BCCS) program.
Any provider can diagnose a woman for breast or cervical cancer so that she may be eligible for Medicaid through MBCC.
After a woman has received an eligible breast or cervical cancer diagnosis from a provider, she must go to a DSHS contracted provider that has received federal CDC grant funds for BCCS so that her diagnosis can be reviewed to determine her eligibility for MBCC and enroll her in the program.
In order to be eligible for MBCC, a woman must be diagnosed and in need of treatment for one of the following biopsy-confirmed definitive breast or cervical cancer diagnoses:
• CIN III
•Severe cervical dysplasia
•Cervical carcinoma in situ
•Primary cervical cancer
•Ductal carcinoma in situ
•Primary breast cancer
In addition, a woman may be eligible for MBCC with a diagnosis of metastatic or recurrent breast or cervical cancer and a need for treatment.
In addition to the diagnosis listed above, a woman must meet the following criteria to qualify for benefits:
•A household income at or below 200 percent of the federal poverty level
•64 years of age or younger
•U.S. citizen or eligible immigrant
•Uninsured or otherwise not eligible for Medicaid
Women eligible to receive Texas Medicaid under MBCC receive full Medicaid benefits beginning the day after she received a qualifying diagnosis and for the duration of her cancer treatment. She can continue to receive Medicaid benefits as long as she meets the eligibility criteria and provides proof that she is receiving active treatment for breast or cervical cancer. Services are not limited to the treatment of breast and cervical cancer.
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