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2012 Texas Medicaid Provider Procedures Manual

Volume 1, General Information : Section 4: Client Eligibility : 4.10 Medicaid for Breast and Cervical Cancer (MBCC) : 4.10.2 MBCC Program Eligibility

To be eligible for MBCC, a woman must be diagnosed and in need of treatment for one of the following biopsy-confirmed breast or cervical cancer diagnoses:
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.
After a woman has received an eligible breast or cervical cancer diagnosis from a provider, a BCCS provider must review her diagnosis to help determine her eligibility for MBCC. Once a BCCS provider has reviewed the diagnosis, her application is sent to HHSC to determine eligibility for the program. The client cannot apply for MBCC at an HHSC benefits office.
In addition to having received an eligible diagnosis, a woman must meet the following criteria to qualify for benefits:
A woman who is eligible to receive Texas Medicaid under MBCC receives full Medicaid benefits beginning the day after she received a qualifying diagnosis and for the duration of her cancer treatment. Services are not limited to the treatment of breast and cervical cancer.

Texas Medicaid & Healthcare Partnership
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