To be eligible for BCCT, a woman must be uninsured. Health insurance is defined as insurance that minimally provides coverage for physician’s services and hospitalization. It must also cover breast and cervical cancer treatment. There is no penalty or waiting period for dropping insurance.
Health insurance does not have to cover all medical conditions (such as pre-existing conditions) to cause ineligibility for BCCT, however it must cover breast and cervical cancer treatment services. A woman with insurance that does not cover breast or cervical cancer treatment is considered uninsured.
The term “health insurance” does not include short-term, accident, fixed indemnity, limited benefit or credit insurance, coverage issued as a supplement to liability insurance, insurance arising out of a worker’s compensation or similar law, automobile medical payment insurance, or insurance under which benefits are payable with or without regard to fault and which is statutorily required to be contained in any liability insurance policy or equivalent self insurance.
Women who have exceeded a lifetime maximum for all benefits under their health plan are considered uninsured. If a woman has exceeded an annual maximum or the maximum for one particular service (other than breast or cervical cancer), she is considered insured. The applicant must provide documentation they have reached their lifetime maximum for all benefits.