WAG 06-20-04

The BCC Eligibility Unit is responsible for maintaining active BCC cases.

REDETERMINATIONS

revised textBCC participants receive certification periods that are based on their diagnosis. The BCC certification periods are:

  • new text3 months for precancerous conditions ,
  • new text6 months for cervical cancer, and 
  • new text12 months for breast cancer or recurrent metastasized cancer.

new textNote: If an initial BCC application is approved and certified too late for IES to automatically generate the 3 or 6 month REDE, the worker must initiate the REDE manually as soon as the EDG is certified.

Review the following eligibility factors at REDE:

  • age,
  • insurance (including Medicare),
  • residency, and
  • currently receiving treatment for breast or cervical cancer.

A person determined eligible will not lose eligibility due to income changes. A person can lose eligibility only for nonfinancial reasons.

Eligibility for BCC ends when:

  • the need for treatment for breast, cervical, or a related cancer no longer exist, 
  • the person reaches 65 years of age,
  • is no longer an Illinois resident, or
  • becomes covered by qualifying insurance (including Medicare).

BUREAU OF COLLECTIONS DISCOVERS HI-LEVEL TPL

The HFS Bureau of Collections notifies the BCC Eligibility Unit when they discover that a BCC client has Hi-Level TPL (codes A-E).  The BCC Eligibility Unit determines whether the case meets eligibility criteria (see PM 06-20-02).

ADMISSION TO A LONG TERM CARE FACILITY

If the FCRC receives screening or physician certification documents for a person who has an active Local Office 189 case, contact the HFS Bureau of Medical Eligibility Policy for Guidance.