PM 06-20-02: BCC Eligibility Criteria

Financial Criteria

All income and assets are exempt under this program.

Nonfinancial Criteria

Medical Criteria

An applicant must be diagnosed by a medical provider and found to be in need of treatment for breast or cervical cancer, or one of the precancerous cervical conditions listed below, as supported by a pathology report. A person must continue to meet this medical criteria to remain eligible:

  • Cervical Intraepithelial Neoplasia, grade III (CIN III);
  • Severe dysplasia of the cervix;
  • High-Grade Squamous Intraepithelial Lesion (HGSIL); or
  • Atypical Glandular Cells (AGC) with a suspicion of adenocarcinoma in situ.

Additional Nonfinancial Criteria

To qualify for this program a person must also meet the following requirements:

  • is an Illinois resident;
  • is under the age of 65;
  • is uninsured (see insurance coverage exceptions below);
  • meets citizen or immigration requirements per PM 03-01-00;
  • comply with Social Security Number policy per PM 03-11-00; and
  • is not eligible for another HFS medical program (revised textother than the *ACA Adult program).

new text*Note: A BCC application received from the Illinois Breast and Cervical Cancer Program (IBCCP) may be approved for BCC benefits even if the individual is otherwise eligible for the ACA Adult program. At redetermination, the individual may continue to receive BCC benefits as long as they meet all other program criteria.

Insurance Coverage Exceptions

A person with medical insurance may be eligible for this program under one of the following conditions:

  • insurance coverage is limited (for example, it covers only dental, vision, long term care or a specified disease or illness);
  • the lifetime benefits cap has been met or exceeded;
  • plan excludes coverage for breast or cervical cancer or precancerous conditions; or
  • the person is an American Indian or Alaska Native whose coverage is provided by a medical care program of the Indian Health Service or a tribal organization.