Section 16.03.05.802 - WOMAN DIAGNOSED WITH BREAST OR CERVICAL CANCERA woman not otherwise eligible for Medicaid and meeting the conditions in Subsections 802.01 through 802.06 of this rule is eligible for Medicaid for the duration of her cancer treatment. Medicaid income and resource limits do not apply to this coverage group.
01.Diagnosis. The participant is diagnosed with breast or cervical cancer through the CDC's National Breast and Cervical Cancer Early Detection Program.02.Age. The participant is under age sixty-five (65).03.Creditable Health Insurance. The participant is uninsured or, if insured, the plan does not cover her type of cancer.04.Non-Financial Eligibility. The participant meets the Medicaid non-financial eligibility requirements in Sections 100 through 108 and Sections 166 and 167 of these rules.05.Medical Support Cooperation. The participant meets the medical support cooperation requirement in Sections 702 through 706 of these rules.06.Group Health Plan Enrollment. The participant meets the requirement to enroll in available cost-effective employer group health insurance.07.Presumptive Eligibility. The Department can presume the participant is eligible for Medicaid, before a formal Medicaid eligibility determination is made. A clinic authorized to screen for breast or cervical cancer by the National Breast and Cervical Cancer Early Detection Program makes the presumptive eligibility determination. The clinic tells the participant how to complete the formal Medicaid determination process. The Medicaid notice and hearing rights do not apply to presumptive eligibility. No overpayment occurs if the formal Medicaid determination finds the participant is not eligible.08.End of Treatment. The Department determines the end of treatment date under IDAPA 16.03.10, "Medicaid Enhanced Plan Benefits."Idaho Admin. Code r. 16.03.05.802