Effective January 1, 2004, women who are diagnosed with breast or cervical cancer through DPH's women's health network and who are un- or underinsured with incomes at or below 250% FPL may be eligible for MassHealth Standard through the PCC plan for the duration of their treatment. Those who don't meet citizenship criteria (non "Qualified" or undocu-mented) may be eligible for MassHealth Limited. To enroll, the applicant must apply with a special BCCTP (Breast and Cervical Cancer Treatment Program) form, available through the women's health network provider (WHN). MGH Community Health Associates is a collaborative of 14 community healthcenters, (6 MGH and 8 non MGH health centers) who provide services under the WHN program.

Included as un- or underinsured are those women who are in an exclusion period for treatment of breast or cervical cancer, have exhausted lifetime limit on all plan benefits, have limited-scope coverage or coverage only for a specified disease, and American Indian or Alaskan natives who are provided care through a medicalcare program of the Indian Health Service or tribal organization.

Other eligibility criteria-

• Women under age 65
• In need of treatment for breast or cervical cancer including precancerous conditions or early stage cancer*
• Income at or below 250% FPL ($1,871 month for an individual)
• Not otherwise eligible for MassHealth Standard
• Meet other MassHealth eligibility requirements (such as citizenship** and residency requirements).

If eligible, coverage is retroactive to 10 calendar days before the date DMA gets application (if application is complete within 60 days). Coverage lasts as long as the member remains in cancer treatment.

Care must be provided through the MassHealth Primary Care Clinician plan. Co-pays will apply. If income is above 133% FPL ($996 a month maximum for an individual) the member may be charged a monthly premium as well. Monthly premiums range from 0 for those at or below 133% of FPL to $72 for those between 240.1% and 250% of FPL. The full income eligibility and premium chart is available by request from the CRC and will be posted on the CRC section of the department's webpage.

**Immigrants who aren't in the "Qualified" category or are undocumented will be eligible for MassHealth Limited. DMA is currently training WHN staff that this means that though they will be eligible through this category for MassHealth Limited, that they will NOT be able to access cancer treatment through Limited. Limited only covers "emergency" treatment. As a result of a recent lawsuit filed by the Mass. Law Reform Institute (MLRI), the definition of "emergency" was recently clarified to include chronic dialysis. What, if any, cancer treatment should be considered an "emergency" is one of the issues that MLRI is exploring and hopes to have resolved in the coming months. If anyone has a case that would be appropriate to share for advocacy purposes, or knows a cancer specialist who would like to work with MLRI on this, please contact Ellen Forman for MLRI contact information.

BCCTP is a national program with each state enhancing and running it as they decide. The federal government passed the treatment act 4 years ago, but left it up to each state to implement it as they chose. Massachusetts is the very last state in the nation to finally enact it. However, Massachusetts obtained a waiver and added some strings to the program, such as a sliding scale fee and premiums.

The DPH Women's Health Network can be reached at 877-414-4447 (TTY 617-624-5992).

-Thanks to Eileen Manning RN, BS, Clinical Director, Dana Farber/PartnersCancerCare Breast & Cervical Screening Collaborative, for writing part of this article.