Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 3
Subtitle 14 - CANCER CONTROL
Chapter 10.14.04 - Breast Cancer Program
Section 10.14.04.04 - Eligibility-Breast and Cervical Cancer Program
Universal Citation: MD Code Reg 10.14.04.04
Current through Register Vol. 51, No. 19, September 20, 2024
A. To be eligible to receive breast cancer services under this chapter through the Breast and Cervical Cancer Program, an applicant shall:
(1) Be a resident of
Maryland;
(2) Be 40 years old or
older;
(3) Meet the financial
eligibility criteria specified in §B of this regulation;
(4) Meet the health insurance criteria
specified in §C of this regulation; and
(5) Be determined to be eligible to receive
covered services by a:
(a) Local health
department or an agency or organization designated by the local health
department; or
(b) Private entity
that contracts with the Department to render services in Baltimore City or
Calvert County.
B. Financial Eligibility Criteria.
(1) Financial eligibility under this chapter
is based on annual gross income and family size.
(2) To be financially eligible to receive
breast cancer services under this chapter through the Breast and Cervical
Cancer Program, an applicant may not have an annual gross income that exceeds
250 percent of the most recent federal poverty guidelines updated annually in
the Federal Register by the United States Department of Health and Human
Services in accordance with 42 U.S.C. § 9902(2).
(3) For the purposes of determining family
size under the federal poverty guidelines set forth at §B(2) of this
regulation, the following individuals are family members of the applicant:
(a) The applicant;
(b) The applicant's spouse;
(c) The applicant's financially dependent
children; and
(d) The applicant's
financially dependent relatives.
C. To be eligible to receive breast cancer services under this chapter through the Breast and Cervical Cancer Program, an applicant shall meet one of the following health insurance criteria:
(1) The applicant is not currently covered by
health insurance; or
(2)The
applicant is currently covered by health insurance that:
(a) Does not provide reimbursement for a
service covered under this chapter; or
(b) Requires the applicant to pay a co-pay,
co-insurance, or a deductible that has not been met for a service covered under
this chapter.
D. An applicant may not receive breast cancer services under this chapter through the Breast and Cervical Cancer Program if:
(1) The applicant is enrolled in Medical
Assistance; or
(2) The applicant is
enrolled in a health maintenance organization
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