WVBCCSP Eligibility for Screening Services: Effective 6/30/2012

Effective June 30, 2012, a woman MUST be a West Virginia resident to be eligible for services to be reimbursed by the WVBCCSP. The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) administered by the Centers for Disease Control (CDC) experienced budget cuts for the 2012-13 grant year that decreased the funds available to the grantees including the West Virginia Program. In order to maintain the quality breast and cervical screening services currently available to eligible West Virginia women, the WVBCCSP will no longer be reimbursing for any screening or diagnostic services for women who do not reside in West Virginia beginning with the 2012-13 grant year that starts on June 30, 2012. There will be no exceptions for out of state women who have previously been screened with WVBCCSP funds. There will be no “grand-mothering” a woman for WVBCCSP eligibility. This includes any women enrolled in the West Virginia WISEWOMAN Program. Please contact WVBCCSP/WISEWOMAN staff at 304-558-5388 if you have questions about eligibility.

Due to the fact each federally funded NBCCEDP grantee determines their own eligibility guidelines, you or the woman should contact her state NBCCEDP funded program to see if she can receive services in her home state. Do not assume a woman who has been eligible for WVBCCSP will be eligible for the NBCCEDP in their state. Contact information for the states that border West Virginia are listed below:

PENNSYLVANIA:

Healthy Woman Program Pennsylvania Department of Health Room 1011 Health and Welfare Building Harrisburg, PA 17120 1 (800) 215-7494 Fax: (717) 772-0608

OHIO

Breast and Cervical Cancer Project Ohio Department of Health 246 North High Street Columbus, OH 43215 1 (800) 4-CANCER (614) 728-2177 Fax: (614) 564-2409

Patient Eligibility for Screening Services:

  • 25-64 years of age
  • West Virginia resident- female
  • Income at or below 200% of the current Federal Poverty Level
  • Uninsured

OR

  • Underinsured
  • Medical insurance does not cover WVBCCSP screening services

OR

  • Has an unmet deductible or a required co-payment causing hardship for services covered by WVBCCSP

Follow—Up to Post—Hysterectomy
Pap Test

  • WVBCCSP will reimburse for a Pap test as part of the initial exam, which allows the provider to determine if the woman has a cervix post-hysterectomy. If the woman does not have a cervix, the initial exam Pap test result is abnormal, and the hysterectomy was not due to cervical dysplasia, WVBCCSP will NOT reimburse for a colposcopy.

Screening Mammogram Eligibility

  • 50-64 years of age
  • 40-49 years of age with a documented *high risk factor
  • No one under 40 years is eligible for a WVBCCSP funded screening mammogram

*High Risk Factors (for Screening Mammogram Eligibility)

  • Personal history of breast cancer
  • Family history of breast cancer
  • Never had children
  • First child born after age 30
  • Abnormal breast biopsy result

Please note: a previous breast biopsy is not a high risk factor.

WVBCCSP Colposcopy Eligibility
For 18—24 Year Olds
Pap results within previous 6 months:

  • ACS-H
  • HSIL
  • AGC
  • Adenocarcinoma
  • Squamous Cell Carcinoma