WOMEN’S CANCER SCREENING PROGRAM/ MEDICAID – TREATMENT

The Women’s Cancer Screening Program provides free breast and cervical cancer screening for RI residents who meet age, income and health insurance requirements.

Age: Women age 21-64 are eligible for services, with scope of services varying by age group.  Women age 65+ are not eligible for program services except for women who do not have Medicare Part B coverage. In addition, women of any age with symptoms suspicious for breast cancer or an abnormal finding on a clinical breast exam are eligible for breast services including diagnostic follow-up. And, women at high-risk for breast cancer may be eligible for screening with both an annual mammogram and an annual MRI.  See https://health.ri.gov/programs/womenscancerscreening/ for more details about age and scope of services.

Income: Income must be within 250% FPL (see below).

Insurance:  Must be uninsured or underinsured (health insurance does not provide annual screening for breast and cervical cancer).

TREATMENT – Special MEDICAID ELIGIBILITY

A woman who is uninsured may apply for Medicaid through the WCSP to cover the cost of treatment for a precancerous condition of the breast/cervix or a diagnosis of breast or cervical cancer. To qualify for Medicaid through WCSP, the woman must be:

  • A U.S citizen or eligible immigrant. Eligible immigrants include refugees.
  • A Rhode Island resident.
  • Have no other individual or group insurance.

A person who is applying for this special Medicaid coverage completes a one-page application for Medical Assistance at the WCSP provider site.*  The provider needs to complete a Verification of Medical Need for Treatment which is attached to the application. The application is mailed to the Department of Health which transmits it to the Center for Adult Health at the Department of Human Services. A decision of eligibility must be made within 30 days from the date the application was filed. If the application is denied, the woman has 30 days to file a written appeal. For more information contact the Women’s Cancer Screening Program.

Income Guidelines Women’s Cancer Screening Program (2021)

Family Size Monthly Income Annual Income
1  $2,683 $32,200
2  $3,629 $43,550
3  $4,575 $54,900
4  $5,521 $66,250
5  $6,467 $77,600
6  $7,413 $88,950

Note: Women age 19-64 who have income below 138% FPL ($1,481/$17,774) are otherwise eligible for Medicaid if they meet other program requirements, including eligible immigrant status. This access to Medicaid under this special category is only necessary for women with income above 138% and below 250% FPL.

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