X-940, New State Residents

Revision 13-4; Effective October 1, 2013

If a woman is screened in another state through the CDC’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and moves to Texas, she may be eligible for MBCC in Texas. If a woman meets the MBCC eligibility criteria in Texas, her screening in another state does not prohibit her from receiving MBCC in Texas.

A new state resident requests MBCC in Texas by contacting 2-1-1. Form H2340-OS, Medicaid for Breast and Cervical Cancer, is mailed to the woman for her to complete and return.

Upon receipt of Form H2340-OS, CBS determines the woman’s eligibility for MBCC. Staff must verify with the losing state the woman’s screening under NBCCEDP and termination of any Medicaid benefits received in that state, if any, before certification. Use Form H1550, Out of State NBCCEDP Verification, to verify the applicants screening and diagnosis.

Related Policy

New Texas Residents, A-720
Medicaid Coverage for New State Residents, A-822