Breast & Cervical Cancer Control Navigation Program (BC3NP)

Are you worried that you can't afford your mammogram or Pap test? Or even worse — are you worried you can't afford the follow-up care? If you are 21-64 years old (for cervical cancer screening) or 40-64 years old (for breast cancer screening), a resident of Michigan, and within the income guidelines below, call your local Breast and Cervical Cancer Control Navigation Program to see how we can help you.

Check eligibility and find a local coordinating agency

Cancer Treatment

In the event of a diagnosis of breast or cervical cancer through the BC3NP, a woman may be eligible for Medicaid coverage. If eligible, Medicaid will pay for all of her medical expenses for as long as she is being treated for the cancer. Once treatment is no longer needed, the woman is then potentially eligible (once again, based upon age and income) for continued annual screening services through the BC3NP.

A woman remains eligible for Medicaid coverage until:

• Her health professional deems the woman is free from cancer and will not require continued cancer therapy or
• She no longer meets the eligibility criteria for this program (e.g., she has obtained creditable insurance coverage, has reached the age of 65 and has Medicare Part B, or has an income that exceeds 250 percent of the federal poverty level (FPL)).

Note: Women who are undocumented, although eligible for BC3NP services, cannot receive Medicaid coverage. Federal law limits Medicaid coverage to citizens and documented women.

The BC3NP is a federal program funded by the Centers for Disease Control and Prevention (CDC) and is administered by the Michigan Department of Health and Human Services.

Those who are eligible for the BC3NP include women; transgender or gender nonconforming (taken from CDC guidance), who are uninsured or underinsured, at or below 250% of the federal poverty guidelines, ages 40 to 64 years for breast cancer services and ages 21 to 64 years for cervical cancer services.  

Eligible clients who will benefit from this program include those who are at increased risk of breast and/or cervical cancer and who need preventive health screenings as part of their wellness routine.

Who Is Eligible?

The following information MUST be determined PRIOR to enrolling women in BC3NP.

1. Income:
• at or below 250% of the federal poverty guidelines (See below.)
• No Cost Breast & Cervical Cancer Services Available for Women
  •  2024 MDHHS English BC3NP Flyer 
  •  2024 MDHHS Arabic BC3NP Flyer
  • 2024 MDHHS Spanish BC3NP Flyer
2. Age:
   • 21-64 and requiring cervical screening/diagnostic/treatment services, and/or
   • 40-64 and requiring breast screening/diagnostic/treatment services
                OR 21-64 and referred to BC3NP with an abnormal screening Pap test
                OR clinical breast exam which requires breast/cervical diagnostic services
     
     
3. Residency and Citizenship Status:
   • Current Michigan resident OR         
   • Migrant worker OR
   • Woman living near the border of a neighboring state (Indiana, Ohio, Wisconsin, Minnesota) who plans to receive screening and diagnostic services in Michigan

Note: Women who are enrolled in a managed care program, a health maintenance organization, or Medicare Part B are not eligible for the BC3NP.
 

Find out more about becoming a BC3NP healthcare partner and referring your patients to the program on our BC3NP – Information for Healthcare Providers page.

Mailing Address:
Michigan Department of Health and Human Services
Cancer Prevention and Control Section
BC3NP
P.O. Box 30815
Lansing, MI 48909

Enrollment: 844-446-8727 (TTY 711)

Interpreters Available.

Claim Status: (866) 930-6324

Claim Questions: MDHHS-Claims-CAN@Michigan.gov

Secure Fax: 517-763-0290

Email: BC3NP@michigan.gov

Cancer Treatment Financial Resources for Clients Ineligible for BC3NP Medicaid Treatment Act

1. Options for uninsured U.S. citizens diagnosed with cancer
• If not eligible for BC3NP Medicaid Treatment Act (MTA), apply for Medicaid at your local Department of Health and Human Services (DHHS).
• If initially rejected for Medicaid for a reason other than "over income," then carefully review the application and reapply.
• Contact local hospitals and ask to speak with a social worker or financial counselor to find out if they have any charity care/financial hardship programs.
• Contact a community health clinic for free or sliding-fee services.
• A final option would be to make payment arrangements with a physician willing to see you on that basis. For medical bills already incurred, the client will need to find out if that facility/provider has a financial assistance program.
  
  
2. Options for uninsured non-U.S. citizens diagnosed with cancer (Note: The availability of financial support for non-U.S. residents is extremely limited, depending on their status.)
• Resident aliens who possess a green card may apply for Medicaid 5 years after they have been in the U.S.  If they apply prior to the 5 year period, they will be granted Emergency Services Only (ESO) coverage, which covers emergency treatment in an Emergency Room.  No routine health costs are covered.
• Some clients may find the care they need through clinical trials. Additional information to make an informed decision about the clinical trial may be limited depending on the person's status.  The patient, the family or the physician can inquire about currently recruiting trials and their locations at the following web sites: www.nih.gov  (National Institutes of Health), www.cancer.gov  (National Cancer Institute), or www.clinicaltrials.gov (National Institutes of Health Clinical Trials).
• Other options:
  • Contact a community health clinic for free or sliding fee services.
  • Inquire about making payments with a physician willing to see the client on that basis. For medical bills already incurred, the client will need to find out if that facility/provider has a financial assistance program.
    
    

Immigration Terms to Know

A general summary of U.S. immigration terminology follows, as defined by the United States Citizenship and Immigration Services (USCIS). (Please Note: This is not an all-inclusive list or summary. Questions regarding a client's status should be directed to Venetta Tucker, Quality Analyst for Medicaid and the BC3NP MTA, at TuckerV@michigan.gov.)

Alien:

An individual who is not a U.S. citizen or U.S. national.

Legalized Aliens:

Certain undocumented women who were eligible to apply for temporary resident status under the legalization provision of the Immigration Reform and Control Act of 1986. To be eligible, women must have continuously resided in the United States in an unlawful status since January 1, 1982, not be excludable, and have entered the United States either 1) illegally before January 1, 1982, or 2) as temporary visitors before January 1, 1982, with their authorized stay expiring before that date or with the Government's knowledge of their unlawful status before that date. Legalization consists of two stages — temporary and then permanent residency. In order to adjust to permanent status aliens must have had continuous residence in the United States, be admissible as an immigrant, and demonstrate at least a minimal understanding and knowledge of the English language and U.S. history and government.

Lawful Permanent Resident Alien (LPRA):

An alien who has been lawfully afforded the privilege of residing permanently in the U.S.

Permanent Resident Alien:

A person that enters the country with an immigrant visa or adjusts his status after entering as a nonimmigrant, refugee, or asylee. Persons with this status are entitled to live and work in the U.S. and collect entitlement benefits, if qualified.

There are two tests for whether someone is classified as a resident alien:

• The green card test.
  This applies to someone who has U.S. permanent or conditional residence, or a green card. The person is a citizen of another country who is authorized to live and work in the U.S. on a permanent basis (or, in the case of a conditional resident, for two years that may then be continued into a permanent stay). By the very nature of the requirements placed upon permanent residents, they spend most of their time living in the United States. To keep a green card, the person must not make their primary home in another country, nor remain outside the U.S. for more than one year. (People who plan to remain outside the United States for more than one year can, however, apply for a re-entry permit before leaving, in order to preserve their green card.)
  
  
• The substantial presence test.
  Even without having a green card, a person who spends 31 days in the United States during the current year and 183 days during a three-year period that includes the current year and the two years immediately before that, is considered a resident alien. This affects many people who are in the U.S. on temporary, otherwise known as nonimmigrant, visas. There are various exemptions, such as for time the person spent in transit (less than 24 hours in the U.S.), time during which the person couldn't leave because he or she required medical treatment, as well as for teachers and students (on an F, J, M, or Q visa) who haven't stayed in the U.S. beyond a certain period of time.

Non-Resident Alien:

A person spending some time in the U.S., but does not meet (or is exempt from) either the green card or the substantial presence tests. Students and teachers are often classified as non-resident aliens in the early years of their U.S. stay.

Alien Registration Receipt Card (also known as a "Green Card"):

An INS document that certifies lawful permanent resident status, commonly called the "green card," older versions may be green or blue/white. Newest versions are now rose/off-pink. It carries the INS form number I-151 or I-551.

Undocumented Alien (same as "Illegal Alien"):

An alien who entered the United States illegally without the proper authorization and documents, or who entered the United States legally and has since violated the terms of his or her visa or overstayed the time limit. An undocumented alien is deportable if apprehended.

Immigrant:

An alien who has been lawfully afforded the privilege of residing permanently in the U.S. with the right to eventually obtain citizenship. This status allows authorization for work and entitlement benefits. (See also the definitions for lawful permanent resident alien and permanent resident alien, which are terms used interchangeably with this term).

Nonimmigrant:

An alien who has been granted the right to reside temporarily in the United States. Each nonimmigrant is admitted into the U.S. in the nonimmigrant status that corresponds to the type of visa issued.

Aliens in some nonimmigrant statuses are permitted to be employed in the United States, and others are not. Some nonimmigrant statuses have strict time limits for the alien's stay in the U.S., while others do not.

Each nonimmigrant status has rules and guidelines, which must be followed in order for the nonimmigrant to remain "in status." A nonimmigrant who violates one of these rules or guidelines will fall "out of status." A nonimmigrant who remains "out of status" for at least 180 days is deportable and will be unable to re-enter the United States for 3 years. A nonimmigrant who remains "out of status" for at least 365 days is deportable and will be unable to re-enter the United States for 10 years.

Migrant:

A person who leaves his/her country of origin to seek residence in another country.

Refugee:

Any person who is outside his or her country of nationality who is unable or unwilling to return to that country because of persecution or a well-founded fear of persecution. Persecution, or the fear thereof, must be based on the alien's race, religion, nationality, membership in a particular social group, or political opinion.

Refugees are subject to ceilings by geographic area set annually by the President in consultation with Congress and are eligible to adjust to lawful permanent resident status after one year of continuous presence in the United States.

U.S. National:

An individual who owes his sole allegiance to the United States, including all U.S. citizens, and including some individuals who are not U.S. citizens.

For tax purposes, the term "U.S. national" refers to individuals who were born in American Samoa or were born in the Commonwealth of the Northern Mariana Islands who have chosen to be U.S. nationals instead of U.S. citizens.

U.S. Citizen:

1. An individual born in the United States.
2. An individual whose parent is a U.S. citizen.
3. A former alien who has been naturalized as a U.S. citizen.
4. An individual born in Puerto Rico.
5. An individual born in Guam.
6. An individual born in the U.S. Virgin Islands.

Below are BC3NP's program-approved procedures, rates, diagnosis codes, place of service codes, and revenue codes.

BC3NP is a federally funded program and not an insurance company. Our rates are based on the Centers for Medicare Services (CMS) Detroit rate, and our approved procedures are provided to us by our funder, the Centers for Disease Control and Prevention (CDC). Rates are reviewed bi-annually in January and July, but are subject to change at any time without notice.

If you have questions, please email MDHHS-Claims-CAN@michigan.gov.
 

FY2025 (October 2024 - September 2025)

• BC3NP FY25 Rate Schedule (rev. Sept 30, 2024)
   

FY2024 (October 2023 - September 2024)

• BC3NP FY24 Rate Schedule
   

Claims-Related Documents

• BC3NP ICD-10 Codes (rev. July 1, 2024)
• BC3NP Place of Service Codes
• BC3NP Revenue Codes
• BC3NP Hold Codes/ Adjustment Codes
• 2024 Federal Poverty Guidelines
   

Claim Submission, Status, and Refund Information

• Paper Claim Submission Guidelines and Billing Deadlines (rev. April 22, 2024)
   

 
Paper Claim Submission Address:
BC3NP/WISEWOMAN Claims
Elliott-Larsen Building, 5-N
320 S. Walnut St.
Lansing, MI 48933
 

Claim Status:
In order to provide the most complete and timely claim status, we ask that you fax a copy of your UB-04 or HCFA-1500 claim form to our secure fax line at 517-763-0290. Be sure to include your email address and phone number so we can reach you.

Please do not fax new claim submissions.

Phone (Toll-Free): 866-930-6324
 
If you have questions, please email MDHHS-Claims-CAN@michigan.gov.
 

Payment Refund Address:
State of Michigan
Attn: BC3NP/Billing
P.O. Box 30437
Lansing, MI 48909
 

Below are BC3NP's program manuals, including clinical algorithms, policies, and procedures.  Should you have any questions about the BC3NP program, please email BC3NP@michigan.gov.

• BC3NP Medicaid Treatment Act (MTA) Enrollment Procedure
• BC3NP Medical Protocol
• BC3NP Clinical Resource Manual
• BC3NP Cancer Risk Assessment Eligibility Algorithm
• BC3NP Breast Follow-up Algorithms
• BC3NP Retention Policy
• BC3NP Business Objects User Manual
• Michigan 211 Referral Manual
• MBCIS Access Instructions
• MBCIS Access Form (MDHHS-6096)
• DCH-File Transfer Access Instructions

BC3NP Educational Videos

• BC3NP Program Mission & Purpose -Provides an overview of the history and purpose of the Breast and Cervical Cancer Control Navigation Program (BC3NP), discusses the gaps this program aims to fill and how it carries out this mission.

• Presentation

• BC3NP Client Eligibility - Provides a detailed review of the eligibility requirements clients must meet to qualify for BC3NP screening and diagnostic services.

• Presentation

• BC3NP Medicaid Treatment Act (MTA) Eligibility - Provides a detailed review of the eligibility requirements clients must meet to qualify for BC3NP Medicaid Treatment Act (MTA) coverage.

• Presentation

• Sexual Orientation & Gender Identity -Defines SOGI data, discusses why and how to collect this data, and provides resources for more information to share with providers and clients.

• Presentation
• Video

• FY23 Q2 Clinical Webinar - Breast Biopsies

• Presentation
• Video

Below are BC3NP's program-approved forms. Information on the forms with an asterisk (*) is mandatory and, if not filled out when the forms are submitted, may delay enrollment/ processing/ reimbursement/etc. If you have any questions, please email BC3NP@Michigan.gov.

• BC3NP Enrollment Form
  • Spanish
• BC3NP Agreement for Program Participation (English)
  • Arabic
  • Spanish
  • Vietnamese
• BC3NP Screening Form
• BC3NP Breast & Cervical Follow-up Form
• BC3NP Release of Information
• BC3NP and WISEWOMAN Provider & Facility Enrollment Form (rev. August 2024)
• BC3NP Fax Cover Sheet
• BC3NP and WISEWOMAN Client Enrollment Form (MDHHS-6126) (rev. March 2024)
• BC3NP Client Referral (MDHHS-6127) (rev. March 2024)

All forms can be faxed to MDHHS at 517-763-0290.