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MEDICAL ASSISTANCE BULLETIN ISSUE DATE EFFECTIVE DATE NUMBER September 21, 2015, October 1, 2015 991510 BY SUBJECT New Breasts and Cervical Cancer Prevention and Treatment (BCC PT) Program Application
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How to fill out bccpt program applications for:

01
Gather necessary information: Before starting the application, gather all the required information such as personal details, medical history, income, and insurance information. This will help you complete the application accurately and efficiently.
02
Read instructions carefully: Carefully read through the instructions provided with the application. This will help you understand the requirements and ensure that you provide all the necessary information.
03
Complete personal information section: Start by filling out the personal information section, which may include your name, address, contact details, and date of birth. Double-check the accuracy of the information provided.
04
Provide medical history: Next, provide details about your medical history, such as any previous diagnoses, treatments, or surgeries related to breast cancer. Include the names of healthcare providers and dates of these procedures if applicable.
05
Submit income and insurance information: The bccpt program requires income and insurance information to determine eligibility. Provide accurate details about your income, including wages, benefits, and any other sources of financial support. Additionally, provide information about your insurance coverage, such as your policy number and the name of your insurance provider.
06
Attach required documents: The application may require you to attach supporting documents, such as proof of income, insurance cards, or medical records. Make sure to gather these documents beforehand and attach them as instructed.
07
Review and submit: Once you have completed all sections of the application, review it carefully for any errors or missing information. Make necessary corrections before submitting the application. Ensure all required documents are attached and double-check for completeness.

Who needs bccpt program applications for:

01
Individuals without insurance coverage: The bccpt program is designed to assist individuals who do not have insurance coverage for breast and cervical cancer screening and treatment. It provides financial support for necessary services to eligible individuals.
02
Low-income individuals: The program is specifically targeted towards low-income individuals who meet the income eligibility requirements. If you meet the income criteria, you may be eligible for cost-free breast and cervical cancer screening and treatment through the bccpt program.
03
Individuals in need of breast and cervical cancer services: The bccpt program is meant for individuals who require breast and cervical cancer screening, diagnostic services, and necessary treatment. If you are in need of these services and meet the program's eligibility criteria, you may benefit from applying for bccpt program assistance.
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The bccpt program applications are for individuals to apply for the Breast and Cervical Cancer Prevention and Treatment program.
Individuals who are seeking assistance with breast or cervical cancer prevention and treatment are required to file bccpt program applications.
You can fill out bccpt program applications by providing detailed information about your medical history, diagnosis, and financial situation.
The purpose of bccpt program applications is to determine eligibility for assistance with breast and cervical cancer prevention and treatment.
Information such as medical history, diagnosis, income, and insurance coverage must be reported on bccpt program applications.
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