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Notice of Privacy Practices 

 

 

 

 

 

 

 

 

 

 

Form PA600B

Spanish Version of Form PA600B

WERE YOU JUST TOLD YOU HAVE BREAST OR CERVICAL CANCER AND ARE LOW INCOME WITH NO INSURANCE?

Here’s how you can get FREE cancer treatment if you are eligible!

PhoneCall 1-800-215-7494 and ask for HealthyWoman Program Case Management.

 

You must meet the eligibility guidelines to receive free cancer treatment.


 

HealthyWoman Program (HWP) Eligibility Guidelines – Department of Health

Age :  The general age is 40 through 64 (unless you are 65 or older and not covered by Medicare).

 

Income : 

 

2013 Federal Poverty Annual Income Guidelines at

250% of Poverty

Family Size

Gross Monthly Income

Annual Income

1

$2,394

$28,725

2

$3,231

$38,775

3

$4,069

$48,825

4

$4,906

$58,875

5

$5,744

$68,925

6

$6,581

$78,975

7

$7,419

$89,025

8

$8,256

$99,075

 Each Additional Person

$   838

$10,050

 

Insurance Status:  You must be uninsured or underinsured.  Underinsured means that you have health insurance, but it does not cover breast or cervical screening offered by the HWP or you are financially unable to pay any required deductible or co-payment.


If you are enrolled in Medicare Part B, Medicaid, or HMOs you are not eligible for the HWP.


Breast & Cervical Cancer Prevention Treatment (BCCPT) Program Eligibility Guidelines – Department of Public Welfare

You must be:

  •  Under age 65;
  •  Diagnosed with breast or cervical cancer or a pre-cancerous condition of the breast or cervix;
  •  Uninsured or have limited health care coverage; and
  •  A resident of PA with a social security number.

LET'S GET STARTED!

A Short, Three-Step Process

1.   Fill out the HealthyWoman Enrollment Form (PA600B ), Part A Application Form.

2.   The doctor who told you that you have cancer should fill out PA600B Part B – Medicaid Eligibility Application.

3.   Your doctor should fax both forms to the HWP Case Management Team at 412-201-4702.

If you have any questions, please contact the HWP Case Management Team at 800-215-7494.  

 

For more information about the HWP and BCCPT Program, go to the Department of Public Welfare website at www.dpw.state.pa.us/omap and Search for BCCPT Program, this will give information on the BCCPT Program.

 

Additional Resources

Compass: Compass gives you information and an application to see what health and social services you may be able to get through various state agencies.

 

Helping Families Cope: A Guide for Families Facing Cancer

For additional information on breast and cervical cancer, visit the Centers for Disease Control and Prevention and the National Cancer Institute.  


 
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