Men with Breast Cancer Denied MEDICAID Treatment Coverage


By Laura Riley, Esq.

Medicaid provides health insurance for certain people who have low incomes, have limited resources, and meet other eligibility requirements. Individuals with cancer often qualify for Medicaid through the Aged, Blind and Disabled Program, which provides coverage to individuals with low incomes who are over 65 or who have a disability.

Many states have also enacted screening and treatment programs through Medicaid for specific types of cancer. For example, in California, under the Breast and Cervical Cancer Treatment Program (BCCTP) Medicaid services are provided to qualifying individuals who have been diagnosed with breast or cervical cancer.

However, one of the eligibility criteria as it is written in the Breast and Cervical Cancer Prevention and Treatment Act of 2000 for Medicaid coverage for breast cancer treatment is someone’s gender—to be covered, you have to be a woman.

Breast cancer among men is relatively rare. According to the American Cancer Society (ACS), breast cancer is about 100 times less common among men than among women. (

That does not mean that men are not affected by the disease. ACS expects 2,140 new cases of invasive breast cancer to be diagnosed in men in 2011. One of these men was Raymond Johnson, a 26-year-old construction worker living in South Carolina. He was recently denied Medicaid coverage when he would otherwise be eligible for it, due to his breast cancer diagnosis, because he is a man.

Want to learn more?

To read Raymond Johnson’s story, please visit:

For more information about Medicaid, other coverage issues, and more, contact the Cancer Legal Resource Center (CLRC) at 1-866-THE-CLRC or


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