A confusing situation has popped up due to the way that Medicaid has laid out some of the requirements for certain kinds of insurance coverage. Medicaid does cover the costs of treatments related to breast cancer. However, they will only do this for patients who are female, even though men can get breast cancer too.
Medicaid is a form of health insurance that is run by the government. It is not something that private insurance companies sell. The specific eligibility requirements that a person must meet in order to get Medicaid can vary from one state to another.
In general, a person must be age 65 or older. People who are under age 65 may also qualify for this insurance if they are disabled, or blind. This insurance could also cover people who have cancer, or other serious health conditions. Medicaid is a health insurance program that is designed for people who are low-income. However, just because a person has low-income does not mean that the person will automatically qualify for Medicaid.
Breast cancer is something that can affect both women and men. A man in South Carolina, named Raymond Johnson, was recently diagnosed with breast cancer. He is only 26 years old. About 2,000 men are diagnosed with having breast cancer every year.
Women are much more likely, (around 100 times more likely), to be diagnosed with breast cancer than men are, but it does happen. Anyone, female or male, who carries a mutated version of the BRCA1 or BRCA2 genes is at an increased risk of developing breast cancer.
In short, Medicaid refused to cover Raymond Johnson’s breast cancer treatment because Mr. Johnson was not a woman. Presumably, this would leave him to cover the entire expense of his cancer treatment out of his own pocket, specifically because of his gender. It seems quite discriminatory.
Lawmakers in the state of South Carolina, the state where Raymond Johnson lives, have been trying to make changes to Medicaid’s rules regarding coverage for breast cancer treatment. The problem has to do with the specific wording of a few laws.
Medicaid says that a law that was created in 2000 doesn’t explicitly exclude the coverage of breast cancer treatment for men. The problem seems to be that in order to qualify for this type of coverage, a person has to have first gone through a program that includes a screening. A separate law has designated this particular program, and the screening, as something that is only for women.
Image by SCA Svenska Cellulosa Akitebolaget on Flickr