Special Supplemental Benefits for the Chronically Ill (SSBCI)

SSBCI benefits are available to members with certain chronic conditions that meet specific criteria set by the Centers for Medicare and Medicaid Services (CMS). The benefits are designed to help improve or maintain your overall health and/or ability to function. CMS requires us to verify your eligibility before you can get these benefits.  

Having one of the SSBCI conditions alone does not mean you automatically qualify. We will review your eligibility. If you qualify, we will let you know.

Self-attestations are not accepted. If we can’t confirm that you qualify, you will not receive SSBCI benefits.

Healthy Benefits+ gives you an allowance each month. If you don’t use the whole amount during the month, it will roll over. If you have SSBCI, you may use that allowance on additional eligible benefits and services.

* The benefits mentioned are Special Supplemental Benefits for the Chronically Ill (SSBCI). You may qualify for SSBCI if you are at high risk for hospitalization and require intensive care coordination to manage one or more chronic conditions such as cardiovascular disorders, diabetes, overweight/obesity/metabolic syndrome, chronic and disabling mental health conditions or neurologic disorders. For a full list of qualifying chronic conditions or to learn more about other eligibility requirements for SSBCI, please contact Member Services or your Care Coordinator.

What are the qualifying conditions to be eligible for SSBCI benefits?