Special Supplemental Benefits for the Chronically Ill (SSBCI)
What is SSBCI?
Special Supplemental Benefits for the Chronically Ill (SSBCI) are benefits 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.
Which benefits offered by CCA are considered SSBCI?
You can use your quarterly Healthy Savings benefit allowance for food1 (excludes post-discharge meals)1 and utility payments1 if you qualify for SSBCI benefits.
To see a full list of qualifying items, visit our Healthy Savings card page.
What are the qualifying conditions to be eligible for SSBCI benefits in 2025?
- Cardiovascular disorders limited to:
- Cardiac arrhythmias
- Coronary artery disease
- Peripheral vascular disease
- Chronic venous thromboembolic disorder
- Chronic heart failure
- Chronic lung disorders limited to:
- Asthma
- Chronic bronchitis
- COPD
- Emphysema
- Pulmonary fibrosis
- Pulmonary hypertension
- Diabetes mellitus
CCA must receive information supporting that you have at least one of the listed chronic conditions and it meets all of the following criteria:
- Is life-threatening or significantly limits your overall health or function; and
- Puts you at a high risk of hospitalization or other adverse health outcomes; and
- Requires intensive care coordination.
How do I get approved for SSBCI benefits?
To be approved, CCA must have one of the following:
- A valid attestation completed by your treating provider demonstrating that you meet all criteria to qualify for SSBCI benefits or
- Claims of an active qualifying chronic condition and documentation via claims and a current MDS assessment that you meet all SSBCI qualifying criteria.
Once all SSBCI criteria have been met, your Healthy Savings card will be updated with your approved SSBCI benefits. Approval of eligibility for SSBCI is limited to the current benefit year. Approval of benefits are not retrospective.
If you have additional questions about SSBCI benefits, call Member Services at 866-610-2273 (TTY 711), 8 am to 8 pm, 7 days a week.
1The food and utilities benefits mentioned are part of a special supplemental program for the chronically ill. Members with chronic heart failure, cardiovascular disorders, chronic lung disorders, and diabetes may be eligible for these additional benefits. Not all members with those conditions will qualify. Certain restrictions may apply. Only at participating locations.
CCA Senior Care Options (HMO D-SNP) is a health plan that contracts with both Medicare and MassHealth (Medicaid) to provide benefits of both programs to enrollees. Enrollment in the plan depends on contract renewal.
CCA complies with applicable Federal civil rights laws and does not discriminate on the basis of, or exclude people or treat them differently because of, medical condition, health status, receipt of health services, claims experience, medical history, disability (including mental impairment), marital status, age, sex (including sex stereotypes and gender identity), sexual orientation, national origin, race, color, religion, creed, public assistance, or place of residence.
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