Starting in Plan Year (PY) 2026, newly enrolled members may qualify for Special Supplemental Benefits for the Chronically Ill (SSBCI) through provider attestation. These benefits are designed to support individuals living with qualifying chronic conditions by offering additional services beyond standard Medicare coverage.
How to Determine Eligibility
To begin the SSBCI manual eligibility process, members must schedule an in-person office visit with their healthcare provider. During this visit, the provider will evaluate the member’s health status and determine if they meet SSBCI criteria.
Provider Instructions for SSBCI Attestation
Once the appointment is scheduled, providers should follow these steps:
- Visit ssbci.rrd.com
- Review the eligibility criteria outlined on the site and evaluate the patient accordingly.
- Submit an attestation through the website confirming the patient meets SSBCI eligibility requirements.
- Submit a claim from the office visit that includes the appropriate diagnosis codes indicating the member has one or more qualifying chronic conditions listed on ssbci.rrd.com.
What Happens Next?
Once all required documentation is received:
- The member will receive an approval or denial letter within 10 business days.
- If approved, the letter will include details about the specific SSBCI benefits available and instructions on how to access them.
