Special Supplemental Benefits for the Chronically Ill (SSBCI)

jimorrison

Is anyone familiar with SSBCI? One of the eligible conditions is Dementia. What are the benefits? And how long does it take to process? I would appreciate hearing from anyone who has gone through the process. Thank you in advance for your comments.

Jeff H

SSBCI is a program that allows certain Medicare Advantage plans to give non-medical benefits to people whose chronic illness significantly affects their health or daily functioning.

Dementia (including Alzheimer’s and other forms) is one of the qualifying chronic conditions.

Examples of SSBCI benefits

Depending on the insurance plan, SSBCI benefits may include things like:

• Healthy food or grocery allowances
• Help paying utilities, rent, or household needs
• Transportation for non-medical needs
• Home modifications or pest control
• Care coordination or support services
• General supports that help someone live safely at home

Some plans even load a monthly allowance onto a debit card that can be used for food or living expenses.

Who qualifies

To qualify for SSBCI benefits, typically the person must:

1. Have a chronic condition like dementia
2. The condition must limit their health or daily function
3. They must be at high risk of hospitalization or complications
4. Their doctor or the plan must verify the condition.

Important: Not everyone with dementia automatically gets SSBCI. It depends on the specific Medicare Advantage plan and whether the plan determines the person meets the criteria.

blacksparky

Here’s what I have researched.
SSBCI is not a separate program you apply for.

It only exists if:

• The person is enrolled in a Medicare Advantage plan that offers SSBCI, and
• The plan determines they meet the chronic illness criteria

So the benefits and amounts vary widely by insurance plan.

To be eligible, the person must generally:

1.Have a serious chronic condition (dementia/Alzheimer’s qualifies)

2.Be at high risk for hospitalization or health decline

3.Need care coordination or extra support  

Maru

I had never heard of this before. Quickly scanning info on the internet I found that both DH and I might qualify. That would really come in handy when I have to stop driving.