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Special Supplemental Benefits for Chronically Ill (SSBCI) - Member Eligibility Verification

January 21, 2022

If you receive questions from your clients regarding SSBCI benefit eligibility, you can use the following information to validate eligibility and determine if a member call to Wellcare Customer Service by your client is needed:

Is Your Client Eligible?

  • Members MUST be on a plan that covers SSBCI benefits and is available in the state that your client has coverage. For information on SSBCI availability by state, please go to Wellcare's 2022 AEP Readiness Resources page.
  • Members MUST meet one or more of the eligibility requirements for SSBCI enrollment, as attested to by their provider:
  • ~~Autoimmune disorders
  • ~~Cancer
  • ~~Cardiovascular disorders
  • ~~Chronic alcohol and other drug dependence
  • ~~Chronic heart failure
  • ~~Chronic and disabling mental health conditions
  • ~~Chronic lung disorders
  • ~~Dementia
  • ~~Diabetes
  • ~~End-stage liver disease
  • ~~End-stage renal disease (ESRD)
  • ~~HIV/AIDS
  • ~~Neurologic disorders
  • ~~Severe hematologic disorders
  • ~~Stroke

When Manual Enrollment Into SSBCI Is Needed

  • If your client has met all eligibility requirements noted above, the member should call Customer Service using the number on the back of their ID card to manually enroll into SSBCI. PLEASE NOTE: Only members can initiate the manual enrollment process through Customer Service.
  • Once your client contacts Customer Service, validation will be performed to confirm the member is on a plan that covers SSBCI. The member will be connected to an internal Wellcare team member to manually enroll the member into SSBCI. PLEASE NOTE: Manual enrollment can take 2-5 business days.
  • The Wellcare team member assisting your client will advise of any next steps that may be necessary, depending on the SSBCI benefit.

For further detailed information on the SSBCI benefit, you can reference this previous communication from Wellcare: 2022 Wellcare: Product Pointers - SSBCI.

Visit the 2022 AEP Readiness Resources page that provides additional information on SSBCI and access to other valuable resources geared toward helping you to see what benefits may be available to your clients.

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