What Medicare Advantage plan enrollees need to know about SSBCI

Extra health benefits can be very helpful if you have Medicare. CMS ended a program (VBID) which allowed for certain supplemental benefits, such as money for food and utility bills. With the program ending, it was necessary to offer extra benefits in other ways. Fortunately, eligible members with a qualifying chronic condition or more complex health needs may still be able to access similar support through Special Supplemental Benefits for the Chronically Ill (SSBCI).

SSBCI stands for Special Supplemental Benefits for the Chronically Ill. The program was introduced in 2019 by the federal government, as a benefits program for select Medicare Advantage plans, including certain Special Needs plans. Like VBID, SSBCI allows Medicare Advantage plans to offer supplemental benefits.

These benefits are for members with complex chronic conditions who are at a high risk of hospitalization. Complex chronic conditions include cancer, chronic heart failure and diabetes.

To receive food and utility credits through SSBCI, Medicare Advantage plan members must have a qualifying chronic condition and more complex health needs. Your plan provider will verify your eligibility and notify you.

A complete list of qualifications will be available on October 1, 2026. UnitedHealthcare members can also access those qualifications on the UnitedHealthcare member site.

Unlike VBID, SSBCI does not include benefits related to prescription drugs. Low-income Medicare recipients may qualify for the federal “Extra Help” program instead. The Inflation Reduction Act (IRA) also caps prescription drug spending at $2,100 in 2026 and $2,400 in 2027.

Hospice care remains covered as part of Original Medicare (Part A). It is also included with Medicare Advantage plans.

To receive SSBCI benefits, you must have completed the verification form and be enrolled in a participating Medicare Advantage plan. Verification is specific to your plan provider, and if you change carriers you will need to be re-verified.After you’re verified, the plan should automatically identify your qualification based on claims. If needed, your primary care provider can attest to your qualifying chronic condition.

For more information regarding the SSBCI verification process or qualifications, visit cms.gov.