SSBCI processing for Plan Year 2027 will begin December 1, 2026.
eternalHealth members with certain health conditions may be eligible for additional benefits as part of the Special Supplemental Benefits for the Chronically Ill (SSBCI) program. Read on to learn whether you qualify and how to get approved so you can take full advantage of the benefits available to you.
Special Supplemental Benefits for the Chronically Ill (SSBCI) are benefits available to members who have been diagnosed with certain chronic conditions and meet specific criteria established by the Centers for Medicare & Medicaid Services (CMS). These benefits are designed to help improve or maintain your overall health and your ability to function day to day.
If you qualify for SSBCI, you may be able to use your quarterly Healthy Grocery* benefit allowance for eligible grocery purchases and utility payments** through NationsBenefits.
To be eligible for SSBCI benefits, you must have been diagnosed with at least one of the following chronic conditions:
Cardiovascular Disorders
Chronic & Disabling Mental Health Conditions
Diabetes Mellitus
Cancer
Chronic Kidney Disease (CKD)
In addition to having at least one qualifying condition, eternalHealth must receive information confirming that the condition meets all three of the following criteria:
For eternalHealth to approve your SSBCI benefits, we must have one of the following on file:
Getting a provider attestation
Once all SSBCI criteria have been confirmed, your Healthy Grocery card will be updated to reflect your approved SSBCI benefits.
Please note: SSBCI eligibility approval applies to the current benefit year only and is not applied retroactively.
Use the attestation form to confirm that your patient, an eternalHealth member, has been diagnosed in the past 12 months with one or more of the qualifying chronic conditions listed above. By signing, you confirm that the patient’s condition:
- is life threatening or significantly limits the overall health or function of the individual;
- has a high risk of hospitalization or other adverse health outcomes; and
- requires intensive care coordination.
Eligibility for SSBCI cannot be guaranteed based solely on your patient’s conditions. All applicable eligibility requirements must be met before the benefit is provided. All fields on the form are required.
Supporting documentation required
Please submit documentation to support your responses on the form, such as encounter records, progress notes, or acute stay notes. Send it together with the completed form. Attestations received without supporting documentation may not be approved.
Provider Attestation of Patient Diagnosis
Printable PDF. Complete the patient, diagnosis, and provider sections, sign the form, and return it to us with supporting documentation.
How to complete and submit
Have Questions? We're Here to Help.
Member Services: 1-800-680-4568 (TTY 711)
October 1 – March 31: 8am – 8pm local time, 7 days a week
April 1 – September 30: 8am – 8pm local time, Monday – Friday
Providers: Call Provider Relations at 1-800-680-9255.
**Utility payments are only available to Valor Give Back HMO-POS members.
