10/16/2026
Effective January 1, 2027, members must meet all CMS eligibility criteria to qualify for SSBCI benefits. Eligibility will not be based solely on a chronic condition diagnosis, and enrollment in a C-SNP plan does not automatically qualify a member for SSBCI benefits.
FOR THOSE OF YOU THAT LOVE YOUR SPENDABLE CREDIT CARD!!! PLEASE READ BELOW BEFORE SOMEONE OFFERS YOU THE MOON AND THE STARS AND SWITCHES YOUR PLAN AND YOU END UP WITH HEADACHE'S!
Easily translated: if you don't have all three : have a chronic condition, are at risk of ending up in the hospital and require intensive care coordination you will no longer be eligible for the spendables credit card with ANY insurance company!!!!
As outlined by CMS under Section 1852(a)(3)(D)(ii), an eligible member must meet all the following criteria:
Have one or more medically complex chronic conditions that are life-threatening or significantly limit overall health or functional status;
Be at high risk for hospitalization or other adverse health outcomes; and
Require intensive care coordination.
All eligibility requirements must be met for a member to qualify for SSBCI benefits. Members who do not satisfy all CMS criteria will not be eligible.
Effective January 1, 2027, members must meet all CMS eligibility criteria to qualify for SSBCI benefits. Eligibility will not be based solely on a chronic condition diagnosis, and enrollment in a C-SNP plan does not automatically qualify a member for SSBCI benefits.
