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

Attention Valued Partner,

The start of a new benefit year provides a great opportunity to further assist members with inquiries regarding their 2022 plan benefits and options. Providing great customer service is important to us at Wellcare. During this time of year, call volumes into our Customer Service call centers may be higher than normal. Therefore, 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 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 our 2022 AEP Readiness Resources page.
• Members MUST meet one or more of the eligibility requirements for SSBCI enrollment, as attested to by their provider:

• 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 our previous communication: 2022 Wellcare: Product Pointers - SSBCI.

We encourage you to visit our 2022 AEP Readiness Resources page that will provide additional information on SSBCI and access to other valuable resources geared toward helping you to see what benefits may be available to your clients and why Wellcare should be their healthcare provider of choice.

As always, thank you for your continued partnership!