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SSBCI benefits can be offered to Medicare Advantage members with one or more complex chronic conditions, who are at high risk for hospitalization or adverse health outcomes, and who require intensive care coordination. These benefits are in addition to the benefits that traditional Medicare covers, and can include non-primarily health related benefits so long as there is a reasonable expectation of improving or maintaining the health or overall function of the member.
To be eligible for Special Supplemental Benefits for the Chronically Ill (SSBCI) benefits, members must have one or more of the following conditions:
1. Autoimmune Disorders
Dermatomyositis
Polymyalgia rheumatica
Polyarteritis nodosa
Polymyositis
Psoriatic arthritis
Rheumatoid arthritis
Scleroderma
Systemic lupus erythematosus
2. Cancer
All cancer diagnoses (excluding pre-cancer conditions or in-situ status)
3. Cardiovascular Disorders
Cardiac arrhythmias
Chronic venous thromboembolic disorder
Coronary artery disease
Peripheral vascular disease
4. Chronic Alcohol or Drug dependency
5. Chronic and Disabling Mental Health Conditions
Bipolar disorder
Major depressive disorder
Paranoid disorder
Schizoaffective disorder
Schizophrenia
6. Chronic Gastrointestinal Diseases
Hepatitis B
Hepatitis C
Inflammatory bowel disease
Non-alcoholic fatty liver disease (NAFLD)
Pancreatitis
7. Chronic Heart Failure
8. Chronic Kidney Disease (CKD)
Must be on dialysis
9. Chronic Lung Disorders
Asthma
Chronic bronchitis
Chronic Obstructive Pulmonary Disease (COPD)
Emphysema
10. Conditions associated with cognitive impairment
Alzheimer’s disease
11. Diabetes
12. Immunodeficiency and Immunosuppressive Disorders
HIV
13. Neurologic Disorders
Amyotrophic lateral sclerosis (ALS)
Cerebral palsy
Chronic fatigue syndrome
Epilepsy
Extensive paralysis (hemiplegia, monoplegia, paraplegia, quadriplegia)
Fibromyalgia
Huntington’s disease
Multiple sclerosis
Parkinson’s disease
Polyneuropathy
Spinal cord injury
Spinal stenosis
Stroke-related neurologic deficit
14. Post-Organ Transplantation Care
15. Severe Hematologic Disorders
Aplastic anemia
Chronic venous thromboembolic disorder
Hemophilia
Immune thrombocytopenic purpura
Myelodysplastic syndrome
Sickle-cell disease (excluding sickle-cell trait)
16. Stroke
Already a member?
Call (833) 388-8168 (TTY: 711)
to speak to a Member Advocate
Interested in becoming a member?
Call (833) 721-4365 (TTY: 711)
to speak to a Medicare Advisor
8:00 AM – 8:00 PM, 7 days a week from October 1st to March 31st
8:00 AM – 8:00 PM, Monday through Friday from April 1st to September 30th
Please do not include personal identifying information such as your birth date, or personal medical information in any emails you send to us. Communications via email over the internet are not secure. Submit your rewards form via traditional postage mail, online through the member portal, or via fax at (657) 210-6635.
Clever Care Health Plan, Inc. is an HMO and HMO C-SNP with a Medicare contract. Enrollment depends on contract renewal. H7607_26_CM1469_M

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