You may have seen Medicare Advantage ads mentioning allowances for groceries, utilities, or other everyday needs. Many of these fall under a category called SSBCI: Special Supplemental Benefits for the Chronically Ill. They can be valuable, but they don’t apply to everyone.
What SSBCI benefits can include
Depending on the plan, SSBCI benefits may help with things that support your health but aren’t traditional medical care, such as:
- Healthy food or groceries
- Utility bills
- Transportation for non-medical needs
- Pest control or home modifications
- Other services that help manage a chronic condition
Who is eligible
SSBCI benefits are only for members who meet the plan’s criteria. Generally, you must:
- Have one or more qualifying chronic conditions, such as diabetes, heart disease, or chronic lung disease, as defined by the plan
- Have a condition that is life-threatening or significantly limits overall health or function
- Be at high risk of hospitalization or other adverse health outcomes
- Need intensive care coordination
Plans may ask your doctor to confirm your condition, and even then, not every member with that condition will qualify.
Read the fine print
- Eligibility varies by plan. Two plans may offer similar-sounding benefits with very different rules.
- Allowances usually don’t roll over. Unused monthly amounts often expire.
- It shouldn’t be the only reason you choose a plan. Your doctors, prescriptions, and total costs matter more.
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This article is for general educational purposes and is not a recommendation of any specific plan. Plan availability, benefits, and costs vary by plan and county and may change each year. For complete information, contact Medicare.gov or 1-800-MEDICARE.