Updates to SSBCI (food benefits) for MAPD next year
For plan year 2027, the Centers for Medicare & Medicaid Services (CMS) has updated eligibility requirements for Special Supplemental Benefits for the Chronically Ill (SSBCI) for Chronic Special Needs Plans (C-SNPs) and Dual Special Needs Plans (D-SNPs).
There are 4 key changes:
As we previously communicated, beginning with new enrollments starting Oct. 1, members will no longer receive temporary access to SSBCI benefits while eligibility is being verified. Members must first meet all SSBCI requirements and complete the verification process before benefits become available.
A qualifying chronic condition alone no longer automatically qualifies a member for SSBCI. To qualify, a member must:
Have a qualifying chronic condition.
Be identified as at risk for hospitalization or adverse health outcomes.
Be identified as needing intensive care coordination.
C-SNP members, like D-SNP members, will require verification to access healthy food (which is a change from 2026).
Existing members who may currently be receiving SSBCI benefits will be required to complete re-verification to confirm SSBCI benefits for next year.
These updates support a consistent and compliant eligibility process while helping ensure SSCBI benefits are available to members who qualify.
Learn more in the updated "SSBCI" 2027 Agent Quick Reference Guide.