Attestation for Special Supplemental Benefits for the Chronically Ill


In plan year 2023, we will be using this site to allow members and providers to work together to determine if qualifying criteria are met for Special Supplemental Benefits for the Chronically Ill (SSBCI).


Here is what you will need to do after Jan. 1, 2023:

  1. Make an appointment with your provider of choice. We recommend using one of our contract providers and the Annual Wellness Visit that you get through Medicare. Copays or coinsurance may apply.
  2. Ask your provider to check your health against the criteria and to submit their response through this website: (

After we receive their response, we will send you a letter within 10 business days to let you know if you qualify. We'll also tell you about any next steps you will need to take.

As a reminder, you must meet the eligibility criteria listed below in order to qualify.


Your patient has requested access to benefits that require us to validate if they meet specific clinical criteria. While we make every effort to automatically validate as many as possible, we sometimes require additional data to make this decision.

We ask that you or your staff utilize this site ( to evaluate your patient (our member) against the eligibility criteria below. Your successful submission of this form will allow us to determine if your patient meets the criteria for these benefits.

The site will be available for all providers – those we have contracted with, and those we have not.