Special Supplemental Benefits for the Chronically Ill (SSBCI)

Starting Jan. 1, 2026, UPMC for Life Complete Care (HMO D-SNP) plans will begin offering additional benefits under a new program called Special Supplemental Benefits for the Chronically Ill (SSBCI). Members who qualify for this program can access additional benefits to help support their health and wellness. If you receive Low-Income Subsidy (LIS) and have certain chronic illnesses, you may be eligible for this program. Eligibility for this benefit cannot be guaranteed based solely on your condition. All applicable eligibility requirements must be met before the benefit is provided.

If you were a UPMC for Life member in 2025 and have one of the below conditions, your chronic illness diagnosis was likely already submitted by your provider.

If you are a new UPMC for Life member or your chronic illness has not been submitted to UPMC Health Plan, your chronic illness must be diagnosed by your doctor, and your doctor must submit the claim to UPMC Health Plan. Once we receive, process, and pay the claim from your doctor, you can receive these additional benefits. This could take two to three months from the time you see your doctor. You can qualify for this program at any time during the year. Once UPMC Health Plan recognizes that you qualify, you will remain qualified throughout the remainder of the calendar year.

Here’s how you can find out if you’re eligible:

• Log in to the UPMC Health Plan member site or download the UPMC Health Plan app.
• Call the phone number on your member ID card.

Here’s a full list of eligible chronic illnesses:

If you qualify for SSBCI, you get these additional benefits: 

• Additional Shop Healthy Card allowances – You get additional allowances added to your Shop Healthy Card, including $110 per month for healthy foods and $40 per month for household utilities. This is in addition to the $60 monthly allowance all members get for over-the-counter and home safety products. Learn more about the Shop Healthy Card.

• Trips to nonmedical locations –You can use some of your one-way trips to go to or from plan-approved nonmedical locations, including grocery stores, places of worship, salons, libraries, banks, funeral homes, and adult day/community centers. Learn more about transportation benefits.

• Healthy food kits –You can order two healthy food kits per year. Learn more about healthy food kits.

This benefit is part of the Special Supplemental Benefits for the Chronically Ill (SSBCI) program. To be eligible, you must qualify for Low-Income Subsidy (LIS) and have one of the following chronic illnesses: chronic/disabling mental health conditions, metabolic disorders, cardiovascular disorders, substance use disorders, diabetes, or other eligible conditions not listed. Eligibility for this benefit cannot be guaranteed based solely on your condition. All applicable eligibility requirements must be met before the benefit is provided. For details, please contact us.