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Medicare Advantage

Starting in 2027, Medicare Advantage Plans Must Publicly Post Who Qualifies for Special Supplemental Benefits for the Chronically Ill

A provision in the 2027 Medicare Advantage final rule closes a transparency gap that left many chronically ill enrollees unaware of extra benefits they may have been entitled to claim.

By the Goodsurance editorial teamAugust 2, 2026

Beginning in 2027, Medicare Advantage plans that offer Special Supplemental Benefits for the Chronically Ill must post their eligibility criteria in a publicly accessible location, according to the final rule for contract year 2027 that CMS issued in April 2026. Special Supplemental Benefits for the Chronically Ill, commonly known as SSBCI, allow Medicare Advantage plans to offer non-medical benefits such as food and produce, meal delivery, pest control, structural home modifications, and transportation for non-medical purposes to enrollees who have at least one qualifying chronic condition and whose plan determines the benefit is likely to prevent or improve the condition. Plans have wide discretion in setting eligibility rules, and those rules have historically not been required to be posted publicly. Advocates and researchers have noted that many chronically ill enrollees are unaware of what SSBCI benefits their plan offers or whether they qualify. In 2026, the share of Medicare Advantage plans offering SSBCI benefits has been a significant design feature, particularly for the Special Needs Plans that now cover roughly 23 percent of all Medicare Advantage enrollees. The new transparency requirement means that for 2027, a prospective enrollee or an existing member can look up the specific conditions or criteria a plan uses to determine SSBCI eligibility before choosing or staying in a plan. The requirement applies to plans that choose to offer SSBCI benefits, which are optional. Not every Medicare Advantage plan offers them. Enrollees who believe they may qualify for food, transportation, or other SSBCI benefits should look for the posted eligibility criteria on their plan's website or contact the plan directly ahead of or during open enrollment.

In plain words

Medicare Advantage plans can offer extra benefits to people with serious chronic conditions, like food, pest control, or rides to appointments. These are called SSBCI benefits. In the past, plans did not have to explain who could get them. Starting in 2027, plans that offer these benefits must post the rules publicly so people can see if they qualify before picking a plan. This is a new transparency rule from CMS. Not every plan offers these benefits, but if yours does, you should be able to find out if you are eligible by checking the plan's website.

Understand the basics first

Source: CMS
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