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  • Wellcare Attestation Form

Get Wellcare Attestation Form

ATTESTATION: I hereby attest that I have the ability to make medical decisions on behalf of: Wellheads Member Name: Member ID: (if known) Medicare Number: Medicaid Number: For example: I am the court.

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Visit ssbci.rrd.com. Follow the steps on ssbci.rrd.com to evaluate your patient against the eligibility requirements outlined on ssbci.rrd.com. Submit an attestation form through ssbci.rrd.com indicating your patient meets the eligibility requirements.

Special Supplemental Benefits for Chronically Ill (SSBCI) are offered to Wellcare's highest-risk members who meet specific criteria for eligibility based on the Centers for Medicare and Medicaid Services (CMS) guidelines.

Examples of supplemental benefits include additional health insurance, such as dental and vision, retirement contributions, and extended leave benefits. Talent no longer desires a paycheck and the bare minimum benefits.

An Optional Supplemental Benefit (OSB) is an added benefit option, available with select plans, that a member may choose to elect in addition to the medical benefits covered by their Medicare Advantage plan.

What are SSBCI? SSBCI are benefits that can be offered to Medicare Advantage members with one or more complex chronic conditions, who are at high risk for hospitalization or adverse health outcomes, and who require intensive care coordination.

Listen to pronunciation. (SUH-pleh-MEN-tul helth in-SHOOR-ents) An additional insurance plan that helps pay for healthcare costs that are not covered by a person's regular health insurance plan. These costs include copayments, coinsurance, and deductibles.

Services not covered by Medicare that enrollees must purchase as a condition of enrollment in a plan. Usually, those services are paid for by premiums and/or cost sharing. Mandatory supplemental benefits can be different for each Medicare Advantage plan.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232