Medicare SNP: Verification of chronic condition begins Jan. 1, 2026
AI Summary
Starting January 1, 2026, UnitedHealthcare Medicare Special Needs Plans (SNPs) will require documented chronic condition verification for members to access Special Supplemental Benefits for the Chronically Ill (SSBCI), including healthy food and utility benefits. Providers must submit verification forms within 60 days or benefits will be removed from the member's plan.
Action Required
By January 1, 2026: Billing and clinical staff must implement workflow to verify chronic conditions for all Medicare SNP members seeking SSBCI benefits. Submit C-SNP chronic condition verification forms, D-SNP SSBCI verification forms, or IE-SNP verification forms within 60 days of member enrollment. Ensure documentation includes eligible diagnosis codes or provider attestation. Failure to provide verification within 60 days will result in removal of SSBCI benefits from member's plan.
Plan Types
Medicare Advantage
Specialties
all-specialties