SSBCI BENEFITS

[CynthiaG231761]

Does anyone know anything about SSBCI Benefits? Special Supplemental benefits for the chronically ill. I found information about it on CMS website and the criteria it has for SSBCI benefits is similar to criteria my advantage plan is using however w/one major difference,that to be eligible for my advantage plan’s SSBCI benefits an enrollee must have had 2 inpatient hospital stays or 3 ER visits within the last 60 days.I meet all requirements I saw on CMS website but have been to ER only once in past 60 days (thankfully) This part of WellCare’s criteria seems rather unreasonable. Plus I can not find that requirement anywhere on the CMS website. I called Medicare but she didn’t know and told me to call Social Security Administration.  Also Wellcare informed me of the program to begin with in 2022&approved me for it but changed their “process” they told me and my SSBCI benefits were not renewed in January of 2023. Wellcare requires an enrollee’s PCP to fill out an Attestation form online attesting that all criteria is met so my benefits were denied because of the hospital admissions/ER visits in last 30 days requirement. Is it allowed that insurers can impose their own stricter criteria than CMS criteria/standards?? Thanks for any advice