SSBCI Special Supplemental Benefits for Chronically Ill

Members who request access to SSBCI benefits will require their physician to attest that they meet the requirements.

Please complete the online attestation form or the hard copy form and fax to 1-888-710-8090 or mail to:

Healthy Mississippi

10 Canebrake Boulevard, Suite 110

Flowood, MS 39232

Member Name
Address
Chronic Conditions
Provider Name
Address
This field is for validation purposes and should be left unchanged.

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