December 14, 2000  
Dear State Medicaid Director:  
The Health Care Financing Administration (HCFA) is committed as part of the Government 
Performance and Results Act (GPRA) to locating, educating, and enrolling additional dual 
eligible beneficiaries. As many of you know, there is inconsistency in how HCFA, other Federal 
agencies, and the States refer to the dual eligible programs (see the enclosed list of definitions of 
the various dual  
eligible programs). To address this inconsistency and develop a program title that is "beneficiary-
friendly", HCFA conducted a series of beneficiary focus groups. The focus groups revealed that 
the title "Medicare Savings Program" tested well among beneficiaries and engendered a high level 
of program identification and understanding.  
We would also like to provide you with a copy of our latest outreach tool, "SHIP-to-SHIP: A 
Practical Guide to Conducting Outreach on the Medicare Savings Programs." This CD-ROM, 
which is enclosed, provides information on how State Health Insurance Assistance Programs 
(SHIPs) around the country are conducting outreach and education activities to serve beneficiaries 
who qualify for Medicare Savings Programs (qualified beneficiaries), an assessment of outreach 
and education practices that SHIPs have found to be effective, and helpful tips on reaching 
traditionally underserved audiences. The "SHIP-to-SHIP" CD-ROM will give you a window on 
SHIP activities across the country and, although it was designed for use by SHIPs, contains many 
ideas that can be adapted to bolster your own outreach activities.  
SHIPs are State-administered programs that have the role of providing objective, free counseling 
to those persons who have questions pertaining to Medicare. SHIP counselors are required to 
undergo an intensive educational program to provide them with the knowledge and skills to render 
information and advice in areas such as Medicare, Medicare supplemental insurance, managed 
care, and the Medicare Savings Programs. SHIP coordinators maintain strong community linkages 
with local partners that may include area agencies on aging, faith-based organizations, community 
action agencies, nursing homes, hospitals, and other organizations.  
HCFA endorses the formation of partnerships between Medicaid State agencies and SHIPs. (See 
the enclosed contact list for information on the SHIP in your State.) There is evidence to suggest 
that collaboration between Medicaid agencies and SHIPs can substantially increase enrollment in 
Medicare Savings Programs. Most of these collaborative activities revolve around joint education 
efforts.  
Advantages for Medicaid State agencies that partner with SHIPs may include:  
1  Reducing the workload of Medicaid intake workers through activities such as eligibility pre-
screening or outreach about the eligibility criteria by specially trained SHIP counselors (although it 
is always done with the caveat that actual determinations must be made by the State Medicaid 
agency or appropriate government employee and that the individual has a right to request such a 
determination) or development of a shortened application form;  
2  Improving access to a variety of community-based organizations that have contacts with  
individuals who may qualify for Medicare Savings Programs;   
3  Educating potential applicants of Medicare Savings Programs through services provided by 
SHIP counselors; and  
4  Enhancing customer service through dissemination of applications via SHIP counselors and 
the ability of SHIP counselors to troubleshoot complex cases.  
 
For those who have already begun to establish these important links for improving outreach to 
qualified beneficiaries, we thank you for your contributions to the field. For those contemplating 
the value of such collaboration, we encourage you to contact State and local SHIP offices and 
speak with Medicaid colleagues in other States that have already established these important 
partnerships. You may be surprised to find that simply designating a Medicaid contact person for 
SHIPs to work with or copying the SHIP director on relevant communication goes a long way in 
facilitating a mutually beneficial working relationship.  
In addition to the "SHIP-to-SHIP" CD-ROM, HCFA is updating the "Outreach Kit" and "Resource 
Guide" that were created in 2000 and is continuing to develop outreach tools such as public service 
announcements (PSAs), training videos, posters, and brochures. The materials will be targeted to 
distinct segments of the population including Native Americans/Alaskan Natives, Hispanics, Asian 
Americans and Pacific Islanders, individuals with disabilities, and persons who care for potential 
qualified beneficiaries. These new tools will be available in May 2001. Further, HCFA released the 
grant solicitation, entitled, "Building Partnerships for Innovative Outreach and Enrollment of Dual 
Eligibles" on June 2, 2000. The Agency has awarded grants to six States to encourage partnership 
at the State, local, and community level. Those States include Connecticut, Maryland, Minnesota, 
Montana, Texas, and Washington. Additional grants may be available next year if funding is 
obtained. If you have questions about any of these activities, please contact Donna Wenner of my 
staff at (410) 786-6608, or E-mail her at Dwenner@hcfa.gov.  
Whatever your course of action, HCFA thanks you for your taking the time to consider SHIPs and 
other State, community, and local partners in your efforts to reach qualified beneficiaries. Your 
hard work in this area is greatly appreciated.  
Sincerely,  
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/s/  
Timothy M. 
Westmoreland Director  
Enclosures:  
List and Definition of Dual Eligibles "SHIP-to-SHIP: A Practical Guide to conducting Outreach on 
the Medicare Savings Program" State Health Insurance Assistance Program Coordinators  
cc: HCFA Regional Administrators HCFA Associate Regional Administrators for Medicaid and  State Operations Lee Partridge Director, Health Policy Unit American Public Human Services 
Association Janice Jackson Executive Director National Association of Area Agencies on Aging 
Bernice Hutchinson Director, State Health Insurance Assistance Programs Resource Center 
National Association of State Units on Aging Joy Wilson Director, Health Committee National 
Conference of State Legislatures Matt Salo Director of Health Legislation National Governors' 
Association SHIP Program Coordinators  
 
LIST AND DEFINITION OF DUAL ELIGIBLES  
Dual Eligibles - The following describes the various categories of individuals who, collectively, 
are known as dual eligibles. Medicare has two basic coverages: Part A, which pays for 
hospitalization costs; and Part B, which pays for physician services, lab and x-ray services, durable 
medical equipment, and outpatient and other services. Dual eligibles are individuals who are 
entitled to Medicare Part A and/or Part B and are eligible for some form of Medicaid benefit.  
1. Qualified Medicare Beneficiaries (QMBs) without other Medicaid (QMB Only) - These 
individuals are entitled to Medicare Part A, have income of 100% Federal poverty level (FPL) or 
less and resources that do not exceed twice the limit for SSI eligibility, and are not otherwise 
eligible for full Medicaid. Medicaid pays their Medicare Part A premiums, if any, Medicare Part B 
premiums, and, to the extent consistent with the Medicaid State plan, Medicare deductibles and 
coinsurance for Medicare services provided by Medicare providers. Federal financial participation 
(FFP) equals the Federal medical assistance percentage (FMAP).  
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1   QMBs with full Medicaid (QMB Plus) - These individuals are entitled to Medicare Part A, 
have income of 100% FPL or less and resources that do not exceed twice the limit for SSI 
eligibility, and are eligible for full Medicaid benefits. Medicaid pays their Medicare Part A 
premiums, if any, Medicare Part B premiums, and, to the extent consistent with the Medicaid State 
plan, Medicare deductibles and coinsurance, and provides full Medicaid benefits. FFP equals 
FMAP.  
2   Specified Low-Income Medicare Beneficiaries (SLMBs) without other Medicaid 
(SLMB Only) -These individuals are entitled to Medicare Part A, have income of greater than 
100% FPL, but less than 120% FPL and resources that do not exceed twice the limit for SSI 
eligibility, and are not otherwise eligible for Medicaid. Medicaid pays their Medicare Part B 
premiums only. FFP equals FMAP.  
3   SLMBs with full Medicaid (SLMB Plus) - These individuals are entitled to Medicare Part 
A, have income of greater than 100% FPL, but less than 120% FPL and resources that do not in 
exceed twice the limit for SSI eligibility, and are eligible for full Medicaid benefits. Medicaid pays 
their Medicare Part B premiums and provides full Medicaid benefits. FFP equals FMAP.  
4   Qualified Disabled and Working Individuals (QDWIs) - These individuals lost their 
Medicare Part A benefits due to their return to work. They are eligible to purchase Medicare Part A 
benefits, have income of 200% FPL or less and resources that do not exceed twice the limit for SSI  eligibility, and are not otherwise eligible for Medicaid. Medicaid pays the Medicare Part A 
premiums only. FFP equals FMAP.  
5   Qualifying Individuals (1) (QI-1s) - This group is effective 1/1/98 - 12/31/02. There is an 
annual cap on the amount of money available, which may limit the number of individuals in the 
group. These individuals are entitled to Medicare Part A, have income of at least 120% FPL, but 
less than 135% FPL, resources that do not exceed twice the limit for SSI eligibility, and are not 
otherwise eligible for Medicaid. Medicaid pays their Medicare Part B premiums only. FFP equals 
FMAP at 100%.  
6   Qualifying Individuals (2) (QI-2s) - This group is effective 1/1/98 - 12/31/02. There is an 
annual cap on the amount of money available, which may limit the number of individuals in the 
group. These individuals are entitled to Medicare Part A, have income of at least 135% FPL, but 
less than 175% FPL, resources that do not exceed twice the limit for SSI eligibility, and are not 
otherwise eligible for Medicaid. Medicaid pays only a portion of their part B premiums ($2.23 in 
1999). FFP equals FMAP at 100%.  
7   Medicaid Only Dual Eligibles (Non QMB, SLMB, QDWI, QI-1, or QI-2) - These 
individuals are entitled to Medicare Part A and/or Part B and are eligible for full Medicaid benefits. 
They are not eligible for Medicaid as a QMB, SLMB, QDWI, QI-1, or QI-2. Typically, these 
individuals need to spend down to qualify for Medicaid or fall into a Medicaid eligibility poverty 
group that exceeds the limits listed above. Medicaid provides full Medicaid benefits and pays for 
Medicaid services provided by Medicaid providers, but Medicaid will only pay for services also 
covered by Medicare if the Medicaid payment rate is higher than the amount paid by Medicare, 
and, within this limit, will only pay  
 
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to the extent necessary to pay the beneficiary's Medicare cost-sharing liability. Payment by 
Medicaid of Medicare Part B premiums is a State option; however, States may not receive FFP for 
Medicaid services also covered by Medicare Part B for certain individuals who could have been 
covered under Medicare Part B had they been enrolled. FFP equals FMAP.  
 
STATE  HEALTH  INSURANCE  ASSISTANCE  PROGRAM  PROGRAM 
COORDINATORS  
STATE NAME ADDRESS PHONE/FAX  
   
   
 
 
   
 
 
 
California Department of Aging 1600 K Street Sacramento, California 
95814  
 
 
   
 
 
  Bob Pierce State of 
Colorado Division 
of Insurance 1560 
Broadway, Suite 
850 Denver, 
Colorado 80202  
 
 
 
 
Margaret Gerundo- 
  S
tate of Connecticut  Department of Social Murkette 
 
Services Division of Elderly Services 25 Sigourney 
Street, 8th Floor Hartford, Connecticut 06106  
 
 
 
 
 
     
 
 
DC 
  Karyn 
Penelope Lantz   Barquin    
 
   
Health Insurance Counseling Project 2136 Pennsylvania Ave., NW  (f)  
Washington, D.C. 20052  
DC Office on Aging 441 4th Street NW, Suite 900 South Washington, 
DC 20001  
(cid:31)  (202) 676-3900  
(cid:31)  (202) 293-4043  
 
(f)  
(cid:31)  (202) 727-8367  
(cid:31)  (202) 724-4979  
 
 
  (cid:31)  (302) 577-
Delaware Insurance Department 841 Silver Lake Blvd. Dover,  4791  
Delaware 19904   (cid:31)  (302) 577-
4793  
Division of Aging 1901 DuPont Highway New Castle, Delaware   
(f) DE  
19720  
 
 
(cid:31)  (302) 739-6266  
(cid:31)  (302) 739-5280  
 
(f)  
 
Donna Donhauser  
Janet Villarreal  
   
  Human Resources 
Division of Aging 
Services 2 
Peachtree Street, 
th
NE 36  Floor Atlanta, 
Georgia 30303  
 
Tom Reimers Florida Dept. of Elder Affairs 4040 Esplanade Way #280 
S Tallahassee, Florida 32399-7000 Brenda Cook Georgia Dept. of 
 
 
 
 
         
 
 
Gwen Ouye Hawaii Executive Office on Aging 250 South Hotel Street, 
#109 Honolulu, Hawaii 96813-2831  
   
Kenneth Hurt Idaho Department of Insurance 700 West State Street, 3rd 
Floor Boise, Idaho 83720-0043  
 
 
 
Kathy Claunch Illinois Department of Insurance 320 West Washington 
Street Springfield, Illinois 62767  
 
 
 
Grace Chandler Indiana Department of Insurance 311 West Washington 
Street Suite #300 Indianapolis, Indiana 46204-2787  
 
 
 
Kris Gross Iowa Insurance Division 330 Maple Street Des Moines, 
Iowa 50319  
 
 
 
Melissa Gregory Kansas Insurance Department 130 S. Market, Suite 
4030  
P.O. Box 3850 Wichita, Kansas 
67201 Sandra Rolland Kentucky 
Cabinet for Human Resources 
Division on Aging 275 East Main 
Street, 5th FL, W-CCF Frankfort, 
Kentucky 40621  
 
 
 
         
 
 
 
Alan Heumann Louisiana Department of Insurance 950 North 5th Street  
P.O. Box 94214 Baton Rouge, Louisiana 
70804-9214  
 
 
  Services State 
Mary Walsh Maine Dept. of Human Services Bureau of Elder & Adult  House Station #11 35 Anthony Ave. Augusta, Maine 04333-0011  
 
 
 
Michelle Holzer Maryland Office on Aging 301 West Preston Street 
Baltimore, Maryland 21201  
 
 
 
Mary Kay Browne Massachusetts Executive Office of Elder Affairs 1 
Ashburton Place, 5th Floor Boston, Massachusetts 02108  
 
 
 
 
 
 
 
MI 
  Wendi 
Sarah Slocum   Middleton      
MMAP Project 
Director 6105 West St. 
Joseph Highway Suite 
209 Lansing, Michigan 
48917  
 
 
Michigan Office of Services to the Aging 
 
(f) Minnesota Board on 
P.O. Box 30676 Lansing, Michigan 48909   Aging 444 Lafayette 
(cid:31)  (517) 622-5226  
Road St. Paul, 
(cid:31)  (517) 622-4217  
Minnesota 55155-3843  
 
(f)  
(cid:31)  (517) 373-4071  
(cid:31)  (517) 373-4092  
 
 
 
 
 
     
 
 
  Ivory Craig 
Mississippi 
Division of Aging 
and Adult Services 
750 North State 
Street Jackson, 
Mississippi 39202  
 
 
 
 
Jay Dobbs CLAIM Program Missouri Patient Care Review Foundation 
3425 Constitution Court, Suite E Jefferson City, Missouri 65109  
   
Gary Refsland Montana Partnership for Health Insurance Information 
Montana State Office on Aging 212 Ridge Trail Bozeman, Montana 
59715  
 
 
 
Tiffany Geis Nebraska Department of Insurance The Terminal Building 
941 "O" St., Suite 400 Lincoln, Nebraska 68508  
 
 
 
 
 
 
 
NV Myra Davis Deborah Cormier 
     
 
  Las  Vegas,  Nevada 
89101 
Nevada Division of Aging Services 340 North 11th Street, Suite 203 
   
(f) NH  
Same  
(cid:31)  (702) 486-3796  
(cid:31)  (702) 486-3572  
 
(f)  
(cid:31)  (702) 486-3578  
(cid:31)  (702) 486-3572  
 
 
Lloyd Farnham  
Suzann Knight  
   
 
 
 
 
 
 
 
    Hampshire 03301-
3843 
 
Department of Human Services 129 Pleasant Street Concord, New 
 
Family Resource Management 110B Pettee Hall 55 College Road Durham, New 
Hampshire 03824-3599  
 
 
  (cid:31)  (603) 271-
0966  
(cid:31)  (603) 271-
4643  
 
(f)  
(cid:31)  (603) 862-
0092  
(cid:31)  (603) 862-
0107  
   
(f)  
 
   
Deborah Breslin Division of Senior Affairs  
 
(cid:31)  P.O. Box  807  
 S. Broad & Front Streets Trenton, New Jersey 08625  
 
Division of Senior Affairs Quakerbridge, 
Blvd. Building 12B Hampton Township, New 
Jersey 08619  
 
 
 
 
 
   
  NY 
 
Ann R. Krull  
T. Brendan Mooney  
 
 
Gerald Garcia New Mexico State Agency on Aging 228 East Palace 
Avenue Ground Floor Santa Fe, New Mexico 87501  
 
 
 
New York State Office for the Aging Two Empire State Plaza Agency 
Bldg.. #2 Albany, New York 12223-1251  
Same  
   
 
 
(cid:31)  (518) 473-5108  
(cid:31)  (518) 486-2225  
 
(f)  
(cid:31)  (518) 473-5108  
(cid:31)  (518) 486-2225  
 
(f)  
 
 
 
Carla Suitt Obiol North Carolina Department of Insurance 111 
Seaboard Avenue Raleigh, North Carolina 27604  
   
 
 
 
 
North Dakota Dept. of Insurance  
600 East Boulevard, Fifth Floor  
Bismarck, North Dakota 58505 
 
 
       
 
  Gretchen Margraf 
Ohio Department of 
Insurance 2100 
Stella Court 
Columbus, Ohio 
43215  
 
 
 
 
Bill Smith Oklahoma Insurance Department  
P.O. Box 53408 2401 N.W. 23rd, Suite 28 
Oklahoma City, Oklahoma 73107  
 
  Margaret Scott  Oregon Division of Insurance 350 Winter Street NE, Room 440 Salem, 
Oregon 97310  
 
 
 
Jack Vogelsong Pennsylvania Department of Aging 555 Walnut Street, 
5th Fl. Harrisburg, Pennsylvania 17101-1919  
 
 
 
Jose Gonzalez Puerto Rico Governor's Office of Elderly Affairs Cobia's 
Plaza Building Umlevel, Stop 23 Poncedel  
 
P.O. Box 50063 Old San Juan Station San 
Juan, Puerto Rico 00902 Will Speck Rhode 
Island Department of Elderly Affairs 160 
Pine Street Providence, Rhode Island 
02903-3708  
 
 
 
 
       
 
 
 
Gloria McDonald South Carolina Office on Aging 1801 Main Street 
Columbia, South Carolina 29202  
 
 
 
 
   
 
SD Mike Parker Candise Gregory 
 
Mellissa Parette South Dakota Office of Adult Services & Aging 700 
Governors Drive Pierre, South Dakota 57501-2291  
 
   
  Street., Suite 2 
Rapid City, South 
South Dakota Office of Adult Service & Aging 335 Main Avenue, Suite 
Dakota 57702 
300 Sioux Falls, South Dakota 57102-0305  
South Dakota Office of Adult Service & Aging 2638 West Main 
   
(cid:31)  (605) 773-3656   (f)  
(cid:31)  (605) 773-6834  
 
(f)  
(cid:31)  (605) 336-2475  
(cid:31)  (605) 336-6919  
 
(f)  
(cid:31)  (605) 342-3494  
(cid:31)  (605) 342-7718  
 
   
  Patti George 
Tennessee 
Association of 
Legal Services 211 
Union, #833 
Nashville, 
Tennessee 37201  
 
 
 
 
Kay Ferris Texas Department on Aging 806 Blue Hills Drive Dripping 
Springs, Texas 78620  
 
Sally Ann Brown 
Utah Division of 
  Aging and Adult  Services 120 North 200 West St., Box 45500 Salt Lake City, Utah 
84103 Northeastern Vermont 1161 Portland Street St. Johnsbury, 
Vermont 05819  
 
 
 
 
       
 
  Joe Guarino 
Virginia 
Department for the 
Aging 1600 Forest 
Avenue, Suite 102 
Richmond, Virginia 
23229  
 
 
 
 
Iris Bermudez Governor's Hospital and Medical Center 4007 Estate 
Diamond Ruby, Box 18 St. Croix, Virgin Islands 00820-4421  
   
Joan Lewis Washington Office of Insurance Commissioner  
P.O. Box 40256 Olympia, Washington 
98504-0256  
Washington Office of Insurance 
Commissioner 4224 6th Ave. Lacey, 
Washington 98504  
 
 
 
Barbara Reynolds West Virginia Bureau of Senior Services 1900 
Kanawha Boulevard East Bldg. #10 Charleston, West Virginia 25305-
0160  
 
Glen Silverberg Wisconsin Bureau of Aging and LTC Resources 217 South 
Hamilton Street, Suite 300 Madison, Wisconsin 53703 Wyoming Department of 
Insurance 1 W. Wilson Street, Rm 450 Cheyenne, Wyoming 53707-7851  
 
 
 
 
 
 
Wyoming  Senior Citizens 1130 Major Ave.  
P.O. Box BD Riverton, Wyoming 82501 WY  
 
 
 
 
 
 
 
   
Lloyd Wilder   (f)  
(cid:31)  (307) 856-
6880  
Janet Hackelman  
(cid:31)  (307) 856-
(cid:31)  (307) 777-7401  
4466  
(cid:31)  (307) 777-5895     (f)  
 
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