Building Bridges between Medicare and Medicaid
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Building Bridges between Medicare and Medicaid

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September 2, 2011

In Oregon, 15% of all Medicare enrollees are also enrolled in Medicaid. Yet many more Medicare beneficiaries are eligible for Medicaid but not enrolled. 

To provide improved referrals and application assistance for this population, the Senior Health Insurance Benefit Assistance (SHIBA) and the State Unit on Aging (SUA) partnered with local Medicaid offices to cross-train their counselors on the respective programs. The cross-trainings offered an opportunity for Medicaid eligibility workers and SHIBA benefits counselors to gain a better understanding of how eligibility is determined—including the sometimes unique situations outside normal paths to eligibility—and how benefits are accessed from Medicare and Medicaid.

What did they do?

A total of six “Building Bridges” events were conducted between April and June 2011 in six areas across Oregon, with 139 attendees. The state sent invitations to a range of SHIBA counselors, Medicaid specialist, AAA, and ADRC staff.

The day-long trainings began with a half-day overview of Medicaid eligibility and coverage delivered by a SUA trainer. This session included information about eligibility determination formulas, service needs, income cap trusts, spousal impoverishment protections, long-term care, and estate recovery. As SHIBA Program Assistance Donna Delikat noted, “This was the most important information shared with the SHIBA counselors to impress upon them the complexity of determining Medicaid eligibility so that they do not pre-determine someone who may benefit from a referral to the Seniors & People with Disabilities (SPD) office.”

After a networking lunch, state SHIBA training staff gave participants a more in-depth background of Medicare programs and coverage—including sessions on Original Medicare, Medicare Advantage, Medigap, Part D, Extra Help, and the benefits counseling services offered by SHIBA.

What was the result?

SHIBA received significant positive feedback from attendees, many of whom expressed the wish that more of their colleagues could have attended:

  • “It was a useful training and I especially appreciated meeting some Medicaid workers to better understand the ‘ins and outs’ of their work with clients.  The presentations clarified some of my questions and I would recommend the training to other SHIBA volunteers.” — Helena, SHIBA counselor
  • “The information I received at this training impacted my work as a SHIBA volunteer by helping me to have a clearer understanding of the variety of Medicaid benefits available, which are more extensive than I realized prior to this training.” —Lynn, SHIBA counselor 
  • “I will say that I learned a lot more about how valuable a service SHIBA provides and how serious the commitment of your volunteers is.” —Kristen, Medicaid eligibility specialist


An additional benefit of the cross-training was the opportunity for specialists from the same county to meet face-to-face to facilitate better relations and referrals between the two networks. As Multnomah County’s SHIBA/Medicare outreach coordinator stated: “I now have a common basis for referring to specific Medicaid programs…Our volunteers have formed better partnerships with the Medicaid staff.  We couldn’t be happier.”

The results of the cross-training extended even to the state level. As Delikat describes, “We, the state office staff that participated, benefited greatly from this cross-training and have incorporated much of what we learned in our ongoing volunteer counselor training. The SUA participants were very appreciative to have more in-depth education about the Medicare program. We definitely built some bridges between these two, very committed, entities that will no doubt be able to provide much more comprehensive assistance to the most needy in our community. We hope to continue to build more bridges as funding allows.

For more information

Donna Delikat, Program Assistant
Senior Health Insurance Benefits Assistance (SHIBA)
PO Box 14480
Salem, OR 97309-0405
Tel: 503-947-7089 direct
donna.delikat@state.or.us 

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