The following information is necessary to complete the medicaid application. The more documentation provided, the quicker the processing time.
1. Proof of Age
- US Passport
- Birth Certificate
- Driver’s License
- Baptismal Certificate
2. Proof of Citizenship
- US Passport
- Birth Certificate
- Naturalization Papers
- Alien Registration Card
- Final Adoption Decree
3. Identity
- US Passport
- Photo License
- School ID
- US Military ID
- County ID
4. Marital Status
- Marriage Certificate
- Separation Papers
- Divorce Decree
- Spouse’s Death Certificate
5. Financial Resources
All data applicable to resources owned in the last 5 years.
- Checking Account Statements
- Savings Account Statements
- Money Market Accounts
- Certificate of Deposit
- Credit Union Accounts
- Stocks or Bonds
- Annuities
- IRA, 401k, 403B, Keogh Accts
- Title to Automobile & Value
- Deeds to Property Owned and Listing Agreement
- Property Proceeds I HUD-1
- Mortgages
- Special Needs Trusts
- Life Insurance Policies with Cash Value Statement
- Burial Plot Information
- Prepaid Funeral Contracts
6. Income
- Most Recent Pay Stubs
- Social Security Award Letter
- Railroad Retirement Award Letter
- Temp. Disability Check or Award Letter
- Pension Statement
- Unemployment Check Stubs
- Support/Alimony Checks or Court Order
- VA Award Letter
- SSI Award Letter
7. Other
- Social Security Card (front & back)
- Medicare Card (front & back)
- Additional Insurance Cards/ RX Card
- Insurance Premium bill or Payment coupon
- POA
- Guardianship Documentation
The following living expense will be taken into account if the Medicaid recipient is placed in a nursing facility but the spouse remains living in the community
- All Income Verification (Social Security Award Letter, Pension Stub, Etc.)
- Spouse’s ID & Cards
- Electric Bills
- Real Estate Tax Bills
- Gas/Oil Bills
- Mortgage Statements
- Rent Receipts
- Water/Sewer Bills
- Home/Renter’s Insurance