Documents Needed for a Medicaid Application

MEDICAID APPLICATION DOCUMENTS

• DRIVERS LICENSE, PHOTO ID CARD, OR PASSPORT
• SOCIAL SECURITY CARD FOR APPLICANT (and spouse if living)
• RED, WHITE, AND BLUE MEDICARE CARD
• HEALTH INSURANCE CARDS, PREMIUM AMOUNT STATEMENT
• BIRTH CERTIFICATES FOR APPLICANT (naturalization papers for immigrants) MARRIAGE CERTIFICATE (if married)
• MILITARY SERVICE RECORD
• PROOF OF MONEY FROM OTHER SOURCES (LOANS, GIFTS, RENTAL INCOME)
• PROPERTY: COPY OF DEED. IF PROPERTY SOLD IN LAST FIVE YEARS THEN COPY OF CLOSING PAPERS
• TITLE AND REGISTRATION FOR ALL VEHICLES
• ALL INDIVIDUAL AND GROUP LIFE INSURANCE POLICIES THAT HAVE CASH VALUE, AMOUNT OF CASH VALUE AND FACE VALUE
• PROOF OF OWNERSHIP AND VALUE OF BURIAL LOTS AND PREPAID BURIAL PLANS
• STATEMENT OF GROSS AMOUNT OF PENSIONS
• SOCIAL SECURITY AWARD LETTER SHOWING AMOUNT OF SOCIAL SECURITY FOR THE CURRENT YEAR
• LAST FIVE YEARS OF INCOME TAX RETURNS
• PROVIDE ALL INVESTMENT AND BANK STATEMENTS AND COPIES/IMAGES OF CANCELED CHECKS FOR LAST FIVE YEARS (including accounts that were closed)
• IF ACCOUNTS WERE CLOSED IN LAST FIVE YEARS, THEN PROVIDE STATEMENTS THROUGH CLOSING, PROOF OF CLOSING OF ACCOUNT, AND PROOF OF DEPOSIT INTO NEW ACCOUNT (if amounts do not match then provide explanation)
• WRITTEN EXPLANATION FOR ANY CHECKS DURING LAST FIVE YEARS THAT WERE PAYABLE TO INDIVIDUALS (checks written for services, utilities, or doctors are obvious payees and do not need explanation)
• WRITTEN EXPLANATION FOR ANY CASH WITHDRAWALS (if withdrawn and deposited into another account then provide proof)
• WRITTEN EXPLANATION OF SOURCE OF DEPOSITS AND TRANSFERS ON THE FINANCIAL STATEMENTS (provide deposit slips and images of checks deposited. If cash was deposited then provide proof of the source of deposit (i.e. check copy))