Jay J. Sangerman, PLLC
171 East 84th Street, Unit 21B
New York, New York  10028

 

 

© 2006

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Medicaid Documentation Checklist -- Abbreviated
A More Detailed List Is Available By Clicking Here

FOR MARRIED APPLICANTS, INFORMATION NEEDS TO BE PROVIDED FOR BOTH HUSBAND AND WIFE

1. PROOF OF AGE AND CITIZENSHIP

2. VERIFICATION OF MONTHLY INCOME

3. VERIFICATION OF RENT & RELATED EXPENSES

4. HEALTH INSURANCE

5. MEDICARE

6. SOCIAL SECURITY CARD

7. PROOF OF MARITAL STATUS

8. VETERAN STATUS

9. SPOUSAL REFUSAL

 

FINANCIAL DOCUMENTATION AND INFORMATION

 

(Please note that financial documentation is needed for 36 months for a nursing home application, but only for ONE month for a homecare community application. The documentation set forth below requiring 36 months of information and transaction explanations is only for nursing home Medicaid. For married applicants, documentation must include all information, whether it pertains to the Medicaid applicant or the spouse and whether in joint name with another or sole name)

 

10. CHECKING, SAVINGS, CD, MONEY MARKET AND OTHER ACCOUNTS

11. STOCKS & BONDS

12. REAL PROPERTY

13. COOPERATIVE APARTMENTS

14. LIFE INSURANCE

15. IRS FEDERAL TAX FORM 1040 AND ALL RELATED SCHEDULES FOR THE PRIOR THREE YEARS (no tax returns required for homecare community application)

16. REPARATIONS

17. PROOF OF TRANSFERS OF MONEY OUT OF APPLICANT'S NAME:
(This information is not required for homecare/community applications)
      

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    JAY J. SANGERMAN, ESQ.
    JAY J. SANGERMAN, PLLC
    171 East 84th Street - Unit 21B
    New York, New York 10028
    Telephone (212) 922-0711
    Facsimile (212) 439-0056