Verification of Income & Assets
Medicaid Verification – Quick Facts
Typical single applicant LTC Medicaid limit: $2,901/month income, $2,000 in countable assets.
Applicants must provide documentation for both income and assets.
Many states use databases to cross-verify financial information.
Most states review 60 months of financial history for asset transfers.
Fines, repayment, benefit loss, and even criminal charges.
How Does Medicaid Confirm Your Income and Assets?
For long-term care Medicaid, applicants must meet strict income and asset limits. In 2025, most single applicants are limited to $2,901/month in income and $2,000 in countable assets. But Medicaid doesn’t take your word for it — they require proof and may cross-check your financial records electronically.
How Is Income Verified?
The responsibility to prove income falls on the applicant. You must submit documentation showing both earned and unearned income exactly as listed on your application. This may include:
- Recent pay stubs
- Social Security, SSI, Railroad Retirement, or VA benefit award letters
- Pension statements
- Alimony or dividend checks
- Employer or supporter statements
- Tax returns
If no official proof exists, some states allow a signed self-declaration form. Many states also use databases — such as California’s Income Eligibility Verification System — to cross-match your reported income with other government and financial records.
Do You Have to Report Financial Changes?
Yes. Any changes to income or assets — like an inheritance, higher VA benefits, or new investments — must be reported, typically within 10 days. Failing to do so can result in benefit loss, fines, repayment demands, and even prosecution.
How Is Asset Ownership Verified?
Applicants must also document their assets. Medicaid distinguishes between countable assets (which affect eligibility) and exempt assets (which do not), such as:
- Primary home
- Household goods
- One vehicle
- Burial plots
- Term life insurance
Proof may include bank and credit union statements, property deeds, insurance policies, stock and bond records, and retirement account statements.
What Is the Medicaid Look-Back Rule?
Most states review the previous 60 months of financial activity to ensure assets were not given away or sold below market value. Violations trigger a penalty period of ineligibility. Exceptions include California, which ended its look-back for transfers made after January 1, 2024 (full elimination in July 2026), and New York, which currently has no look-back for Community Medicaid but plans to implement one in 2025.
How Do States Electronically Verify Assets?
Some states use systems like New York’s Asset Verification System (AVS), which connects with banks, investment firms, and property databases to confirm holdings and detect any hidden or transferred assets — even closed accounts within the look-back period.
What Happens If Your Finances Are Misrepresented?
Underreporting or hiding income or assets is illegal and can result in felony charges, jail time, large fines, repayment of benefits, and permanent disqualification from Medicaid.
Do You Have to Go Through Verification Again?
Yes. Medicaid redetermination generally happens every 12 months. You may need to resubmit documentation or have your finances checked electronically to confirm ongoing eligibility.
