Application Documents Checklist for Long-Term Care Medicaid

Paperwork is the part of a Medicaid application that takes the most time. Caseworkers must verify every fact on the application, and most delays and denials come from documents that are missing, out of date or hard to read. This checklist lists the records most states ask for, explains why each one matters, and offers tips for finding records that are hard to locate. A shorter printable version is at Printable documents checklist. Your state guide explains any state-specific forms.

Figures change periodically. Double-check current amounts before relying on them.

How to use this checklist

Start early. Some records, such as old bank statements or a deed, can take weeks to get.
Do not wait for every document to file. You can file the application and send missing papers later, within the deadlines the caseworker gives you. Filing early protects the earliest possible coverage date.
Make copies. Send copies, not originals, unless the state asks for an original. Keep a complete set of everything you send.
Label each page with the applicant’s name and case number once you have it.
Keep a log of what you sent, when, how (mail, fax, upload, in person) and to whom.

1. Identity, age and status

Document	Why it is needed
Photo ID (driver’s license or state ID)	Proves identity
Social Security card or number	Required on the application; used to check income and benefits
Medicare card and any Medicare Advantage or Part D card	Shows other coverage that pays first
Birth certificate or other proof of age	Age 65 or older is one way to qualify
Proof of U.S. citizenship or qualified immigration status	Required for full Medicaid. See Citizenship and residency
Proof of state residence (lease, utility bill, property tax bill, nursing home admission letter)	Medicaid is paid by the state where the person lives
Marriage certificate, divorce decree or spouse’s death certificate	Marital status changes which rules apply. See Marital status

Many states can check citizenship and Social Security information electronically. Provide the documents you have, and tell the caseworker about any you cannot find.

2. Income

Document	Notes
Social Security award letter for the current year	Shows the gross amount before Medicare premiums
Pension statements	Including any survivor pensions
Annuity payment statements	Plus the annuity contract itself
IRA or 401(k) required distribution statements	Rules on retirement accounts vary. See Retirement accounts
VA benefit letters	Pension, compensation, Aid and Attendance. See VA benefits and Medicaid
Rental income records	Leases, rent ledgers, expenses
Interest and dividend statements	Often shown on account statements
Pay stubs	If the applicant or spouse still works
The spouse’s income	Needed to calculate the spousal income allowance

3. Bank and investment accounts

Statements for every checking, savings, money market and credit union account, including joint accounts and accounts the applicant is a signer on.
Brokerage and mutual fund statements.
Certificates of deposit.
Savings bonds (list serial numbers and issue dates).
Retirement accounts (IRA, 401(k), 403(b), TSP).
Health savings accounts.
Cash value of any cryptocurrency or digital accounts.

How far back? Many states ask for the full 60 months (five years) of statements for the look-back; others ask for a few recent months first and more if something looks unusual. Expect questions about large withdrawals, checks to family members and transfers between accounts. A short written explanation, with receipts if you have them, prevents delays. See How Medicaid verifies income and assets.

4. Property and other assets

Deeds for the home and any other real estate.
Recent property tax bills or assessments.
Mortgage, home equity loan or reverse mortgage statements.
Leases for any rental property.
Vehicle titles and registrations (and loan statements).
Life insurance policies, with a current statement showing face value and cash surrender value. See Life insurance.
Prepaid funeral contracts, burial plot deeds and funeral trust documents. See Funeral trusts.
Business ownership records, if any.
Trust documents for any trust the applicant or spouse created or benefits from.
Annuity contracts.
Any promissory notes, loans made to others, or mortgages the applicant holds.

5. Transfers and sales in the past five years

Records of any gift of money or property, including to children, grandchildren, churches or charities.
Records of any sale of property, with the price and proof of value (such as a settlement statement).
Deeds showing property put in someone else’s name, or a name added to a deed.
Caregiver or personal care agreements and payment records. See Caregiver agreements.
Receipts for large purchases.

Transfers do not automatically cause a penalty. Some are exempt, and some can be explained or undone. But they must be reported. See Gifts and the look-back and Exempt transfers.

6. Health insurance and medical

Medicare supplement (Medigap) policy and premium notices.
Other health insurance and premiums (premiums are often deducted from the patient liability).
Long-term care insurance policy and benefit statements. See Long-term care insurance.
Medical records or a physician’s statement of care needs, if requested.
Nursing home admission date and records, or the date of a hospital stay that led to admission.
Unpaid medical bills, which may be used in some states to meet a spend-down or reduce the amount owed.

7. Legal authority

Durable power of attorney (financial).
Health care power of attorney or proxy.
Guardianship or conservatorship order.
The state’s authorized representative form.

If no one has legal authority and the applicant cannot sign, ask the caseworker about the authorized representative process. See Powers of attorney.

8. For married couples

Both spouses’ income and asset records, regardless of whose name is on the account.
Records showing the date the applicant first entered a hospital or nursing home for a stay expected to last at least 30 days (for the snapshot date).
The spouse at home’s housing costs: rent or mortgage, property taxes, homeowners insurance, condo fees and utilities. These can increase the spousal income allowance.

9. If a Miller trust is used

In states with an income cap, people with income over the cap may need a Qualified Income (Miller) Trust. Bring:

the signed trust document;
proof of the trust bank account;
proof that income is deposited into the account each month.

Tips for hard-to-find records

Old bank statements: banks can usually provide them, sometimes for a fee. Online banking often shows several years.
Deeds: the county recorder or register of deeds keeps copies.
Life insurance: look for premium notices in old mail or bank statements. The insurer can provide a statement of cash value.
Social Security award letter: can be requested from the Social Security Administration.
VA letters: can be requested from the VA.
Lost birth or marriage certificates: the state vital records office keeps them.

Common document problems that cause delays

Statements with missing pages. Caseworkers usually need every page, including the blank back pages that show the account number or the closing balance. Send whole statements.
Unreadable copies. Phone photos that are blurry, cut off or taken at an angle are often rejected. Scan or photograph flat pages in good light.
Out-of-date statements. Most states want the most recent statement, often within the last month or two, in addition to older ones.
No explanation for large withdrawals. A withdrawal of a few thousand dollars with no explanation may be treated as a gift. Attach a short note with receipts.
Life insurance statements that show only the face value. The caseworker usually needs the cash surrender value as of a recent date.
Funeral contracts that do not say whether they are irrevocable. Ask the funeral home for a statement that shows the contract type and what goods and services it covers.
Documents sent to the wrong office. If your state uses a central processing center, sending papers to a local office can delay them. Use the address or upload method on the request letter.

What happens after you send documents

The caseworker reviews each document against the application. If something is still missing or unclear, the state sends another written request with a new deadline. Respond to each request separately and completely, and keep proof of what you sent and when. If you cannot get a document by the deadline, ask in writing for more time before the deadline passes and explain what you have done to get it. Many states must help applicants who cannot get records on their own, for example by contacting a bank directly with the applicant’s permission.

Getting experienced help

Gathering documents is tedious but straightforward. Knowing what the documents reveal, and how a caseworker will treat a withdrawal or a transfer, is the harder part. A Certified Medicaid Planner can review records before filing, spot transfers that need explanation, and prepare written responses that prevent denials. As a rough guide, published fees for help with an application range from about $500 to $6,000, and hourly help from about $150 to $600.

Frequently asked questions

What if a bank account was closed years ago? Report it anyway, with the closing date and where the money went. The bank can usually provide the final statement.

Do I need every statement for five years? Many states ask for them; others ask for fewer at first. Gather what you can and respond to each request as it comes.

Can I send documents by email or upload them? Many states accept uploads through an online portal. Keep the confirmation.

What if Dad paid cash for things? Write a short explanation of what the cash was used for, with any receipts. Large unexplained cash withdrawals may be treated as transfers.

Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.