Printable Application Documents Checklist

This is a tick-box version of our Application documents checklist, designed to be printed and carried to the kitchen table, the bank or the caseworker’s office. Tick each item as you find it, note where it is, and bring the list when you file. Below the checklist, we explain what to do about items you cannot find and how to organize what you send. Nothing on this page is stored or sent anywhere.

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

Identity and status

☐ Photo ID (driver’s license or state ID)
☐ Social Security card or number
☐ Medicare card; Medicare Advantage or Part D card
☐ Birth certificate or other proof of age
☐ Proof of U.S. citizenship or qualified immigration status
☐ Proof of state residence (lease, utility bill, property tax bill or facility admission letter)
☐ Marriage certificate, divorce decree or spouse’s death certificate

Income (applicant and spouse)

☐ Social Security award letter for this year
☐ Pension statements
☐ Annuity statements and contracts
☐ IRA or 401(k) distribution statements
☐ VA benefit letters (showing each part of the benefit)
☐ Rental income records
☐ Pay stubs, if working
☐ Any other income (interest, dividends, royalties, support)

Accounts (applicant and spouse)

☐ Checking account statements (number of months requested: ____)
☐ Savings and money market statements
☐ Certificates of deposit
☐ Brokerage and mutual fund statements
☐ Retirement account statements
☐ Savings bonds (serial numbers and dates)
☐ Health savings account statements
☐ Payment app or digital account balances
☐ Closed accounts in the past five years, with final statements

Property and other assets

☐ Deed to the home
☐ Property tax bill or assessment
☐ Mortgage, home equity or reverse mortgage statements
☐ Deeds and leases for other real estate
☐ Vehicle titles and loan statements
☐ Life insurance policies and cash value statements
☐ Prepaid funeral contract (showing whether it is irrevocable)
☐ Burial plot deed
☐ Trust documents
☐ Business ownership records
☐ Promissory notes or loans made to others

Transfers in the past five years

☐ Records of gifts of money or property
☐ Records of sales of property, with sale price and settlement statements
☐ Deeds showing ownership changes
☐ Caregiver agreements and payment records
☐ Receipts for large purchases
☐ Written explanations of large withdrawals

Insurance and medical

☐ Medigap or other health insurance policy and premium notices
☐ Long-term care insurance policy and benefit statements
☐ Nursing home admission date or hospital discharge papers
☐ Physician’s statement or medical records, if requested
☐ Unpaid medical bills

Legal authority

☐ Durable power of attorney (financial)
☐ Health care power of attorney or proxy
☐ Guardianship or conservatorship order
☐ State authorized representative form

For married couples

☐ Both spouses’ income and asset records
☐ Date of the first continuous hospital or nursing home stay (snapshot date)
☐ Spouse at home’s housing costs: rent or mortgage, taxes, insurance, condo fees, utilities

If a Miller trust is used

☐ Signed trust document
☐ Trust bank account information
☐ Proof of monthly deposits

If VA benefits are involved

☐ Discharge papers (DD-214)
☐ Current VA award letter
☐ Any notice reducing the pension

Tracking what you send

Date sent	Item	How sent	Confirmation	Notes

How to use this checklist

Print it and keep it with the application folder.
Tick each item as you find it, and write where the original is kept.
Mark items that do not apply with “N/A” so the caseworker knows you checked.
Do not wait for every item to file. You can file and send missing documents later, within the deadlines the caseworker gives you. Filing early protects the earliest coverage date and retroactive coverage.
Send copies, not originals, unless the state asks for an original.
Write the applicant’s name and case number on every page.
Use a cover letter listing each item enclosed. See Working with your caseworker.
Keep a full set of everything you send.

If you cannot find something

Bank statements: ask the bank; many keep several years of records and can print them, sometimes for a small fee.
Deeds: the county recorder or register of deeds keeps copies.
Life insurance: look for premium notices in old mail or bank statements, then ask the insurer for a cash value statement.
Social Security letters: request a benefit verification letter from the Social Security Administration.
VA letters: request them from the VA.
Birth and marriage records: the state vital records office keeps them.
Funeral contracts: ask the funeral home for a copy and a statement of whether the contract is irrevocable.
Military discharge papers: request them from the military records center.

If a record truly cannot be found, tell the caseworker in writing what it is, what you have tried and what other proof you have. States must help applicants who cannot get records on their own.

What the caseworker looks for

The caseworker compares each document with the application: Do the balances match? Are all accounts listed? Are there large withdrawals or transfers that need explanation? Does the income on the award letter match what was reported? Is the funeral contract irrevocable? Is the power of attorney broad enough? Anticipating these questions, and attaching short written explanations where needed, prevents delays. See How Medicaid verifies income and assets.

Organizing a binder

Many families find a simple three-ring binder or a single digital folder works best:

Front pocket: this checklist, the contact log and the tracking table.
Section 1: the application and every notice from the agency, newest on top.
Section 2: identity and legal authority documents.
Section 3: income documents.
Section 4: account statements, one tab per account.
Section 5: property, insurance and funeral documents.
Section 6: transfers and explanations.
Section 7: copies of everything sent, each with its cover letter.

When a verification request arrives, the binder makes it easy to find the document, send a copy and record what was sent.

A simple timeline

When	What to do
Week 1	Print this checklist, gather what is at home, request missing records
Week 2	Request bank statements for the look-back period; find the deed and insurance policies
Week 2 to 3	File the application with what you have
After filing	Respond to each verification request by its deadline
Ongoing	Keep the binder up to date; note every call and letter

Common problems with documents

Missing pages. Send every page of each statement, including pages that look blank.
Unreadable copies. Scan or photograph flat pages in good light.
Old statements only. Include the most recent statement as well as older ones.
Unexplained withdrawals. Attach a short note and receipts.
Policies without values. Ask the insurer for a current cash value statement.
Funeral contracts without terms. Ask the funeral home to confirm whether the contract is irrevocable.

Getting experienced help

Gathering documents is something most families can do. Knowing what the documents will reveal, and how a caseworker will treat a withdrawal or transfer, is where experienced help is most useful. A Certified Medicaid Planner can review the documents before filing and prepare explanations. 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

How many months of bank statements do I need? It depends on the state. Many ask for the full 60-month look-back; others ask for a few months first. Fill in the number requested on the checklist.

Do I need the spouse at home’s documents? Yes, for an applicant who is married. Both spouses’ assets are counted at the start.

Can I upload documents? Many states accept uploads through an online portal. Keep the confirmation number.

What if Dad kept cash at home? Cash counts as an asset. Report it, and deposit it in an account so it can be documented.

What if a document is in a safe deposit box? List the box itself as well; its contents can count as assets, and the caseworker may ask what is in it.

Should I send originals? No, send copies unless the state asks for an original document.

What if the applicant has no bank account? Say so on the application, and explain how income is received and bills are paid.

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