Medicaid Eligibility Requirements in New York: January 2011

Each county in New York State demands a unique set of paperwork when applying for Medicaid assistance to pay for nursing home care. While this is subject to change in April when the New York State Department of Health will institute statewide uniformity application rules, right now the rigid documentation requirements by individual county can often slow down the process – even when a family member may need immediate transfer into a residential health care facility. In order to prevent any delay, it is absolutely necessary to gather all relevant documentation before the application is actually submitted. (See below document list.)

No matter what New York State county you or your family member lives in, Medicaid requires documentation from five years ago. Be prepared to gather, research and request paperwork dating back to 2006. There are absolutely no exceptions. An application will be denied without all of the requested paperwork. Often applicants request that a Medicaid application be incompletely submitted, hoping that the documents that they provided will be enough.

“There is no ‘let’s make a deal’ with a county’s Department of Social Services. Even if clients have submitted two or three years’ worth of paperwork, but omit one year, I still have to explain them that without all of the necessary documentation, their Medicaid application will be denied,” says Elizabeth Schalk, Ettinger Law Firm’s experienced Medicaid supervisor.

As New York elder law attorneys with offices in over eleven counties, Ettinger Law Firm is familiar with many application requirements of statewide Department of Social Services offices. Schalk is well-apprised of how county application processes differ and what is required in order to improve the likelihood of a speedy process of individual Medicaid applications.

Please see this general list of documentation that may be required for your New York State County’s Department of Social Services when applying for Medicaid for nursing home care:

1.Original birth certificate, passport or Social Security confirmation.
2.A copy of naturalization papers if applicant was not born a U.S. Citizen.
3.A Social Security Card.
4.A copy of Medicare and secondary health insurance cards.
5.Verification of all life insurance policies and their face and cash values.
6.If a spouse is deceased, a copy of his/her death certificate.
7.If the applicant is married, a copy of the marriage license.
8.If the applicant is divorced, a copy of the divorce decree.
9.A copy of all burial plans and prepaid funeral arrangements.
10.Verification of Social Security benefits received
11.If the applicant still owns a home, a copy of the deed.
12.If the home has been sold on or after January 1, 2006, verification that the home
as sold at fair market value, with a statement from a real estate agent.
13.Financial statements for all investment accounts in the applicant’s name from January 2006 until the present, including all those closed or transferred.
14.All pages from bank statements from January 2006 until the present, along with a verification of Origin of Deposit (where the money came from) for any transaction of $1,000 or more and any withdrawals for any transaction of $1,000 or more. Verification of the gross amount of a pension received (such as a current award notice or check or statement from the source or a payor)
15.Federal income tax returns for the year 2006 through the present, including copies of all schedules and attachments. If a return hasn’t been filed for any of those years, a NO FILE letter must be provided from the IRS.

When applying for Medicaid benefits, the help of an experienced New York elder law attorney is invaluable.

This post was written by A.K. Lehmann of Lehmann & Lehmann Legal Communications

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