The process of applying for Medicaid is not easy and becomes even more challenging without acquiring the necessary Medicaid verification items. We help individuals in Buffalo and WNY in applying and being accepted into the NYS Medicaid program. We have a background in elder law, and extensive experience in understanding the many complexities that can become involved, based on a multitude of various case types. Each Medicaid case is different, though eligibility depends on some specific factors.
Once approved, New York State Medicaid will pay doctors, hospitals, nursing homes, home care agencies, and other providers directly, so long as they accept Medicaid clients. One primary eligibility requirement is providing the proper Medicaid verification items to apply. Here are a few main eligibility requirements that must be provided with proof, to verify eligibility.
- Identity
- Residence
- Citizenship
- Disability (if the applicant is under 65 and claims disability)
- Marital Status
- Income
- Resources/financial statements
- Other information that may be necessary in some cases
These are some of the requirements that need to be proven to become eligible for the Medicaid program, and without the right documentation, they won’t be fulfilled, and the individual cannot be eligible. This is why it is vital to work with a professional who has experience acquiring verification items and working with you or your loved one to ensure all your documentation is provided and in order.
Here are a few examples of documentation that might be compiled to help meet eligibility requirements.
Personal Identification–
Birth certificate, valid driver’s license, passport, immigration papers, hospital certificate of birth
Income Statements – All sources of earned and unearned income must be documented and submitted for various time frames. Applicants will have their total monthly income compared against the Medicaid income standard. This determines if the applicant has excess income. Some types of documents related to income that may need to be compiled over the previous 3 months might include things like:
- Pay stubs demonstrating earnings
- Documentation of any Benefits programs
- Pension verification
- IRA/RMD verification
Asset & Resource Statements- Not to be confused with the above “Income Statements,” Asset and Resource Statements must reach back for the last 60 months, or 5 years back. This essentially audits the individual’s financial history in order to see if the applicant has any unreported income or any large withdrawals that are not allowed. The asset and resource verification items may include things like:
- Stocks & Bonds Certificates
- Life Insurance Policies
- Savings Bank Statements
- Checking Statements
- Funeral, burial, or funeral agreement deed to real property.
What If an applicant doesn’t have some of the necessary verification items?
This is why working with a professional who fully understands the Medicaid system is important. Not everyone has access to all of the necessary items. This does not necessarily mean Medicaid is off the table. If the documents requested by the Medicaid agency are not obtainable, an applicant can and should present any substitute evidence available to help establish eligibility. We can work with an individual to help understand what is necessary and what can be substituted.
If an individual has financial information that is not provided, Medicaid may use IRS resources and Social Security Number of the applicant to find any unreported sources of income. If and when this occurs, an investigation will be opened.
Need Help Acquiring Necessary Eligibility Items for Medicaid?
If you or a loved one is struggling to compile all the necessary documentation to get their health care covered by Medicaid, you have help. Elder Source can provide a helping hand every step of the way to ensure you have all the necessary documentation and verification items to ensure a smooth and seamless Medicaid application process. Just give us a call to get in touch today.