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Documents
Needed for Medicaid Application |
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1. |
Birth
certificate, marriage license and citizenship/naturalization
papers |
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2. |
Social
Security Card |
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3. |
Medicare
Card |
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4. |
Health
insurance card (example, Blue Cross) |
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5. |
Life
insurance policy(ies) |
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6. |
Burial
plot information |
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7. |
Irrevocable
Funeral Agreement or any agreement with a funeral
director, Burial Trust or Burial Space information |
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8. |
Most
recent payment stub for health insurance. If health
insurance is a part of a pension benefit, let us
know the name of the company responsible for the
premium |
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9. |
Copy
of bank statements for all accounts for last six
months |
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10. |
Information
regarding other assets, including stocks, bonds,
Certificates of Deposit, Money Market, IRA's, property
other than your home, etc. |
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11. |
Proof
of Social Security benefits, Pensions, VA Benefits
or other income. Pursuant to Family Independence
Agency policy, bank statements are not proof
of current income. Acceptable verifications include
check stubs, award letters, or statements from
the responsible agency. Verification must be for
the current year, not from previous years. |
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12. |
Shelter
costs (i.e. rent receipts, utility bills, real
estate taxes and home insurance) |
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13. |
| Other
information: _______________________________________________ |
| ______________________________________________________________ |
| ______________________________________________________________ |
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“Protecting
and caring for your family as we would our own.”
The
Law Firm of Barron, Rosenberg, Mayoras & Mayoras
1301 West Long Lake Road
Suite 340
Troy, MI 48098
Phone: (248) 641-7526
Fax: (248) 641-7073 |
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