What information will I need to provide on a New York Medicaid application?

Our Elder Law and Medicaid Planning Attorneys Discuss the Information Needed on Your Medicaid Application 

Medicaid is a lifeline for millions of families across New York. Although it was originally designed to provide comprehensive coverage to individuals who can’t afford basic insurance, the rising cost of certain services can make Medicaid seem a more appealing alternative to private policies and self-pay. However, applying for Medicaid—whether to obtain basic care or to fund a long-term stay in assisted living—is a complicated process that is governed by an unusual combination of state law and federal statutes.

Here, the trusted Medicaid attorneys at Landskind & Ricaforte Law Group, P.C. discuss how to fill out a Medicaid application and the information you’ll need.  

Making Sense of Medicaid Requirements

Medicaid is federally subsidized health insurance available to U.S. citizens and lawful residents who meet certain income requirements. Depending on your coverage and circumstances, Medicaid can pay for services including, but not limited to, the following:

• Inpatient hospital services
• Outpatient medical services
• Nursing home and assisted living facilities
• Home health services
• Aging-in-place accessories, services, and facilities

Every state maintains its own Medicaid program, but baseline rules are set by the federal government. Since the U.S. Centers for Medicare and Medicaid Services define “low income” as a prerequisite for obtaining Medicaid coverage, states like New York are required to assess applicants’ finances before extending coverage. Assessments help protect the integrity of Medicaid but often have the unintended consequence of forcing older adults to make difficult decisions about how best to afford the costs of assisted living.

What to Know Before You Apply for Medicaid

Medicaid is a government-run program. Applying for benefits, whether for yourself or for a spouse, typically requires some advance preparation. Before getting started, you’ll need to:

Collect Your Personal Information

Medicaid applications require a significant amount of information about yourself, your family, and your income. You’ll need to provide the following:

• Your basic biographical information (name, date of birth, etc.)
• The names, addresses, and basic biographical information of your spouse, children, and any dependents
• Family medical history
• Your current health insurance details
• Information about your finances, including the properties you own and the accounts you control
• Information about personal possessions, such as your car, recreational vehicles, and collectibles
• Estimates on your monthly expenses
• Any estate planning documents you may already have

Prepare Documents to Prove Your Eligibility

Every Medicaid application examines your eligibility with respect to citizenship, residency, and income. You’ll need to be prepared to submit the following types of documents before applying for Medicaid:

• Your passport, birth certificate, and other proof of citizenship
• Your Social Security card or other proof of Social Security coverage
• Proof of Medicare, if you are currently receiving Medicare benefits
• Proof of marital status, typically fulfilled by providing a copy of your marriage certificate, divorce degree, or death certificate
• Proof of income, including bank statements and a full accounting of any other assets you own or control
• Proof of residence

Some applications require additional documentation. This could include an estimate of your monthly housing costs or information about why your spouse has chosen to refuse Medicare.

What to Expect Before and After Submitting an Application

Applying for Medicaid benefits is a time-consuming process that requires extensive documentation of your physical and financial circumstances. Even if you do everything right, you’ll still have to:

• Present original documents for verification
• Authorize Medicaid to investigate years of your financial history
• Prepare for the possibility of having to file an appeal

Any mistake, omission, or oversight—no matter how seemingly minor—could have big repercussions if left uncorrected. In a worst-case scenario, your request for benefits could be denied, leaving you unable to try again for years.