Long-Term Care

Financial Eligibility Checklist for Long Term Medicaid

Individuals applying for Long-term Care Medicaid must provide documentation verifying any and all income and assets. If married, then all the couple’s resources and assets must be provided regardless of name and ownership.

Social Security, Medicare, and health care insurance cards. Proof of citizenship (i.e., birth certificate, naturalization certificate) and copy of photo identification (i.e., driver’s license). Permanent resident card if applicable.

Copies of policies and/or documents related to life insurance, burial policies, plots, and/or accounts, current cash value in life insurance policies owned solely or jointly by the applicant.

Proof of income, both gross and net, showing deductions (i.e., civil service pensions, military pensions, company pensions, social security, oil and gas royalties, rent-al property income, interest, and dividend income, etc.). Proof of spousal income for Nursing Home applicants

Bank statements on all accounts at any financial institution (checking, savings, CD’s, stocks, bonds, annuities, investments, etc.) We also need safety deposit box contents and mineral rights showing fair market value and royalty income received within the past 12 months. We will need the last sixty (60) months of statements on all accounts held in the past 60 months. If any asset has been sold, traded, or given away within the last 60 months prior to entry into the nursing home and application for Medicaid, we will require documentation of the transfer. Statement of any bank accounts, CD’s, stocks, bonds, etc. That have been closed in the prior 60 months must also be provided.

Legal descriptions and copies of deeds for home property, and other owned real estate, which includes mineral rights. Please note we will need copies of deeds where a Life Estate is retained. If there is a contract for deed or promissory note on any property, provide a copy. If you have a mortgage or reverse mortgage on any property, please provide documentation and statements.

Titles to vehicles, boats, motorcycles, recreational vehicles, etc. (One vehicle is exempted)

Documentation is showing any transfer of property, money, or assets in last 60 months (5 years) belonging to applicant.

Proof of medical expenses such as monthly health insurance premiums, prescription costs, medical supplies, and payments to medical suppliers.

For income and resource standards, please click on the following

Appendix C-1 <https://oklahoma.gov/content/dam/ok/en/okdhs/documents/searchcenter/okdhsformresults/c-1.pdf>.

Please note that this is only a general outline of the information needed. Please always refer to policy on the Oklahoma Human Services website OAC 317 for updates and accurate information.