LIST OF MEDICAID VERIFICATION DOCUMENTS • Copy of Power of Attorney • Copy of Medicaid application • Copy of birth certificate, state ID or passport to verify citizenship • Copy of Social Security card to verify receiving social security benefits • Copy of driver’s license, state ID or passport to prove identity • Copy of front and back of Medicare card • Marriage certificate (if married) • Copy of front and back of any Medicare supplemental insurance or Medicare Advantage Plan • Statement of current premium payments for Medicare supplemental or Medicare Advantage Plan premiums from the insurance company • Copy of front and back of prescription drug plan • Statement of current premium payments for any prescription drug plans from the insurance company. • Prior 3 months - bank statements for each bank account (checking, credit union or savings) • Statement of gross social security benefits for the current year (December SSA benefit award statement) • Statement of gross pension income from the pension company for the current year • VA statement of benefits for the current year if receiving VA pension • Copy of any long-term care insurance policies • Copy of title to any motor vehicles and how titled • Copy of deed to any real property owned, how titled, address, fair market value and whether primary residence (intent to return form or dependent family member living there) • Statement of benefits for any life insurance policies including policy number, name of insurer, cash surrender value and current ownership • Statement of funeral home goods and services if funeral expenses have been pre-paid • Copies of any burial contracts or deeds • Statements verifying the current value of any stocks/bonds, certificates of deposit, trusts, retirement or money market accounts or annuities and how each account is titled • Utility bills with proof of rent or mtg. and home insurance if married. • Any paperwork of property transfers or gifts within the past 5 years