What paperwork will I need to save for five-year lookback?

A check for the exact amount was issued to me and spouse to cover our homeowner damage claim. I deposited it into our joint checking as the check was issued to both of us. I immediately wrote a check for the exact amount to the contractor who repaired the damages. It was fully deducted from our checking real quick.

That said, I had to provide papers, copies of checks to show it was a straight insurance transaction. If your elderly relative may have had any home repairs - during this look back period - try locating that information. If she lived in a house before moving to her apartment, it's possible she could have made unusual deposits/withdrawals that will be reflected in her bank statements.

1) Online payment systems ask for personal details, not POA's often. One of the first things I did was set up her accounts at her credit card companies to make payments.

2) This is the list an Illinois SNF gave me for medicaid application. Sent 85 PDFs and had a family friend get a copy of her 31 year-old divorce decree.

Your state may differ, but this is a headstart:

* Driver's license and/or photo identification card
* Birth certificate or Baptismal certificate, Immigration papers (if applicable) 
* Social Security and Medicare Cards
* Marriage certificate, Divorce Decree, Death certificate of spouse (if applicable) * Legal Guardian / Power of Attorney papers
* Complete health insurance cards and verification of premium payments for patient and spouse (if applicable)
* Monthly bank records to application date, 60 months of checking account statements,  60 months of saving account statements, credit union, money market, IRA, mutual funds, etc…
* Explanation of deposits, withdrawals, and copies of checks over $500 excluding Social Security or Pension income, over the past 60 months.  
* Stock and Bonds owned or sold in the last 60 months
* Social Security, Pension, Railroad Retirement, Disability and/or all income checks.
* Federal or State income tax returns for the past five years. 
* Deeds, property tax statements, mortgage contract, contract for deed, sales contracts, on any  real estate owned currently or sold in the last five years.  Title and registration on any/all motor vehicles. Payment book if applicable. 
* Complete life insurance policies. Obtain letter from insurance company (on company stationery) showing cash and face value. 
* Unpaid medical bills for 3 month period prior to date of application. 
* Burial plot deed and burial plan contract, proof of ownership, and value.

The most critical thing I encountered when getting my Mom qualified for Medicaid, and sorting through everything with an Elder Care Attorney, was the cash/ checks that my father had periodically given me to help with my insurance (medical and car) and assisting with my daughter's apartment rent for just a few months before she graduated.

I had a bad divorce and lost everything, and moved in with my parents to care of them as my Mom had progressive dementia, my Dad COPD and stage III CHF. I am an RN, but due to the issues with both, constant doctors appointments, and frequent hospitalizations, I was unable to work a "regular" job. Retrospectively, had I had appropriate counsel, I would have set up a caregiver agreement. Because I did not, every single check that Dad provided to me I had to account for.....and I was required to pay back every cent before Mom could become Medicaid eligible. This was several thousand dollars (just a few hundred a month for 2.5 years), but it was within the 5 year look back. It didn't matter that I was taking care of them full time....I didn't have a "paid agreement". Medicaid looked at it as if it were cash gifts for heavens knows what....but it was only car insurance, rent for daughter, medication and medical insurance. Not even a new pair of shoes or a haircut.

So it would be a good idea to inventory the bank accounts to see if "cash" or "check gifts" were provided to anyone....this could be a surprise if you all of a sudden are applying for Medicaid, and there is a penalty period due to needing to repay the "gifts".

It would not hurt to go through the exercise of gathering the 5 years of documents with an Elder Care Attorney sooner rather than later. Better to be prepared in case you need extra spend down or need help with a situation as I described above. My Mom entered Memory Care....and was there for 3.5 years before she was literally kicked out to a nursing home due to increased care requirements. She was on hospice 3 times during that period...and not expected to make it....but she did. By the time we moved her to a Nursing Home, we'd paid over $350,000 to the Memory Care facility. So we had to apply for Medicaid because I was about to exhaust their savings.....and I am taking care of my almost 93yo Dad at home, monitoring him 24/7. I need to protect assets in case he one day needs care beyond what I am providing.

On my side I've developed a system too with some differences:

Massive information for 2 separate family members required a 100% of separation. Promise yourself you will never mix her information with your family's information. Best way to keep that promise is to organize early on.

All of my husband's documents are housed on the left side of the cabinet. Every 3 ring binder is blue. For Mom, all of her 3 ring binders are pink and stored on the right side of the cabinet. A box that fits in the same cabinet is always handy. I keep a 3-hole punch nearby. If a document does not initially fit into a pink or blue binder, I deposit it into the empty copy paper box- the kind that had several reams of copy paper. I've named the blue side of the cabinet "Medicaid library". The pink side is named the "Estate library".

Since each requires checks be issued from time to time, I bought a blue zippered pocket-style nylon/plastic see-through envelop that is already 3-hole punched. Well, the blue was put into at the front of my spouse's initial blue binder. His account check book is handy when I need to write a check.
I've done the same for Mom's using a pink zippered envelope for her checking account.

I took 5 years worth of documents reflecting the "look back" years to the local print/copy shop. I had each stack shrink wrapped by year and account number. In case I ever need Medicaid, I will always maintain a documents library for "the last five years" in addition to tax returns. My mom's documents are all still in the binders but are going to be moved to the shrink wrap phase this year! My goal is to be able to literally put my finger on the document that may be requested because they needed it last month.

As you determine the flow of documents that must be handled and organized, set up a system that will allow you to locate a document at nearly a moment's notice. Boxes and binders are pretty useful. This will allow you to collect all items that may be requested without it being too much to manage.

I was a POA for 28 years. I kept immaculate detailed records for everything. First of all, I was learning and I wanted to be prepared - think out of the box - and never get into trouble. So I kept the records and provided what was asked for and never had a problem. Keep "vendors" in date order - one file per "vendor" and you will have a simple but complete filing system should you ever need the documents. Put it all into one large "storage" box you can buy in any office supply store.

One thing they did ask for were copies of the receipts for caregiver services we used for Mom at her home before she had to go to nursing home. Life insurance policies that have cash value too. I handled Mom’s spend down. They do audit you periodocally and Social Security audits you too once you set up that rep payer account.

Many good answers...However, hire a "well-recommended" elder care lawyer.
I can't say enough about "well-recommended." I interviewed a couple of them who did not know their rear end from third base...

Grace + Peace,
Bob

Good answers given by all. To ensure you hold specifically what's needed, ask the DHS Medicaid there. Usually it's bank records, etc., for 3 months etc. But check anyway.

Haven't gone this route and hope we never have to - had enough paperwork and tasks taking over finances, getting her to MC, cleaning out condo, fixing it up and selling it - still things to handle, I don't need Medicaid up my butt too! Sounds like asking the Medicaid office for the area she lives in would be the best solution to that though.

Anyway, I only responded to address this:

"...I don’t want to pay to ship What I don’t need!"
Since you are POA, and this is for her benefit, can you not use her assets to pay for the shipping? It would be nice to keep costs down (my cheap-o side talking), but saving time and working through everything when you are not pressed to get it all or take the chance of missing something, it might be better to just ship all papers.

Just as a example, my mother's cousin was pitching things right and left and didn't want to pay the cost for trash (was tiny bags, $20 each!), so we loaded up my PU multiple times. Our transfer station wasn't open every day, so we had to store in my garage and didn't we find the CD paperwork they were looking for! My son also found $10 in an old wallet... Ship it all and go through it when you are not stressed to get it all done!

(Whenever we did tasks for mom, I would write checks from her account to cover the costs - not paying me, just the necessary costs, and keep that receipt too!)

You'd do yourself a favor by using an elder estate lawyer on this issue.

5 year look back is on bank accounts. Just got my dad on Medicaid in 2018 and now in process of mother getting approved for 2019. Bank will print out copies of statements, savings, etc for you. We only needed 3months, 2before and month after process starts. We are using a law firm. If payment is made to individual they will need reason and or receipt, or if payment is made out to something they do not have knowledge of, they may ask..example they asked us about payment to Beltone had to let them know it was on hearing aids. But Wal-Mart , HEB etc., they did not ask for receipts (which we would not have). But for copies of home, car insurance, etc. Just the latest copy. But they will need copy of title to home, prepaid funeral, etc, stock and other items. Copy of policies, life insurance, etc. SSI, AND ANY OTHER INCOME. I would not be able to do without a firm that handles Medicaid approval process. The nursing home they are in gave us info on firms that would help, may cost some, but in long run, I don't think I would be able to do it on my own. Now getting my mom approved with both being in a nursing home, they were able to keep some of their money, moving it out of their acct.. not having to spend it all down. Hope this helps some..from Tx..

If you know she needs to get on Medicaid soon, within 3 months or more, you should go ahead and start the process. If you hire correct firm to help you, they will let you know what they will need, once they know about all the money your parent has, they will be able to let you know how many months or month you may or may not have to pay and when you will go on Medicaid pending.. the firm we asked, gave us a list of what they needed, came up with a plan, then told us the amount they would charge if we used them after they had info to view. They have a check list of what is needed to begin filing, then more again afterwards as latest copy, questions they need answer and again info/paperwork Medicaid may request.

Best bet and the way to find out what your state requires, call the Medicaid office and ask. They can provide you with a list of items you will need and have the info first hand from the folks you will be working with down the road.

From what it seems, if she is already in there, after the insurance covers their part, you will have to use her savings to pay for her memory care unit and once she is down to a certain level, like at or near 2k in assets, medicaid will kick in for her. The 5-year lookback should have happened long ago so she would have been medicaid ready now. If you are talking about what I think you are, where 5 yrs ago she should have given away her assets so they won’t take those assets now where she will have to pay for her memory care. I am talking about savings, not house or car.

You also need deeds to her house, marriage license, repairs on her house, donations, bank accounts, wills, prepaid funeral, car ownership, it's a long list....
They should have a list of items you need.....ask for it...

All receipts only if you are Guardian.

Hi...
I just want to Add. Don't be nervous about this 5yr look back.
I am right in the middle of this ..

I would suggest getting mailed copies of bank statements. Not online only.

Yes, Save anything regarding real estate, med insurance, bank, & here's my 2 cents...
By all means, CALL MEDICAID/STATE OFFICE & simply ask...😁 im very surprised how helpful they are & I ask social workers anything because i'm always being honest & have nothing to hide..
Goodluck

To be on the safe side, save everything that is related to your relative. Everything. And organize them by categories: meds (prescription drugs, OTC meds), dental (cleaning, toothbrush, toothpaste), clothing, food (meals in wheels, groceries), etc... It takes a lot of effort but will save you a lot of headache later when it is time to apply for Medicaid. Let Medicaid decide what they can accept or not.

Also - Medicaid will want a copy of any check written for $500 or more.

Any documents/bills that reflect payments from home repairs or emergency fixes! For example, if a pipe burst and it cost 4K to fix/repair proof of any homeowners insurance payments should be kept. This proves the money was not gifted. (I HAD TO come up with these papers/cancelled checks followed up with bank statements/receipts to show the chain of claims/payment funds when my spouse applied for Medicaid. I had to show there was a homeowners policy in place. Medicaid even asked me to present a picture! So I called my friend who had a good enough camera to photograph under the sink to show the replacement part that still had it's tag attached!!

Anything that required payment of any amount that has to do with medical or Property issues may be requested at any time.

One means of tracking medical expenses is to get a copy of prescriptions filled at the pharmacy. The local utility will print out running statements of monthly billings for a period of time. If there are any prescription containers, those will have the doctors name/phone number. Your must present your proof as the person in charge of affairs.

I experienced documentation requests for my spouse, living plus Mom after she died. Much happened in the same time frame.

In conducting business for Mom's estate from 2K miles away, I mostly ran into identity issues. Proving I was the legitimate person-very hard with some entities. I had to mail/fax my ID & paperwork to establish mother-daughter relationship, proof I was the designated person etc.
A couple times I was at the teller's window with a paper check in hand, and an employee telling me I could not deposit the check! I was merely trying to transfer her West Coast bank account to a bank in the South. It was the same bank, only a different location.

In all health and financial matters I have had to prove to each provider or institution my legitimacy. I was held to a higher standard of proof as I was 2K miles away. This has applied with creditors, medical, banks, Social Security and others. As long as you have no criminal history or bad credit history it eventually pulls together. I was background checked with several institutions.

If your relative has a state issued ID or a drivers license make sure that ends up in your possession. Health insurance cards must be copied and kept in your possession when the time comes. You will be asked to present them at times. Get copies of all her health insurance cards, auto insurance, homeowners etc! Do so without delay!

You may very well end up having to hire an attorney to help resolve some situations. So I got busy and talked to people in Mom's area and went online to research attorney practices within that community. I eventually made it through this process right alongside getting my husband's Medicaid case established. If you do the legwork now, it will help if you have to ever obtain guardianship or executor status as well.

Mail/bills/correspondence will reach you if your relative will list you as a person authorized to receive copies of bills. If not already done, you should try to convince your relative to sign forms with providers allowing you to conduct business too. You may have to consult an attorney about this if you live so far and can't be present to handle these details while your relative is living.

Contact some of her known friends and neighbors. They may be willing and able to convey information to you that helps determine what direction you need to go.

Proof of you as the legitimate person can require your identification multiple times. If you are going to handle affairs after death too, this will help accomplish such details. Sort of like doing 2 things at the same time.

Type up your own spreadsheet or similar document and just start typing in whatever bits of info you obtain - account numbers, medicines, personal phone numbers, names/addresses/phone numbers of places you need to deal with.