Richard M. Barron
attorney at law
National Academy of Elder Law Attorneys
Need Before You Proceed"
need the following to audit your file and determine qualification
from bank and brokerage accounts for the past 3month
*Bank, brokerage, etc.
*Closed Accounts in the last 36 months showing zero balance
*Statements showing transfer or "chip" transactions
*Certificates of Deposit
bonds, CDs, U.S. government bonds, municipals, annuities not
held in brokerage accounts
Retirement Accounts (IRAs) or any other deferred
compensation plans including the last annual statement
showing income and distributions
*Prepaid burial or
cremation contract, deed to cemetery plot, special burial
*Title's) issued by
Department of Motor Vehicles for automobile, mobile home,
boat, trailer, truck, van, recreational vehicle and
insurance policy for automobiles or other vehicles.
* Deed to residence,
current real estate tax bill, homeowner's insurance policy
and premium statement
* Copy of deed(s), tax
bill, and proof of insurance for any other real property.
If for sale, listing agreement and statement of fair market
value from realtor. Any mortgages, titles or notes on any
other real property.
* Life, Accident,
Health, Auto & Property insurance
policies. Pages needed are the cover page and
declarations page that lists the information about the
policy and the beneficiary information.
* Income verification
from Social Security, Veterans Administrations, Civil
Services, pension, IRA distributions
* Mortgage and/or
promissory note owing to you.
* Income tax returns
and intangible tax returns for the past three (3) years
* Medical expense
* Income Tax returns
for past 3 years
*Credit Cards and
charge account balances, names & numbers
inventory or personal, valued items
*Any debt balances of
*Any income of any
Copies we will
need to complete Medicaid application
nursing home bill
documentation: Social Security cards, Medicare cards,
Medicaid Cars,birth certificates, and marriage license,
divorce decrees, naturalization and adoption papers, or
any information that you can provide for the above
(Explanation of Medical Benefits)
Education and Military
records and/or discharge
health insurance card, policy, and current premium
Long term care
policy. Please include benefit page.
Award letter from
Social Security Disability or Supplemental Security
Names and Address
of children (or location of death certificates, if any
of your children or your spouse is deceased)
List of employers
and dates of employment
Location of Wills
and Trust (you do not need to disclose contents)
Durable Powers of
Attorney, Durable Powers of Attorney for Health Care,
Living Wills, and Funeral Plans
Name, address and
phone numbers of close friends and relatives
Name, address and
phone numbers for doctors, pharmacists, emergency
services and hospitals
Medical conditions; allergies, dates and descriptions or
past illnesses, operations and immunizations
Skip the items on
our list that do not apply.
If the Medicaid
applicant is married, we will need information about
If you are unable
to supply copies of the above listed items, our office
will send your original information to a professional
copy service and bill you for the copies.
at : 903-564-3663
has been provided for informational purposes only. It
does not constitute legal advice.
The receipt of this
information does not establish an attorney-client privilege.
advice can only be given upon consideration of all the
relevant facts and the law.
Therefore, you should not
act upon any information contained herein without seeking
Richard M. Barron
Attorney at Law
209 E. Main Street
Whitesboro, Texas 76273
Fax - 903-564-5562