All Medicaid Programs

Obsolete Policy

Document Types

Retention Requirements

• Applications

Original application for the current span of eligibility is permanent if eligibility has not been interrupted for more than 3 months.  Keep all other applications at least 5 years.

• Closed Case

5 Years (All Documents)

• Handwritten Statements (In any category)

• Reviews

6 Years

• Adoption Papers

• Assets:

-          Annuities

-          Bankruptcy/Repossession

-          Bank Statements

-          Investments (401K/IRA/Misc.)

-          Lien Agreement

-          Other Misc. Assets

-          Property Deed

-          Vehicles

• Bill of Sale/Sales Contract/Promissory Note/Repayment Agreement

• Court Documents

• Duty of Support

• Fair Hearing

• Lump Sum

• Need for Attendant (478)

• Refund Request (79R)

• Release of Information (114’s)

• Request for Medical Information (MI706)

• Spouse Information (48)

• Statement of Medical Need (1049)

• Tax Filer Information (740/741)

• Temporary Medical Card (695)

• Transportation/Lodging (24)

• Cancer Program Referral (928)

• COBRA Health Insurance (116C)

• Employer Health Insurance (116M)

• Funeral and Burial

• Home and Community Based Services Referral Form (927)

• Income

• Investigations

• Life Insurance/Other Insurance (Misc.)

• Long Term Care:

-          Assessment of Assets ((932)

-          Intent to Return Home (75NH)

-          Nursing Home Letter (72NH)

-          Other Long Term Care (Misc.)

-          Short Term Statement (20NH)

-          Spousal Assessment/Asset Packet

• Medical Bills/Receipts

• Payments to Business Office/Other Misc. Payments

• Returned Mail

• School Attendance (126)

• SSI/SSDI Status

• Third Party Insurance (19)
• Targeted Adult Medicaid forms (42A, 43A and 44A)

5 Years (If no longer relevant to current eligibility)

• Assessment of Assets Packet and 62NH

• Citizenship/Alien Status

• Identity

• MRB Packet

• Social Security Number

• Trusts

Permanent