Medicaid long-term care — the version that covers nursing home and skilled nursing facility costs — is one of the most document-heavy benefit applications a family can face, because it requires proving two completely separate things at once: medical need and financial eligibility. * The medical side requires demonstrating a Nursing Facility Level of Care, meaning a doctor or state assessor confirms the applicant genuinely needs the kind of ongoing care a nursing facility provides, not just general assistance. * The financial side is where most of the complexity lives. Medicaid applies a "look-back period" — typically five years — reviewing financial records to check whether assets were given away or transferred below market value specifically to qualify for benefits. That means gathering five years of bank statements, property deeds, and other asset documentation, along with medical records supporting the level-of-care determination. * You apply through your state's Medicaid agency, which most states let you do online, by mail, or in person — the exact application form depends on your state, and Medicaid.gov's "Contact Your State Medicaid Agency" tool can point you to the right office if you're not sure where to start. * Standard processing generally runs 45 to 90 days, but that timeline extends considerably for complicated cases involving multiple properties, trusts, or transfers that require additional review under the look-back rules. Given the complexity, many families work with a Medicaid planning professional before submitting, specifically to make sure the financial documentation and calculations are correct — errors in this part of the application are a common cause of denials.