For caregivers

Becoming an authorized representative

To discuss someone else’s Medicare with Medicare, Social Security, or a plan, you generally need their permission first. There are a few levels: a simple authorization lets Medicare share information with you, an appointed representative can handle appeals, and a power of attorney grants broader legal authority. Which you need depends on whether you’re just helping or actually making decisions.

Reviewed by Scott Stafford, Licensed Insurance Agent

Last updated

Why you need permission

Medicare and health plans are bound by privacy rules, so by default they won’t discuss someone’s coverage — even with a close family member — without that person’s say-so. Setting up the right permission ahead of time saves a lot of frustration, because it lets you make calls, sort out bills, and fix problems without your loved one having to be on every phone call.

Authorizing Medicare to talk to you

The simplest step is having your loved one complete Medicare’s authorization-to-disclose form, available at Medicare.gov or by calling 1-800-MEDICARE. It tells Medicare it’s okay to share their personal health information with you. Each Medicare Advantage or Part D plan has its own authorized-representative form as well, so if they’re in a plan, it’s worth setting that up directly with the plan too.

Acting on appeals

If you need to file an appeal on someone’s behalf — say, when a service or drug is denied — you can be named their representative for that purpose using Medicare’s Appointment of Representative form (CMS-1696). It authorizes you to handle the appeal and receive the related notices, which makes pursuing a denial much more workable.

The permissions above cover information and specific tasks. To make broader decisions — managing finances or making health care choices when your loved one can’t — you generally need a durable power of attorney, which they set up while they’re still able to, or in some cases legal guardianship. Because these are legal arrangements that vary by state, it’s wise to talk with an attorney about getting them in place. This isn’t legal advice, just a map of the options.

Set up the simple Medicare authorization early, while it’s easy. The broader legal tools, like a power of attorney, are best arranged before they’re urgently needed.

Common questions

Becoming an authorized representative FAQ

How do I get permission to talk to Medicare for someone?
Have them complete Medicare’s authorization-to-disclose form (at Medicare.gov or via 1-800-MEDICARE), which lets Medicare share their information with you. Each plan also has its own authorized-representative form.
How can I file a Medicare appeal for a family member?
You can be named their representative for the appeal using Medicare’s Appointment of Representative form (CMS-1696), which lets you handle the appeal and receive the related notices.
Do I need power of attorney to help with Medicare?
Not for sharing information or filing an appeal — simpler authorizations cover those. A durable power of attorney is for making broader financial or health decisions, and it’s set up while the person is still able to grant it.

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