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What is a Medicare Authorized Representative?

Medicare beneficiaries have the right to choose someone to help make decisions about Medicare coverage. This is referred to as an Authorized Representative. 

This person is only authorized to help with Medicare—joining a plan, quitting a plan, finding out information about insurance and handling claims and payments. An authorized representative cannot make decisions about personal medical care. 

These following individuals are already authorized representatives for Medicare decisions

  • A guardian 
  • A durable power of attorney for health care (where allowed by state law) 
  • A durable power of attorney 

If you would like someone else to help you make your Medicare decisions, such as a spouse, child or friend a form can be signed to make someone else an authorized representative. 

Does a person need to be an authorized representative to help join a plan? 

It depends on the situation. If the helper is with the Medicare beneficiary in person, they do not need to be an authorized representative. When speaking with the representative from Medicare or the plan notify them there is someone else on the phone to assist. 

If the helper is not with the Medicare beneficiary, they may need to be an authorized representative. It is possible to get a letter signed that allows the plan to give information to the helper and send it to the company. Start by asking the company if they would take that kind of letter. If not, an official form needs to be signed to make the helper an authorized representative. 

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