As a Medicare beneficiary, you have the right to appoint someone to help you navigate Medicare-related issues. This person is referred to as an authorized representative.

What is a Medicare authorized representative?

An authorized representative is someone who can support you through the process of choosing coverage, enrolling in Medicare, and managing your benefits. This person can talk to Medicare on your behalf, handle paperwork, and help you make informed enrollment decisions. Your authorized representative could be a family member, friend, caregiver, or someone else you trust.

Why do I need a Medicare authorized representative? 

There are a few reasons you might choose someone to represent you:

1. Help understanding your coverage

Medicare is complex. An authorized representative can explain your benefits, options, and notices from Medicare in a way that makes sense.

2. Managing paperwork and phone calls

From choosing plans to filing appeals. Medicare can sometimes involve a lot of paperwork. Your representative can ensure all forms are filled out properly and advocate for you on phone calls.

3. Cognitive or health challenges

If you're dealing with memory issues or illness, or you just don't feel well enough to manage your benefits, having someone else step in can ease the burden.

4. Peace of mind

Sometimes, it helps to have a second set of eyes and ears—especially when making important health care decisions. A trusted family member or friend can offer guidance and support.

Keep in mind your representative is only authorized to help with Medicare issues—like joining a plan, quitting a plan, obtaining information, and handling claims and payments. This person cannot make decisions about your personal medical care.

Who can be my authorized representative for Medicare?

If a person has legal documents showing they can make health decisions for you (e.g. a legal guardian or durable power of attorney), Medicare will usually accept that. But that person still may need to fill out a Medicare form or provide documentation.

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 (Form CMS-1696) to make that person an authorized representative.

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

No, a person does not need to be your official Medicare authorized representative to help you join a Medicare plan. They can still assist you with things like:

• Comparing plans
• Filling out applications
• Talking with plan representatives (with your permission)

But if you want your helper to speak directly to Medicare or make decisions on your behalf, they would need to be formally named as your authorized representative using Medicare's paperwork (e.g. Form CMS-1696).