Medicare and Powers of Attorney

When making decisions about Medicare coverage, there are a lot of factors to weigh. It’s not always easy, which is why it can help to have an agent or trusted advisor. But, what happens if you’re not in a position to make those decisions? One of the things you can do ahead of that time is appoint a representative to act on your behalf through a power of attorney (POA). However, it’s important to understand how Medicare and powers of attorney work.

How Medicare and Power of Attorneys Interact

Is someone appointed through a power of attorney able to make Medicare decisions for you while those powers are in use? Generally, you are the only person who can make decisions around your Medicare enrollment and coverage. Your spouse isn’t even able to make choices for you. Even with the added layer of legal rights that a power of attorney offers, a representative still isn’t necessarily given the ability to make enrollment or plan decisions for you.

Medicare requires your written consent to share your personal medical information with anyone else, even your spouse.

While you can appoint someone through a power of attorney to make many financial and even health decisions for you, Medicare isn’t considered a health decision; it’s considered a health insurance decision, which provides an extra layer of protection for your private health and medical information. A durable power of attorney may be beneficial if documentation clearly states that the attorney has the power to enroll the individual in a health insurance plan. But, Medicare requires your written consent to share your personal medical information with anyone else, even your spouse. This all means that, if you have a power of attorney, Medicare still requires another level of authorization so that your representative can make coverage choices for you.

How Your Representative Can Make Medicare Decisions for You

If you’re in a situation where you cannot make Medicare decisions for yourself, what can your power of attorney do to help you? For Medicare to recognize your power of attorney, you or your representative must fill out and submit the Authorization to Disclose Personal Health Information form to Medicare, your insurance companies, and your health care facilities, attaching a copy of your power of attorney paperwork that shows your representative can act on your behalf. This is an essential step if you want anyone to help with your Medicare coverage. As mentioned earlier, Medicare will not give your personal health information out to anyone, even your spouse.

For Medicare to recognize your power of attorney, you or your representative must fill out and submit the Authorization to Disclose Personal Health Information form.

In some cases, you or your representative may only want or need to use a consent to release form. This only allows someone to receive information but not act or make decisions for the Medicare beneficiary.

Additionally, you or your representative may also want to submit proof of representation, allowing your power of attorney to communicate and provide information to the Benefits Coordination & Recovery Center. There isn’t a specific form required to submit proof of representation. As long as you submit the information requested in this model language document, your representative should be able to fulfil their duties.

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It’s not always an easy choice to give someone else the power to make decisions for you, but there are times when it’s necessary or the right call. This is why it’s important to know what steps to take to set up powers of attorney and allow them to make Medicare decisions for you, if necessary. While all the paperwork may be frustrating, these steps are there for your protection and, ultimately, may just mean a few more signatures from you.