An influence of legal professional will not be sufficient for Medicare

When it comes to Medicare, a power of attorney has no power of attorney.


A Power of Attorney (POA) is a powerful thing. A financial authorization document enables an appointed person to make financial, legal, and property decisions on behalf of another person. For example, a person who owns someone else’s POA can sell that person’s car to pay medical bills. A medical POA is a permanent power of attorney for the healthcare sector. This enables an agent (a trusted friend or family member) to make important and necessary healthcare decisions when the person becomes incapacitated or unable to communicate or participate in care. With this authorization, the POA can, for example, make decisions about health care for a person on a ventilator. Establishment of Powers of Attorney (POA) must be done when a person is reasonable and able to make financial and medical decisions.

Due to COVID-19, this problem is very important. There is no avoiding the fact that the risk of serious illnesses due to this disease increases with age. The hospitalization rate for people aged 65 to 74 years is 198.7 per 100,000 population, compared with 84.6 for 40 year olds. That rate jumps to 513.2 for people aged 85 and over.

We have all read that hospitals do not allow visitors. Relatives have to rely on phone calls, FaceTime, or communications with coworkers to share information and find out what is happening. This lack of access can create serious challenges in managing a family, dealing with critical business issues, and paying bills. The list goes on. But here’s a concern that everyone may not be talking about.

Take the example of Steve and Susan, a retired couple whose names have been changed for this article. Steve, 77 years old, was hospitalized. Little did he know that his wife Susan was trying to resolve some cost and coverage issues related to his care. She tried calling his plan and Medicare but couldn’t speak to anyone because she was not authorized to do so. Susan was stunned. Steve had powers of attorney, so what was the problem?

The problem was that powers of attorney on Medicare matters did not stand alone.

Medicare Agent

By law, Medicare requires written permission from a beneficiary to use or provide personal medical information for any purpose not defined in the privacy policy in the Medicare & You manual. A competent person can complete the 1-800 MEDICARE Personal Health Disclosure Authorization Form. If necessary, the representative can then speak to Medicare, investigate and select Medicare coverage, process claims, and even file an appeal.

Follow these specific instructions for completing the form.

  • Check to see if you authorize Medicare, Restricted, or Share information. If limited, include the type of information; B. Entitlements, Eligibility, or Awards.
  • Determine whether the authorization is for a specific period or indefinitely.
  • Mail the form to Medicare. There is no fax or e-mail transmission.

The individual has the right to revoke this authorization at any time. For those who can no longer give their consent, their personal representative can fill out the form and attach a properly executed power of attorney.

Medicare plans

There is one other eligibility that goes into each Medicare plan – Medicare Advantage, Prescription Drug Part D, or Medicare Supplement. Each plan has an authorization form that goes by many different names, such as: B. the authorization to share personal information or the authorization to share protected health information. This form provides the authority to speak to plan representatives about entitlements or coverage, update contact information, and more, depending on the individual plan.

To start this process, check the plan member information or contact a customer service representative.

Your to-do list

You never know what’s around the corner so time to prepare is before you get there. Take these three important steps.

  • Establish or update your financial and medical powers of attorney.
  • Identify and designate your Medicare Authorized Representative.
  • Contact your Medicare plans and fill out the authorization forms.
  • Add or update your Medicare representatives through your account. Even if you can’t submit the form online at first, you can keep it up to date through your account.

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