How to Become an Authorized Representative for Your Loved One
By law, Medicare must have written permission (an “authorization”) to use or give out personal medical information for any purpose that isn't set out in the privacy notice contained in the Medicare & You handbook.
Your loved one may take back (“revoke”) their written permission at any time, except if Medicare has already acted based on their permission.
If your loved one wants 1-800-MEDICARE to give their personal health information to you, they need to let Medicare know in writing so you can become their Authorized Representative.
To name you as an Authorized Representative, your loved one must complete a form called the “Medicare Authorization to Disclose Personal Health Information.” If your loved one is unable to complete the form, you may do it as long as you have legal documentation giving you that right.
Download the Medicare Authorization to Disclose Personal Health Information form here (pdf).
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