![]() ![]() Other specifics, such as payments to providers.Plan enrollment, such as drug or Medicare Advantage plan. ![]() Medicare will disclose only information that you choose, offering options such as “limited information” or “any information” or allowing you to specify what to disclose, such as information about: The form doesn’t authorize that person to make medical decisions for you. How do I authorize a Medicare personal representative?įill out Medicare’s Authorization to Disclose Personal Health Information form to let the agency know whom you’ve chosen to access your Medicare personal health information. Health care proxies must also have this written permission to speak to Medicare on your behalf. It’s different from a health care power of attorney, also called a health care proxy or health care surrogate, that allows someone to make health care decisions on your behalf if you’re unable to do so. Medicare requires you to complete an authorization form if you want to give someone in your family or another trusted person permission to speak to Medicare on your behalf.įamily members and others helping someone with claims typically use this form.
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