If you want to help your aging parents with their medical decisions or assist with their Medicare enrollment, you’ll need to request authorization from the government insurance program.

If your parents become significantly ill, you may need to become their healthcare proxy. This means you’ll make medical decisions on their behalf.

In the context of Medicare, this may involve helping them enroll. If they’re already enrolled, it may involve accessing their Medicare data, like current or past claims or information about their past or current medical care.

Read on to learn about getting authorization to access your parents’ Medicare.

By law, Original Medicare (parts A and B) must keep your parents’ data private. It can disclose this data without authorization only to certain entities, such as state and federal agencies.

Reasons for disclosure include ensuring correct payments, supporting research studies, aiding with fraud or criminal investigations, reporting public health information like disease outbreaks, or addressing other immediate threats to health or safety.

In addition, in response to a court order, Medicare may share an enrollee’s data with the secretary of the Department of Health and Human Services or with healthcare professionals and their partners to improve care and quality, like those participating in an accountable care organization (ACO).

So, for Medicare to share this data with you, your parent must fill out the Authorization to Disclose Personal Health Information form, which they can do online or by mail.

On the Authorization to Disclose Personal Health Information form, have your parent write their name in the spot for the person holding the Medicare benefits. Ensure they write it in clear, printed letters.

Then, going field by field, they’ll continue filling out the form. Note that section 2C is intended only for residents of New York.

Information they’ll need to fill out includes:

  • their Medicare number, exactly as it appears on their red, white, and blue Medicare card
  • their birth date, using the month, day, and year format
  • what personal health information Medicare can share, and how much
  • how long their authorization should be effective
  • why they’re authorizing the disclosure
  • your name, as the person to whom they authorize the disclosure
  • whether you have a power of attorney to act on their behalf (and you’ll need a copy of the document as proof)
  • their signature, the date they’re filling out the form, and their phone number and address

Once they’ve filled out and signed the form, they’ll mail it to:

Medicare CCO
Written Authorization Dept.
P.O. Box 1270
Lawrence, KS 66044

It’s a good idea to make a copy of their signed form before sending it off. In addition, if they later decide to revoke the authorization, they can send a written notice to the same address.

If they’re enrolled in Medicare Advantage (Part C) instead of Original Medicare (parts A and B), they’ll need to check their plan’s rules about granting authorization. Because private insurers manage Part C plans, they may have a different process than Original Medicare.

If you have questions about this or how to fill out the authorization form, call Medicare at 800-633-4227 (TTY: 877-486-2048) 24 hours per day, 7 days per week, excluding some federal holidays.

They may also need to call their Medicare Advantage insurer about the authorization process. The plan’s contact information is available online or on the back of the insurance card.

Your parent is eligible for Medicare when they turn 65 years old or sooner if:

  • They receive disability benefits from the Social Security Administration or the Railroad Retirement Board.
  • They live with either end stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS).

If eligible based on disability or ALS, they’ll be automatically signed up for Medicare parts A and B. But if they’re eligible based on ESRD or age, they must apply for Original Medicare and any additional coverage they want.

In addition to granting you authorization to access their Medicare information, they can designate you as a medical representative or healthcare proxy who can enroll them on their behalf. This typically requires a power of attorney, but it’s a good idea to check the laws in your specific state.

If your parent can’t grant you authorization due to illness or injury, such as a stroke or dementia, your only option may involve getting a court order.

In this, you’ll be appointed their legal guardian and be able to make decisions regarding their care, as well as speak to their health insurer. You’ll also be responsible for their safety, food, shelter, and care.

Guardians are court-monitored, and regulations vary by state. If this path is necessary, consider consulting an attorney familiar with your state’s guardianship laws.

In certain situations, you may need to act as your parent’s healthcare proxy, requiring you to engage with their Medicare plan or enroll on their behalf.

Your parent must fill out the Authorization to Disclose Personal Health Information form to give you access to their Original Medicare data. The form requires them to provide your name, as well as their Medicare number, birth date, the duration of access, and the reason for disclosure.

Medicare Advantage (Part C) enrollees need to check with their insurer for the specific procedures for authorization for their plan.

if your parent can’t authorize you due to illness, you might need a court order for guardianship, the laws for which vary by state. In addition, if your parent isn’t yet enrolled in Medicare, you’ll need a power of attorney to enroll them.