Photo credit: www.kiplinger.com
Considering your parents’ Medicare needs is crucial during their healthy years. As individuals age, medical care plays an increasingly significant role in their lives. Establishing a proactive approach allows for better management of healthcare options, ensuring that loved ones receive the care they require.
In circumstances where a medical incident leaves your parent incapacitated or if they experience a gradual decline in health, having a family member or trusted loved one to manage their care becomes essential. However, gaining access to medical records and their Medicare account typically involves stringent regulations, limiting access to the patient unless explicit permission is granted. The same applies to decision-making authority regarding their healthcare.
To protect your loved ones—or if you’re an older reader, to safeguard yourself—it’s vital to have the necessary documentation prepared in advance. If enrolled in Original Medicare, the process to obtain access can be straightforward, often requiring simply the completion of a form submitted online or through the mail. In contrast, Medicare Advantage plans may demand a more complex approach, given that various private insurers manage these plans.
How to Get Permission to Access Your Parent’s Medicare
Anyone who has visited a healthcare professional is likely familiar with the numerous HIPAA (Health Insurance Portability and Accountability Act) authorization forms that must be filled out. While these forms are intended to protect patients’ rights regarding their Protected Health Information (PHI), they can feel like obstacles when trying to assist a loved one.
To gain access to a Medicare account, the patient must complete an Authorization to Disclose Personal Health Information (CMS-10106). This form can be submitted online or sent in as a printed document to: 1-800-MEDICARE Written Authorization Dept. PO Box 1270, Lawrence, KS 66044.
The authorization allows the Medicare beneficiary to specify which information the representative can access or discuss, making it easier to address issues like billing discrepancies. The patient has the option to select specific topics or issues that their representative may discuss with Medicare.
Important details needed on the form include:
- Clearly defined parameters regarding the extent of personal health information to be shared.
- The duration of authorization for sharing information or whether it will be indefinite.
- The rationale for the disclosure.
- Identification of the authorized person.
- Clarification on whether the representative holds power of attorney.
*Note: Section 2C of this authorization form pertains solely to New York residents and addresses matters regarding substance abuse, mental health, and HIV. Inhabitants of New York should consult the instructions for this section carefully.*
The Medicare beneficiary can revoke the authorization at any time by submitting a written request to the specified address. Maintaining a copy of the authorization for personal records is also advisable.
How to Enroll Your Parent in Medicare
Even with a healthcare proxy responsible for medical decisions, a separate authorization form is required to discuss Medicare-related matters, such as claims, enrollment, premiums, and provider payments.
Your parent may not only grant you access to their Medicare information but can also name you as a representative who can enroll them via the Authorization to Disclose Personal Health Information form. A power of attorney documentation should accompany this request.
If feasible, visiting a Social Security Administration (SSA) office could be an effective way for you to assist in the enrollment process. Checking the Social Security Administration website can help locate your nearest SSA office.
What to Do If Your Parent Can’t Authorize Access to Their Medicare Due to Incapacity
In cases where your parent is unable to give authorization due to serious health concerns, such as a stroke or dementia, pursuing a court order may be necessary for you to manage their care.
If declared incapacitated, a legal guardian is assigned, providing authority to make healthcare decisions, interact with medical professionals, and communicate with Medicare representatives. The guardian also assumes responsibility for daily needs including nutrition, safety, and housing.
Medicare Advantage Plans
Accessing your loved one’s Medicare Advantage plan requires a similar but sometimes more complex approach, as these plans are overseen by private insurance companies with varying protocols in place.
Engaging with a plan representative can help in understanding how to apply for the ability to manage your family member’s medical needs.
Planning Ahead Will Save Valuable Time
Being able to direct and manage an incapacitated parent’s healthcare is critical for their overall health and well-being. Should your parent be unable to grant you proper authorization, acquiring a court order for guardianship may be necessary. If your parent has yet to enroll in Medicare, having a power of attorney on hand is essential for that process.
Power of attorney laws differ by state. Consulting a Certified Elder Law Attorney (CELA) can be beneficial, as they possess specific training in navigating the legal complexities affiliated with healthcare for seniors.
Related Content
Source
www.kiplinger.com