There are two types of Medicare representatives that you can have:

  • Authorized representative: This is an individual who’s authorized under state or other applicable law to act on behalf of another person when that person can no longer act on their own behalf. This may be during a Medicare appeal or other instances.
  • Appointed representative: This is an individual whom you appoint to act on your behalf in a Medicare claim or in a claim or entitlement appeal.

A representative can also help you navigate other Medicare-related issues, such as choosing coverage, enrolling in Medicare, and managing your benefits. They can handle paperwork, talk with Medicare on your behalf, and help you make informed enrollment decisions.

There are various options for whom you can appoint as your representative:

  • family member
  • friend
  • attorney
  • financial advisor
  • advocate
  • doctor
  • someone else who will act on your behalf

There are a couple of ways you can appoint a representative, especially if you’re filing an appeal with Medicare.

  • Fill out the Appointment of Representative form and send it, along with your appeal, to the Medicare administrative contractor (MAC) that’s listed on your Medicare summary notice (MSN) or your Medicare health plan.
  • Submit a written request that includes the following:
    • your name, address, phone number, and Medicare number
    • a statement that appoints someone as your representative
    • the name, address, and phone number of your representative
    • the professional status of your representative, such as a doctor, or their relationship to you
    • a statement authorizing the release of your personal and health information to your representative
    • a statement that explains why you’re being represented and to what extent

Send your written statement with your appeal to your MAC.

There are a few different reasons why you may choose to have someone represent you:

  • They can help you understand your coverage better.
  • They can help you manage your paperwork and make phone calls.
  • They can help ease the burden of managing your benefits if you don’t feel well enough to do so.
  • It can give you peace of mind to have a second set of eyes and ears when making important health and healthcare decisions.
»Learn more: Advanced directives