When it comes to Medicare, a Power of Attorney has no power.
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A power of attorney (POA) is a powerful thing. A financial power of attorney document allows an appointed person to make financial, legal and property decisions on another individual’s behalf. A person holding another’s POA can sell the individual’s car to pay medical bills, for example. A medical POA is a durable power of attorney for healthcare. This allows an agent (a trusted friend or family member) to make important and necessary healthcare decisions if the individual becomes incapacitated or unable to communicate or participate in care. For example, with this authority, the POA can make healthcare decisions for an individual on a ventilator. Establishing powers of attorney (POA) must be done while a person is of sound mind and able to make financial and medical decisions.
Because of COVID-19, this issue is very important. There’s no getting around the fact that the risk for severe illness from this disease increases with age. The hospitalization rates for those ages 65-74 is 198.7 per 100,000 population, compared to 84.6 for 40-year-olds. That rate jumps to 513.2 for those 85 and older.
We have all read that hospitals do not allow visitors. Relatives must rely on phone calls, FaceTime, or communication with staff to share information and find out what’s happening. This lack of access can create some serious challenges in managing a family, dealing with critical business issues, paying bills; the list goes on. But here’s one concern that may not be on everyone’s radar.
Steve, 77 years old, was hospitalized. He did not know that his wife, Susan, was trying to deal with some cost and coverage issues related to his care. She tried calling his plan and Medicare but could not talk with anyone because she did not have authority to do so. Susan was stunned. Steve had executed powers of attorney so what was the problem?
The problem was that powers of attorney do not stand alone when it comes to Medicare issues.
Medicare Authorized Representative
By law, Medicare requires a beneficiary’s written permission to use or provide personal medical information for any purpose not defined in the privacy notice contained in the “Medicare & You” handbook. A competent person can complete the form, called the “1-800-MEDICARE Authorization to Disclose Personal Health Information.” Then when needed, the representative is authorized to talk with Medicare, research and choose Medicare coverage, handle claims, even file an appeal.
Note these specific instructions for completion of the form.
- Check whether you authorize Medicare to release limited or any information. If limited, identify the type of information, such as claims, eligibility or premiums.
- Identify whether the authorization applies for a specified period of time or indefinitely.
- Submit the form by mail to Medicare. There is no fax or email submission.
The individual has the right to revoke this authorization at any time. For those no longer able to give consent, their personal representative can complete the form and attach a duly executed power of attorney.
Medicare Plans
There’s one more authorization to address and that deals with the individual Medicare plans – Medicare Advantage, Part D prescription drug, or Medicare supplement. Every plan has an authorization form and it goes by many different names, such as authorization to share personal information or authorization to share protected health information. This form would provide authority to speak to plan representatives about claims or coverage, update contact information, and more, depending on the individual plan.
To start this process, check the plan’s member information or contact a customer service representative.
Your To-do List
You never know what’s around the corner so the time to prepare is before you get there. Take these three important steps.
- Establish or update your financial and medical powers-of-attorney.
- Identify and designate your authorized Medicare representative.
- Contact your Medicare plan(s) and complete the authorization forms.