Caregiver decision support

Help with Medicare without taking over

Organize information, prepare questions and document follow-up while keeping the person with Medicare at the center of the decision.

Adult caregiver offering support to an older woman at home
The short answer: A caregiver can organize information, prepare questions, take notes and help use official resources. Family or caregiver status alone does not automatically authorize access to personal Medicare information or authority to act.

Begin by agreeing on the role

Ask what help is wanted: organizing mail, writing questions, listening during a call, taking notes, using official resources or acting through an approved representative process. These roles are not the same.

Get permission before personal account discussions

Medicare cannot share personal account information with another person unless the person with Medicare gives permission through the appropriate process.

The Authorization to Disclose Personal Health Information form allows Medicare to share specified information with a chosen person. An Appointment of Representative is a different process used when someone will act in a claim, appeal, complaint or other request.

Important: Being a relative or caregiver does not automatically create either type of authority.

Prepare one clear objective

Before a call, write one sentence describing what needs to be resolved. Keep a log with the date, organization, representative, reference number, explanation, next action, owner and deadline.

Protect personal information

Do not place Medicare numbers, medical information, account credentials or other private details in a public comment, ordinary social message or unapproved web form. Use an approved secure process and share only what is necessary.

When the answer is unclear

Ask for the decision, the document or rule supporting it, the next step and the deadline. Repeat the answer back in plain language. Medicare and State Health Insurance Assistance Programs can help identify the correct route.

Read the full official sources