Picture this: your mother is in the hospital, you’re standing at her bedside trying to sort out a billing question or a coverage denial, and you call 1-800-MEDICARE to get answers. The representative asks who they’re speaking with. You explain you’re her daughter. They tell you, politely but firmly, that they can’t discuss her account with you.
This isn’t a technicality or a bad customer service moment. Medicare is a form of health insurance, and federal privacy law governs it. By default, Medicare will not discuss a beneficiary’s eligibility, claims, enrollment, or premiums with anyone but the beneficiary – not a spouse, not an adult child, not even a trusted family member or friend holding a folder full of paperwork – unless that beneficiary has said in writing that it’s okay.
Most families find this out the hard way, mid-crisis, on the phone. A Medicare authorization form prevents that, and it takes about fifteen minutes to fill out before you ever need it.
This isn’t Medicare being difficult. It’s federal privacy law doing its job. By default, Medicare protects every beneficiary’s personal health information, and that protection doesn’t bend for family relationships. A representative on the other end of 1-800-MEDICARE has no way to verify, in the moment, that the person calling is actually who they say they are or that the beneficiary wants them involved in their Medicare decisions, so the system defaults to no.
The fix isn’t a phone call or a verbal okay in the moment. It must be in writing and on file before the call happens.
Form CMS-10106, “Authorization to Disclose Personal Health Information,” is what lets a Medicare beneficiary give 1-800-MEDICARE written permission to discuss their account, including, but not limited to, claims, eligibility, enrollment, and premium information, with a specific named person.
A few things worth knowing about it:
Agent tip:
“Fill out an Authorization to Disclose Personal Health Information before you need it, not during a crisis. Once it’s on file, a call to 1-800-MEDICARE goes very differently: the representative can simply verify your name against the authorization and talk to you. Without it, the conversation stops before it starts, no matter how urgent the situation is or how much paperwork you’re holding.”
There’s an important limit to know about, especially for Medicare Advantage households: CMS-10106 authorizes only 1-800-MEDICARE, which handles Original Medicare (Parts A and B). If your family member has a Medicare Advantage plan, a private insurance company runs it, and most carriers require their own separate authorization on file before they’ll discuss coverage details with anyone else. It’s worth calling the plan directly to ask what they need, at the same time you’re filling out CMS-10106.
CMS-10106 lets someone get information and ask questions. It doesn’t allow them to act on the beneficiary’s behalf if a claim is denied or a coverage decision needs to be disputed. That’s a separate form: CMS-1696, “Appointment of Representative.”
This form appoints someone to file an appeal, grievance, or request on the beneficiary’s behalf, present evidence, and receive all related communication. Unlike CMS-10106, an appointment made with CMS-1696 is generally valid for one year from when it’s signed, so it needs to be renewed if the appeal process runs longer than that.
If the situation is “I have questions about my mom’s account,” CMS-10106 is the form. If it’s “my mom’s claim was denied, and I need to fight it for her,” it’s CMS-1696.
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Local, licensed insurance agents with 25+ years of combined experienceIf you’ve searched for a “Medicare power of attorney” (POA) before landing here, it helps to know upfront: there’s no single Medicare POA form. What people usually mean by “Medicare POA” is actually one of two different things: a Medicare-specific authorization like CMS-10106 or CMS-1696 that lets someone help with your account, or a separate legal power of attorney that lets someone make medical care or financial decisions on your behalf. Confusing the two is exactly why families often reach for the wrong form when time is tight.
Families often reach for Power of Attorney (POA) when what they need is one of the two forms above, or reach for CMS-10106 when the situation calls for power of attorney. They’re not interchangeable, and mixing them up can cost time exactly when time matters most.
CMS-10106 and CMS-1696 authorize a trusted family member to help with day-to-day Medicare matters: getting information, asking questions, filing an appeal. The beneficiary still makes the decisions; the authorized person is just allowed to be part of the conversation.
Power of attorney is different. It’s a separate legal document, not a Medicare form, that gives someone the authority to make decisions on the beneficiary’s behalf. Power of attorney isn’t one single thing; it comes in several forms, and which one applies depends on the situation:
It’s typically drafted with an attorney or through a state-specific form, and it applies well beyond Medicare. If your family member can’t make their own decisions, power of attorney lets someone else make them, whether over medical care, finances, or both, depending on how it’s written. CMS-10106 doesn’t do that. It only opens the door to a conversation.
Most households need CMS-10106 long before they need power of attorney, if they ever need power of attorney at all. But when a family is dealing with a serious decline in capacity, power of attorney is the tool that actually applies, and no amount of Medicare paperwork substitutes for it.
Filling out CMS-10106 is also a good moment to talk about protecting a Medicare number in general. Medicare will never call and ask for it out of the blue, and neither will a legitimate health care provider. If a family member starts helping with Medicare matters, it’s worth reviewing how to spot Medicare fraud and protect a Medicare number together, since the people who benefit most from having a trusted second set of eyes on an account are often the same people scammers try to isolate from that support.
Medicare’s privacy protections exist for good reason, but they can turn a routine question into a dead end if the paperwork isn’t already on file. CMS-10106 is free, takes about fifteen minutes, and helps your family get answers when it matters. CMS-1696 covers appeals specifically. And power of attorney is a different, more serious tool for a different situation entirely. Filling out the right one now means one less thing to figure out during a crisis.
Have questions about setting this up for your family? Call (623) 223-8884 to speak with a local, licensed agent at no cost.
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It lets a named person you choose call 1-800-MEDICARE and discuss your eligibility, claims, enrollment, and premium information. It doesn’t give them authority to make decisions for you or file appeals on your behalf.
No. CMS-10106 only authorizes a conversation with 1-800-MEDICARE about Original Medicare information. Power of attorney, whether general, durable, financial, or limited, is a separate legal document that gives someone authority to make decisions on your behalf, and it isn’t a Medicare form.
Not as a single official form. What people usually mean by “Medicare POA” is covered by CMS-10106 or CMS-1696 for day-to-day help with your Medicare account, plus a separate legal power of attorney if someone needs authority to make medical care or financial decisions on your behalf.
You choose. It can run indefinitely, or you can set specific start and end dates. You can also withdraw it in writing at any time.
No. CMS-10106 only authorizes 1-800-MEDICARE, which handles Original Medicare (Parts A and B). If you have a Medicare Advantage plan, contact your plan directly to find out what authorization they require.
That’s CMS-1696, “Appointment of Representative.” It’s a separate form from CMS-10106 and is generally valid for one year from when it’s signed.
Read more by Renee van Staveren
Since 2009, I've been writing about complicated, technical issues, with the goal of making topics like Medicare and healthcare easier to understand. I've been writing about Medicare since 2021 and healthcare since 2019. I am an AmeriCorps alumni. I enjoy gardening, reading, and DIYing.
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