Three important documents grant caregivers permission to consult with a parent’s doctor, access medical records, ask questions about claims and make health care decisions on a parent’s behalf:
- Health care proxy
- Health Insurance Portability and Accountability Act (HIPAA) authorization
- Medicare’s Authorization to Disclose Personal Information, Form CMS-10106
What is a health care proxy?
Two names for one document. A health care proxy, also known as a health care power of attorney, gives you the legal right to talk with doctors and make medical decisions on someone’s behalf if the person is unable to do so. Before your parent designates you as health care proxy, you and your parent should talk about priorities and desires to guide the medical decisions you may need to make later on.
Some states combine a health care proxy and living will, calling them advance directives. A living will spells out to medical professionals the treatments that a patient does and doesn’t want and designates when to end life-sustaining procedures. It’s typically used when a patient meets specific medical criteria or is unable to make health care decisions.
Rules vary by state. AARP has advance directive forms and rules for each state. You can also contact a lawyer in your area specializing in elder law through the National Academy of Elder Law Attorneys.
What is a HIPAA authorization?
HIPAA is a federal law that governs the privacy of medical records and commonly requires written permission for a family member or other caregiver to have access to them.
Most doctors and hospitals have patients sign a HIPAA privacy notice. Patients may authorize one or up to several people to have access to their medical information at that time. You can also fill out a separate HIPAA authorization form to use with any provider.
In some states, having a health care proxy eliminates the need for HIPAA authorization to access protected health information. But having both forms can help avoid delays.
Scope, time frame are flexible. A HIPAA release can allow access to all of a patient’s medical records with a provider or narrow it down to certain information. The timing can vary, too, to allow access to past, present and future records or just limit access to a specific medical event.
Patients can revoke the authorization at any time by notifying their health care providers, preferably in writing. Private insurance companies also have similar forms that provide a caregiver or family member access to information about insurance claims.
Obtaining a form. You usually can get a HIPAA authorization form from a doctor, hospital or other provider. Or you can get one from an elder law attorney along with health care proxy documents.
What is a Medicare authorization form?
Medicare’s Authorization to Disclose Personal Information gives you authority to speak to Medicare on someone else’s behalf. Even if you have a health care proxy to make medical decisions for your parent, you’ll still need a separate Medicare authorization form to talk with Medicare about claims, eligibility, enrollment, premiums and payments to providers.
Your parent will need to identify when and how long to allow Medicare to disclose personal health information, whether for a specific procedure or indefinitely. As with a HIPAA authorization, at any time your parent can write to Medicare to revoke the sharing of information with you.
Patients can print the form from the Medicare.gov website and mail it to the address listed. If they have an online Medicare account, they can log in, go to the My Accounts section and click on Manage my representatives.
Keep in mind
While these forms give you authority to help with medical decisions, you’ll need separate legal documents to help with financial decisions. A durable power of attorney gives a trusted person legal authority to make financial decisions and access bank accounts to help pay bills.
Power of attorney requirements vary by state. Some people choose to have an elder law attorney draft their power of attorney. And you may need a separate power of attorney document to work with some financial institutions.
Having these documents in place while the person you’re caring for can still make decisions is a good idea, especially for someone with dementia or Alzheimer’s disease because the condition is likely get worse through time. If your loved one gets to the point of being unable to sign financial and legal forms, your only recourse may be to go to court and be declared the person’s guardian.