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How to Use a Medicare Authorization Form
If you want someone else to access your Medicare records, you'll need a written authorization.
Talk to a Licensed Agent: (302) 407-0876Why You'd Need One
Under HIPAA, Medicare needs your written authorization before it can share your protected health information — things like your medical history, diagnoses, treatment records, and test results — with someone else, such as a family member helping manage your care.
The form Medicare uses for this is CMS-10106. You can limit exactly what information is shared and set a specific start and end date for the authorization, so it doesn't have to be an open-ended, permanent arrangement.
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Call (302) 407-0876How It Works
Only the specific people or organizations you name on the form will receive the information you authorize. You can revoke the authorization in writing at any time before Medicare processes a specific disclosure, and choosing to grant or refuse authorization has no effect on your Medicare enrollment, eligibility, or benefits.
If someone is acting as your legal representative rather than using this authorization form — for example, an executor or someone with power of attorney — they'll typically need to provide separate documentation proving that authority instead.
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