How to Become Your Parent's Medicare Authorized Representative (Form CMS-10106)

You call Medicare to ask about your mother's coverage. You explain that you're her daughter, that she's 78, that she asked you to handle this. The representative says: "I'm sorry, I can't discuss your mother's account with you. We need authorization on file."

This happens to thousands of adult children every week. Medicare has strict privacy protections, and "I'm their kid" is not sufficient authorization. Your parent needs to formally designate you as their representative using a specific government form: CMS-10106, Appointment of Representative.

This is one of those forms that takes 10 minutes to complete but saves you hours of frustration down the line. Here's exactly how to do it.

Why a Power of Attorney isn't enough

This is the number one thing that surprises families. Many adult children have a Power of Attorney (POA) for their parent and assume that covers Medicare. It often does not.

Medicare -- and specifically the Centers for Medicare & Medicaid Services (CMS) -- has its own authorization process that is separate from state-level POA documents. While some Medicare plans and contractors will accept a POA, many will not, or they will require you to also submit the CMS-10106 form. The safest approach is to have both:

• Power of Attorney for dealing with doctors, hospitals, banks, and legal matters
• CMS-10106 for dealing with Medicare specifically

Having the CMS-10106 on file means you can call Medicare, manage enrollment, file appeals, request plan changes, and access your parent's Medicare information without your parent needing to be on the phone every time.

What the CMS-10106 form lets you do

Once the form is properly submitted, you can:

• Call 1-800-MEDICARE and discuss your parent's coverage, claims, and benefits
• Contact their Medigap carrier, Medicare Advantage plan, or Part D plan on their behalf
• File appeals if a claim is denied or a coverage decision is disputed
• Request enrollment changes
• Access plan documents and Medicare Summary Notices
• Request information about billing and payments

The form does not give you the authority to make medical decisions. That requires a healthcare POA or healthcare proxy, which is a separate legal document.

How to fill out the form: step by step

The CMS-10106 form has two sections. It is straightforward, but filling it out incorrectly can result in delays or rejection.

Section 1: The Medicare beneficiary (your parent)

Your parent fills out this section with:

• Full legal name
• Medicare number (found on their red, white, and blue Medicare card)
• Date of birth
• Mailing address
• Phone number

At the bottom of Section 1, your parent must sign and date the form. This signature is what gives the authorization legal weight. If your parent cannot sign due to physical or cognitive limitations, there are alternative processes (discussed below).

Section 2: The representative (you)

You fill out this section with:

• Your full legal name
• Your relationship to the beneficiary (e.g., "daughter," "son," "spouse")
• Your mailing address
• Your phone number
• Your email address (optional but helpful)

You also need to sign and date this section.

What to write in the "Scope" section

The form asks you to describe the scope of your authority. Keep this broad unless you have a specific reason to limit it. Something like:

"I authorize [your name] to act on my behalf in all matters related to my Medicare coverage, including but not limited to enrollment, plan changes, appeals, grievances, and information requests."

Keeping the scope broad prevents you from having to submit a new form every time a different type of issue comes up.

Where to submit the form

This depends on what you need to do:

For general Medicare issues: Submit the form to 1-800-MEDICARE by:

• Faxing it to the number the representative provides when you call
• Mailing it to the address the representative provides

For issues with a specific plan: Submit the form to the Medicare Advantage plan, Medigap carrier, or Part D plan directly. Call the customer service number on the plan's ID card and ask where to send the authorization form.

For appeals: Include the form with your appeal documentation, submitted to the entity specified in the denial notice.

Keep copies. Always keep at least one copy for your records. You may need to resubmit the form to different entities, and having a copy saves you from getting your parent to sign again.

Special situations

Your parent has cognitive decline

If your parent has dementia, Alzheimer's, or another condition that prevents them from understanding or signing the form, the process is different. You will likely need:

1. A court-appointed guardian or conservator -- this requires a legal proceeding where a court determines that your parent cannot make their own decisions and appoints someone to act on their behalf
2. A healthcare proxy or durable POA executed before the cognitive decline -- if your parent signed these documents while they were still competent, they may be sufficient

In these cases, contact an elder law attorney. The CMS-10106 form requires the beneficiary's signature, so cognitive incapacity requires legal alternatives.

You live in a different state

The form works regardless of where you live. You do not need to be in the same state as your parent. You can submit the form by mail or fax, and once it's on file, you can manage your parent's Medicare entirely by phone and online.

This is particularly important for adult children living abroad. If you're helping a parent in the US from overseas, the CMS-10106 is essential because you cannot easily be present for in-person interactions.

Multiple representatives

Your parent can designate more than one authorized representative by submitting separate CMS-10106 forms for each person. This can be useful if multiple siblings share caregiving responsibilities. Each representative can then independently contact Medicare without needing the others.

How to get the form

Download it from the CMS website: cms.gov/Medicare/CMS-Forms/CMS-Forms/CMS-Forms-Items/CMS012207

Request it by phone: Call 1-800-MEDICARE (1-800-633-4227) and ask them to mail you the form.

Print and fill out by hand. The form is a standard PDF. Print it, fill it out with a black pen, have both parties sign, and submit.

The other form you might need: CMS-L564

If your parent is enrolling in Part B after delaying enrollment due to employer coverage, there's a second form that matters: CMS-L564, Request for Employment Information.

This form is filled out by the employer's HR department and confirms that your parent had continuous employer group health coverage. Without it, your parent cannot use the Special Enrollment Period (SEP) to enroll in Part B without a late enrollment penalty.

If your parent is retiring and transitioning from employer coverage to Medicare, make sure the employer completes this form before your parent's last day of work. Getting it later can be difficult, especially if the company is small or your parent's HR contact leaves.

What to do after the form is submitted

1. Wait a few days, then call the entity where you submitted the form to confirm it was received and processed
2. Test the authorization by calling 1-800-MEDICARE or the plan's customer service number and asking a simple question about your parent's coverage
3. Note any reference numbers from the confirmation -- you may need them for future calls
4. Store the form with your parent's other Medicare documents (see our organizational system in the adult child's Medicare guide)

Don't skip this step

The CMS-10106 form is one of those administrative tasks that feels unnecessary until the moment you desperately need it. The day your parent is admitted to the hospital and you need to call their Medicare Advantage plan about coverage, or the day a claim is denied and you need to file an appeal, you will be grateful the authorization is already on file.

Do it now, while things are calm. It takes 10 minutes and it lasts until your parent revokes it.

The authorization form is the first step in managing your parent's Medicare effectively. For a complete system -- including plan comparison worksheets, enrollment timelines, medication trackers, and annual review checklists -- the Medicare Enrollment Guide organizes everything into one printable reference for $14.