What documents do I need to help my parent with medical decisions and Medicare claims?

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.