Health insurance plans have to follow rules about privacy. You might need permission to talk about someone else's plan.
This is important if you need to:
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File a claim.
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See if the plan covers certain services or drugs
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Appeal if they deny coverage for something
If someone else (like your spouse or an ex-spouse) owns the policy, here's what you can do:
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Call the insurance company. Use the 1-800 number on your family member’s insurance card. Ask if you’re allowed to speak to them about the plan.
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If they say that you're not authorized, tell the policy owner to call and ask them to give you permission. The policy owner may need to fill out a form.
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Submit documents to the insurance company showing that you have the legal right to conduct affairs on behalf of your family member. These could be things like a custody agreement, guardianship, general power of attorney, or a health proxy.
If you have MassHealth, click the box below for specific instructions:
If you need permission to work with MassHealth on your family member's behalf, you can fill out a form asking to be their Authorized Representative.
This will allow you to talk to MassHealth about your family member's application and benefits.
Here's what you can do:
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Make sure you don't already have authorization (permission). If you're not sure, call the MassHealth Customer Service Center :1-800-841-2900 (TTY: 1-800-497-4648)
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If you do need authorization, click the link at the bottom of the page to download the Authorized Representative form. Follow the instructions and submit the form.
Note: Visit the Exceptional Lives Guardianship Guide to learn more about options for helping an adult family member with healthcare decision-making.
Source: MassHealth
Source: MassHealth