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How to Appoint a Personal Representative for Your Aetna Medicare Plan


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Your Aetna Medicare plan could involve some administrative work that you don’t feel prepared to handle, especially if you are ill or have a serious health condition. The good news is you may be able to appoint a representative who can act on your behalf and worry about the paperwork for you.

What kind of Aetna Medicare Plans are there?

Aetna Medicare plans could include:

  • Medicare Advantage plans
  • Medicare Supplement plans

When I appoint a representative what can they do for me?

When you appoint a representative to help you with your Aetna Medicare Plan, that person may be able to help you with:

  • Your benefits and coverage
  • Your claims
  • Your bills
  • Your grievances and appeals

Because this person will have access to your private health care information, you must authorize the release of this information with a form or letter.

Who can my personal representative be?

Your personal representative for your Aetna Medicare plan could be a close personal contact, such as a friend, child, or trusted friend.

Your personal representative could also be a professional, such as a doctor or lawyer.

What is the process to appoint a representative?

The Centers for Medicare and Medicaid Services (CMS) has an Appointment of Representative form. This form has four sections.

  1. Appointment of Representative: Name your representative
  2. Acceptance of Appointment: Your representative accepts the appointment and provides their contact information
  3. Waiver of Fee for Representation (Attorneys or other professional representatives must obtain approval of their fees)
  4. Waiver of Payment for Items or Services at Issue

You may be able to replace this form with a letter you write to your Aetna Medicare plan. The letter must include:

  • Your health care ID number
  • The contact information of yourself and your representative
  • A statement of permission for your representative to act on your behalf
  • A statement that the representative has agreed to act on your behalf

Where should I send my form to appoint a representative?

You can send your form to appoint a representative to the same address where you are sending:

  • Your appeal if you are filing an appeal
  • Your grievance or complaint if you are filing a grievance or complaint
  • Your initial determination decision if you are requesting an initial determination decision

If none of the above applies to you, if you have additional questions, contact 1-800-MEDICARE (1-800-633-4227) or your Medicare plan. TTY users please call 1-877-486-2048, 24 hours a day, 7 days a week.

What else should I know about my Aetna Medicare Plan and appointing a representative?

If someone has durable power of attorney to make health care decisions for you, you don’t need to appoint that person as your representative. They should already have the authority to act on your behalf.

Your form may not be a “once and done.” Your authorization form generally expires one year from the date that you and your representative sign it. If you want to continue having a representative, you will need to submit a new form.

To look for Aetna Medicare Plans in your area, enter you ZIP code on this page.

See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area.

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